Integrative Health and Wellness Coaching in Occupational Therapy-A Scoping Review.
Alyssa M Smith, Kelli Kauffroath, Karen Westervelt and 1 others
Occupational therapists are already using health and wellness coaching skills in practice, but across 25 small studies the field has no standard framework and used 57 different outcome measures.
This is a map of what exists, not evidence that any specific coaching approach works.
Key findings
1Twenty-five articles met inclusion criteria, conducted across nine countries, with individual study sample sizes ranging from 2 to 137 participants.
2Fifty-seven different outcome measures were used across the included studies with little repetition, and the authors identify this as a lack of established assessment tools for occupational therapy health-promoting interventions.
3No clearly defined framework exists within occupational therapy to guide health promotion-specific interventions, despite the review finding that OTs already use skills parallel to health and wellness coaching in their practice.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The included studies are small (sample sizes 2 to 137) and heterogeneous in design, ranging from single-case studies to quasi-experimental trials; none are large multicentre RCTs. Fifty-seven different outcome measures were used with little overlap, making it impossible to compare results across studies or draw conclusions about which interventions work best. The review is a scoping exercise that maps what exists; it does not synthesise effect sizes or test whether any specific HWC approach is superior to alternatives. The authors note a limited availability of comprehensive descriptions of HWC practices within occupational therapy, meaning the included studies may not fully represent how OTs actually deliver coaching in practice. Two of the authors have extensive personal experience in health coaching (1+ and 5+ years), and the first author is both an OT and a health coach, which may shape how the evidence is framed.
Declared interests
No funding was received for the manuscript. The authors declare no conflicts of interest. Two authors have personal experience in health coaching, and the first author is both an occupational therapist and a certified health coach.
The easy way to misread this
Do not read this as evidence that health and wellness coaching is proven effective in occupational therapy. It is a scoping review mapping 25 small, heterogeneous studies (sample sizes 2 to 137) that used 57 different outcome measures with little overlap. The review's own stated conclusion is that the field lacks a formal framework and standardised measures, not that a specific coaching approach has been shown to work. The Discussion's language about 'established efficacy' refers to the component skills appearing in small studies, not to a demonstrated treatment effect.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →