Amandeep Kaur Cheema (Diploma in Resilience and Wellness Coaching Skills)
What is Fibromyalgia?
Fibromyalgia is a long-term condition (LTC) that generally affects women more than men. Fibromyalgia has been defined by the NHS as:
“Fibromyalgia, also called fibromyalgia syndrome (FMS), is a long-term condition that causes pain all over the body.” (NHS, 2016)
It is suggested that FMS may affect up to 1 in 20 people. Symptoms can include widespread and increased sensitivity to pain, fatigue, muscle stiffness, headaches, problems with memory and mental cognition and IBS. It is not currently known what causes FMS, but some schools of thought have attributed it to certain chemicals and the way the brain and body process pain in some people.
FMS and health/wellness coaching
A quick search on the internet shows that there is a growing range of FMS related coaching options available, including face to face and online, one to one and group coaching sessions, and online training. This illustrates that there is clearly an increasing demand for coaching with this specific LTC.
The coaching options available provide information and coaching on a range of subjects including understanding medical science, managing medications, natural therapies, managing symptoms and daily life, nutrition and exercise, goal setting, self-care, meditation, positive psychology and motivational interviewing.
Impact of health/ wellness coaching on FMS studies
Although there has not been a great deal of research on the effects of coaching on FMS, a pilot study conducted in 2016 by Hackshaw et al (Hackshaw, 2016) demonstrated some encouraging results. The study looked at nine females with FMS and provided them with coaching for a year using a combination of one to one and group coaching.
Alongside the standard medication the participants were provided with a health and wellness coach, which involved:
“The HWC approach employs health professionals trained in patient-centred coaching competencies. These include coaching tasks, knowledge, and skills. Coaching competencies are based upon evidence-based theories of behaviour change, self-determination, self-efficacy, self-regulation, positive psychology, and motivational interviewing,”. (Hackshaw, 2016)
The results of the study were highly encouraging showing that after a year of coaching
- the severity of their pain decreased by 31%.
- their pain interfered with their lives almost half as much. (44% reduction in pain interference)
- They had a dramatic reduction in doctor appointments. (11 vs. 1.5 provider visits per year, a 86% reduction in health care utilization)
- This reduction was estimated to save patients $855 per year. (9.5 fewer appointments at an average of $90 per appointment) when used together. (Lyrica 17.2%, Cymbalta 20.4%, Savella 32.8%, Lyrica + Cymbalta 34.1%) Even acceptance and commitment therapy (ACT) only brought about a 27.4% improvement. (fibromyalgiacoachinginstitute, 2015-2018)
This clearly indicates that FMS patients could benefit from participating in health and wellness coaching alongside their medication. However, a larger scale study could go much further in proving this and helping FMS patients become aware of additional methods to help them live well.
Another study conducted in 2012 titled ‘Using Self-Coaching to Improve Life with Fibromyalgia’ by Tracy Hide (Hide, 2012), illustrates a personal experience of FMS and “the use of psychological self-coaching techniques in maintaining optimum health and functioning.” (Hide, 2012)
The study looked at the importance of a range of methods and techniques including metacognition, cognitive distortion, and daily thought records were used as part of a practical model to improve wellbeing. This involved an increased awareness of thoughts and emotions and moving towards a more positive yet realistic outlook.
Overall the study showed how psychological approaches (as can be used in wellness coaching) enabled the FMS patient to live well despite her chronic condition.
Coaching and FMS – General approach
As with many illnesses, particularly chronic illness, one of the keys to management is often in education, as described by The American Pain Society:
“patient education is critical to optimal management of fibromyalgia.” (Liptan, 2016)
However, with the current care system, the onus is usually on the patient rather than the care provider to educate and manage the illness. Often the health professional does not have much themselves as to the most effective ways to manage the condition. As described by Ginevra Liptan, MD:
“This is where a fibromyalgia health coach could fill a critical gap in the health care system, teaching clients how to exercise the right way, make dietary changes that can reduce pain, and best track symptoms to monitor treatment effectiveness. ” (Liptan, 2016)
As the symptoms with FMS involve reduced cognition and pain, a health/wellness coach can facilitate and enable the patient to manage symptoms and improve the quality of their lives more effectively.
Through wellness coaching, the patient is also able to set more realistic, achievable and individualised goals according to their specific requirements, rather than being given a standard formula which may not suit them. By taking responsibility for their own treatment with the help of a wellness coach in a way that suits them, they are more likely to succeed in living well with their condition.
In addition to a more tailored and collaborative approach, wellness coaching can also offer the benefit of experience with a particular condition. The coach themselves may have experienced the same or may have experience working with other patients, therefore having a clearer idea of what may help. With FMS, advice given by health coaches may not always be helpful, such as avoiding convenience food, as sometimes the symptoms may not enable the patient to stick to certain standards. Again, this is where a collaborative and patient-centered approach is more effective.
Another way in which coaching can help one with FMS is that the patient has access to long-term support for long-term conditions, as described by an FMS patient:
“It’s important to understand that long term health challenges take a long-term solution. For lasting change, an intensive and supportive program gives the client time to try solutions and the coach time to monitor progress.” (Ingebretson, 2017)
In conclusion, it is clear through studies and FMS patient experiences that health/wellness coaching can have an effective impact on not only managing symptoms but also the overall quality of life in addition to standard medication. The patient centred, collaborative and customised way of coaching can enable to patient to take their lives back into their own hands with the facilitation of an effective wellness coach.
fibromyalgiacoachinginstitute, 2015-2018. http://fibromyalgiacoachinginstitute.com/why-should-you-choose-fibromyalgia-coaching/. [Online]
Available at: http://fibromyalgiacoachinginstitute.com/why-should-you-choose-fibromyalgia-coaching/
[Accessed 20 July 2018].
Hackshaw, K., 2016. A pilot study of health and wellness coaching for fibromyalgia. BMC.
Hide, T., 2012. Using Self-Coaching to Improve Life with Fibromyalgia. [Online]
Available at: http://www.leadershipaspirations.co.uk/images/Using-Self-Coaching.pdf
[Accessed 20 July 2018].
Ingebretson, S., 2017. Top 5 Reasons WHY Health Coaching Works for Fibromyalgia. [Online]
Available at: https://rebuildingwellness.com/coaching-fibromyalgia/
[Accessed 20 July 2018].
Liptan, G., 2016. Fibromyalgia Health Coaches and Educators Could Fill Vital Gap in Care. [Online]
Available at: http://www.drliptan.com/blog/2016/2/19/fibromyalgia-health-coaches-and-educators-could-fill-vital-gap-in-care
[Accessed 20 July 2018].
NHS, 2016. Fibromyalgia. [Online]
Available at: https://www.nhs.uk/conditions/fibromyalgia/
[Accessed 20 07 2018].