Health Coaching and Behavior Change: How to Build Healthy Habits
✨ Too Long Didn’t Read (TL;DR) / Summary
Changing habits isn’t just about discipline or willpower — it’s about timing, support, and the right conversations.
Research shows that people move through stages of change, not instant transformations.
Health coaching works best when it focuses on your goals, your values, and your life, not just instructions from a provider.
Healthcare professionals — including physical therapists, physicians, and other clinicians — can help guide behavior change through collaboration, encouragement, and coaching strategies.
Interestingly, studies show that social support and shared learning may help people sustain healthy habits better than trying to do it all alone.
Approaches like Cognitive Behavioral Therapy (CBT) can also help people manage pain, change habits, and improve quality of life.
At The Joint Connection Company, we believe something simple but powerful:
Real health change starts with conversation.
When patients and providers work together as partners, people gain confidence, clarity, and control over their health journey.
🧾 Behavioral Change: General Information
Changing Habits Is a Process — Not a Personality Trait
If you’ve ever tried to change a habit and struggled, you’re not alone.
Researchers Prochaska and Velicer developed a well-known framework called the Transtheoretical Model, which describes six stages people go through when changing behavior:
Precontemplation – Not yet thinking about change
Contemplation – Starting to think about change
Preparation – Getting ready to act
Action – Actively making changes
Maintenance – Sustaining the new behavior
Termination – The new behavior becomes part of life
One fascinating finding from their research:
40% of people are not thinking about change yet
40% are considering change
20% are actively preparing for change
That means most people aren’t ready for action yet — and that’s normal.
Healthy change works best when it happens at the right time, not when it’s forced.
Instead of feeling pressured to “fix everything now,” a better question might be:
“What small step would move me closer to the life I want?”
What Is Health Coaching?
Health coaching is becoming more common in healthcare — but what does it actually mean?
A large research review found that health coaching generally involves:
A patient-centered approach
Shared goal setting
Encouraging self-discovery
Building accountability
Tracking behaviors over time
In simple terms:
A health coach doesn’t just tell you what to do.
They help you figure out what works best for you.
Good coaching focuses on:
Your daily life
Your motivation
Your barriers
Your strengths
Because lasting habits rarely come from instructions alone.
They come from understanding what matters to you.
Can Healthcare Providers Actually Help With Behavior Change?
Yes — but the approach matters.
A systematic review studying health coaching delivered by physical therapists found that about 64% of studies showed improvements in things like:
Physical activity
Confidence in managing health (self-efficacy)
Physical function
Quality of life
However, the results varied depending on:
Provider training
Coaching methods
Follow-up and support
In other words:
Healthcare providers can be powerful allies in behavior change — when they work with you, not just prescribe to you.
Why Social Support Matters for Habit Change
One of the most interesting discoveries in recent research is that we change better together.
A 2024 clinical trial studying physical activity in older adults found that interpersonal strategies — such as peer discussion, shared learning, and social support — led to greater and longer-lasting increases in physical activity than individual goal-setting alone.
This means:
Support groups
Group exercise programs
Accountability partners
Shared learning environments
may help habits stick longer than trying to do everything on your own.
Humans are social creatures — and health change often reflects that.
Cognitive Behavioral Therapy (CBT): Changing Thoughts to Change Habits
Cognitive Behavioral Therapy (CBT) is another tool used in healthcare to support behavior change.
CBT focuses on the relationship between:
Thoughts → Feelings → Behaviors
It helps people:
Identify unhelpful thought patterns
Develop coping strategies
Reduce fear of movement or pain
Build confidence in activity and recovery
Large reviews of research show CBT produces consistent improvements in quality of life across many health conditions.
For people with chronic pain, CBT can also help reduce:
Pain intensity
Disability
Avoidance of movement
It’s important to understand that CBT doesn’t mean pain is “all in your head.”
Instead, it helps people regain control over how they respond to symptoms.
Why Behavior Change Matters for Long-Term Health
Healthy habits today can influence health decades later.
For example, research suggests that people who stay physically and mentally active in midlife may reduce their risk of certain forms of dementia later in life.
Behavior change isn’t just about fixing problems today.
It’s about building a healthier future version of yourself.
Healthcare providers — including physical therapists — increasingly recognize their role not only in rehabilitation but also in preventing health problems before they start.
