The demand for individuals with expertise in coaching skills and an understanding of how people change is on the rise. For many health and fitness professionals, this skill can enhance a current career, help transition into a new career, or add a new service to an existing business. While the fields of health coaching and behavior-change coaching are new and evolving, ACE has developed a general consensus and position on what it means to be a certified health coach versus a specialist in behavior change.

ACE Position Statement on Scope of Practice for ACE Certified Health Coaches and ACE-trained Behavioral Change Specialists

Because research has clearly demonstrated the value of coaching in helping people improve health behaviors, and because the United States is currently facing an epidemic of obesity, diabetes and other lifestyle-related diseases resulting from poor nutrition and physical inactivity, it is the position of the American Council on Exercise (ACE) that coaching services should be widely available in communities throughout the country, provided by both lay and professional coaches, and by healthcare providers with specialized training in coaching principles.

ACE believes that all professional coaches, who are primarily compensated in their role as a coach, should attain a nationally accredited professional certification such as the National Commission for Certifying Agencies (NCCA)–accredited ACE Health Coach Certification or other health coaching or wellness certification accredited by the NCCA or International Coach Federation (ICF). This is the highest standard of competence for a coaching professional and provides assurance to the general population that the coach has mastered foundational principles in coaching.

ACE recognizes that professional coaches, professionals from other disciplines who aim to integrate coaching into their work, and lay coaches will benefit from practical training and coaching skill development. The ACE Behavior Change Specialist curriculum prepares these individuals to greatly improve their communication skills and effectiveness in helping to coach clients toward effective behavior change. These skills may serve as an adjunct to another professional role, or they may help professionals or aspiring health coaches to improve the quality of their work. The Behavior Change Specialist training is not intended to replace an accredited coaching credential, and an individual who has completed the behavior change specialist training should not represent him- or herself as an ACE Certified Health Coach.

Ultimately, an individual coach’s scope of practice is determined by state policies and regulations; credentials, education and experience; and competencies and skills. With that said, all individuals who engage in coaching relationships are expected to:

• Apply effective communication skills, such as use of open-ended questions, affirmations, reflective listening and summarizing, to help a client increase motivation and ownership to making a change
• Help clients develop achievable and measurable goals to monitor success and motivate ongoing behavioral change
• Help clients develop and exploit their strengths to support successful behavioral changes

The actions that are outside the scope of practice of the coach (who does not also hold a credential or professional license in another discipline) include:

• Counseling, therapy and consulting
• Nutrition prescription and meal planning
• Exercise prescription
• Laboratory evaluation and assessment
• Diagnosis of medical or mental health ailments
• Recommendation, promotion or sale of supplementation
• Other practices or activities in which the coach does not have the requisite training or credentials required by professional standards or by law

Engaging in these activities can place a client’s health and safety at risk and possibly expose the coach to disciplinary action and litigation. To ensure maximal client safety and compliance with state policies and laws, it is essential that the coach recognize when it is appropriate to refer clients to a licensed professional such as a psychologist, physician, registered dietitian, or other credentialed or licensed professional.

ACE is committed to helping our health coaches, fitness professionals, and professionals from other disciplines who are trained behavior-change specialists to succeed. We aim for all ACE-trained professionals to work to the top of their skills and training, and to benefit from continued opportunities to develop their skills and grow their knowledge base. We would love to hear how you have put your coach training to work, and to receive feedback on how ACE can continue to support you to achieve your professional goals and make an even greater impact in your work.