💙 For Patients
How to Talk to Your Healthcare Provider About Behavior Change
If you're trying to improve habits — whether it's exercise, sleep, nutrition, or stress management — your healthcare provider can be an important partner.
But sometimes patients aren’t sure what to ask.
Here are some helpful questions you can bring to an appointment.
Questions That Open the Door to Better Conversations
Instead of simply asking:
“What's wrong with me?”
Try asking:
“What habits would have the biggest impact on my health right now?”
Other helpful questions include:
“What small change would you recommend starting with?”
“What barriers do you see people struggle with when making this change?”
“How can I stay consistent when life gets busy?”
“Are there programs or groups that could help me stay accountable?”
These questions shift the conversation from diagnosis to strategy.
Questions About Pain and Movement
If pain is affecting your ability to stay active, consider asking:
“What movements are safe for me right now?”
“How should I pace my activity so I don’t flare up symptoms?”
“What signs mean I should push forward vs. slow down?”
“How can I rebuild confidence in movement?”
Many people avoid activity because they fear making things worse — but guided movement is often part of recovery.
Questions About Mental and Emotional Barriers
Behavior change isn’t just physical.
If stress, anxiety, or discouragement are barriers, you can ask:
“Are there strategies like CBT that could help me manage pain or stress?”
“How can I stay motivated when progress feels slow?”
“What do successful patients do differently when building habits?”
Your provider may also recommend:
Behavioral health support
Health coaching
Group programs
Stress management techniques
A Helpful Mindset to Bring to Appointments
Instead of thinking:
“I failed at sticking to this habit.”
Try reframing it as:
“I’m learning what works for me.”
Behavior change is rarely linear.
People often cycle through stages of readiness before lasting change occurs.
That’s part of the process — not a sign of failure.
A Question Worth Asking Yourself
When thinking about a health change, try reflecting on this:
“What would improving this habit allow me to do again in my life?”
Maybe it’s:
Playing with your kids
Traveling comfortably
Returning to hobbies
Feeling more energized
Connecting habits to meaningful life goals makes them far easier to sustain.
📂 Supplemental Information / Citations
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48. doi:10.4278/0890-1171-12.1.38
Wolever RQ, Simmons LA, Sforzo GA, et al. A systematic review of the literature on health and wellness coaching. Glob Adv Health Med. 2013;2(4):38-57. doi:10.7453/gahmj.2013.042
Rethorn ZD, Pettitt CD. What is the effect of health coaching delivered by physical therapists? Phys Ther.2019;99(10):1354-1370. doi:10.1093/ptj/pzz098
McMahon SK, Lewis BA, Guan W, et al. Effect of intrapersonal and interpersonal behavior change strategies on physical activity among older adults. JAMA Netw Open. 2024;7(2):e240298. doi:10.1001/jamanetworkopen.2024.0298
Beissner K, Henderson CR Jr, Papaleontiou M, et al. Physical therapists’ use of cognitive-behavioral therapy for older adults with chronic pain. Phys Ther. 2009;89(5):456-469. doi:10.2522/ptj.20080163
Fordham B, Sugavanam T, Edwards K, et al. The evidence for cognitive behavioural therapy in any condition. Psychol Med. 2021;51(1):21-29. doi:10.1017/S0033291720005292
Stallard P. Evidence-based practice in cognitive-behavioural therapy. Arch Dis Child. 2022;107(2):109-113. doi:10.1136/archdischild-2020-321249
News Now Staff. Can cognitive and physical activity in midlife reduce dementia risk? American Physical Therapy Association. 2019.
Maxwell J. PTs are “abilitation specialists.” American Physical Therapy Association. 2018.
This content drafted, researched, edited, and generated by:
McKinley Pollock, PT, DPT
McKinley Pollock, PT, DPT, OCS, CSCS is a physical therapist with a background in orthopedics and sports rehabilitation. Dr. Pollock earned his doctorate of physical therapy from Campbell University in 2021, is a board-certified orthopedic clinical specialist (OCS), and certified strength and conditioning specialist (CSCS). Dr. Pollock enjoys combining lessons learned from his DPT training and research, translating these into clinical practice. His passions include promoting relationships between patients & clinicians to promote clinical effectiveness, satisfaction, and efficiency, the implementation of primary preventative medicine into clinical practice, and leadership and education development.
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