By Erin Eatough, PhD
June 29, 2021 - 15 MIN READ
In the past year, we’ve seen a groundswell of conversation about rising well-being needs, the continuum of mental health, and how organizations can help support people in mental health improvement. Similarly to physical health mental health requires time and effort to build and maintain. However, unlike physical health, we know very little about the stages or developmental markers of mental health progress. Groundbreaking research from BetterUp Labs showcases the effectiveness of coaching as an intervention for building well-being and mental fitness and provides a roadmap of the stages of mental health growth. This research was published on June 29, 2021, in the Journal of Medical Internet Research which is the leading peer-reviewed digital health journal globally.
In this article, we look at why well-being offerings often fall short and explore the findings of this study that demonstrates how coaching overcomes these gaps to significantly move the needle on employee well-being.
Many of the symptoms associated with poor mental health don’t meet the threshold of a clinical diagnosis. But, suboptimal mental health, even when it isn’t clinical, can have far-reaching and disruptive effects on all aspects of our lives.
We are all, always, somewhere on the well-being continuum. We move along it, day-to-day and week-to-week. Some people may tend to have higher or lower levels of well-being, but we all might find ourselves in any of these states, depending on our immediate circumstances and our mental fitness. Just like physical fitness, our mental fitness may vary throughout our life.
Struggles with mental health can touch all of us – no matter the level of success or celebrity. Tennis champion Naomi Osaka’s withdrawal from the French Open, citing self-care needs for mental health, is a timely example.
In sum: well-being is a universal concern. No one is immune from the ups and downs of life. Whether you are an intern, a top performer, or a CEO.
Organizations have begun to recognize the need to support employees’ well-being. Many offer workplace wellness programs, employee assistance programs (EAP), and employee affinity and resource groups. Forty-one percent of organizations are expanding their mental programs this year. Yet, despite these investments, 55% of the workforce is languishing even pre-pandemic.
Why aren’t corporate well-being offerings meeting the needs of the workforce?
With the variety of wellness-related programs and resources, why is the workforce still struggling?
The answer has to do with efficacy, adoption, and commitment.
First, very little is actually known about how these programs and resources differentially impact well-being. It is difficult to measure, for instance, how an affinity group improves an employee’s mental health. This is a problem. If leaders don’t know how an intervention works, how long it takes to move the needle, or what types of outcomes to expect, how can they confidently invest in these programs or motivate their overstretched workforce to devote time to it?
Also, the effectiveness of well-being interventions depends on the individual. This is what makes improving mental well-being daunting. Everyone experiences their external and internal challenges differently, in the unique context of their own life and personality. This means that people can benefit differently from various support strategies and may need different frequencies and modalities. For example, one person may benefit from weekly group support, while another might prefer curated resources to work through on their own, and another needs regular 1:1 check-ins with a professional. This often makes one-size-fits-all approaches ineffective.
Second, even with personalized support like therapy or counseling through EAPs, adoption is often low. Stigma, sequestered resources, and putting the burden of knowledge to source the right resources on the individual suffering all create low usage.
A third factor: people don’t know how long to commit to a strategy to see results. In the western world, we are more accustomed to prescribed dosages for defined ailments. Many popular practices for improving well-being, however, are rooted in more eastern philosophies (like yoga or meditation) and don’t fit into prescribed dosages.
Part of a failure to commit is that we also often don’t have a lot of data on what improvement looks like. What can we expect to see when well-being is improving? What does progress actually look like day-to-day?
When we don’t have a clear vision for what to expect or how to know if our efforts are working, it’s difficult to stay motivated. One reason Peloton has such a following: they’ve nailed personalized metrics to track progress.
Thankfully, the mental health space is catching up to the physical health space. We are building more science around well-being improvement everyday at just the moment when the pandemic has made clear that everyone has a vested interest in workforce well-being.
Coaching can overcome the gaps to improve well-being
Coaching is a highly personalized and individualized well-being intervention. It accounts for how different we each are, our lifestyles, preferences, needs, and contexts. It also can be seen as a meta-well-being improvement tool because a coach can help support well-being directly during sessions and can guide you to optimal strategies between sessions (e.g. get better sleep), define what success looks like to you, and keep you accountable.
Coaching is powerful because it is a standalone intervention that can adapt to any individual circumstance and meet you where you are. It doesn’t carry stigma like clinical support services and by nature it is designed to empower the individual.
And now, the science behind coaching for mental well-being improvement is building to answer foundational questions about impact that can help people and organizations know how long to commit, what progress looks like, and when to expect results.
New research from BetterUp: Coaching found to be holistically effective
New research by Alexis Jeannotte, PhD, Derek Hutchinson, PhD, and Gabriella Kellerman, MD, from BetterUp Labs investigated dose, time, and impact on well-being outcomes resulting from a coaching intervention. This cutting-edge work brings transparency around what to expect with coaching for well-being improvement.
It is the first research of its kind to directly address if coaching is an effective strategy to improve mental health and well-being and also examine how this intervention changes well-being within a person over time.
BetterUp Labs followed 391 Members with access to unlimited BetterUp coaching over a period of 8 months. Coaching was provided from certified, best-in-class BetterUp coaches who had previously gone through a rigorous vetting process with a 9% acceptance rate. Coaches were either ICF (or equivalent) certified or held a clinical license with over 1,000 hours of supervised clinical experience.
Members were matched to a coach from a pool of over 2,000 coaches globally to optimize Member-coach fit by using BetterUp’s 150-factor matching algorithm, which predicts successful matches with 97% accuracy. The result of the matching process for this study resulted in 315 coaches being matched to one or more Members.
Does virtual 1:1 coaching improve well-being?
Yes. BetterUp virtual 1:1 coaching drove statistically significant, positive improvement on every well-being outcome measured in this study.
How long does it take?
It depends. Some parts of well-being can improve rapidly, in as little as 3 months. Other parts require a longer time investment to get maximal results.
What does progress look like?
In general, large early growth was seen in more introspective skills. For example, coaching appears to help people to understand their needs and goals (self-awareness), develop goals and the plan for achieving them while identifying potential barriers (prospection), and build the beliefs that this vision is attainable (self-efficacy). Emotional regulation also positively shifted early on in coaching.
By three months in, people's skill to manage stress in their lives improves and they experience better relationships and connectedness to others.
By six months growth in resilience accelerates and people find a better understanding of purpose in life.
With more than six months of coaching, the cumulative effects of working with a coach accelerates positive shifts in overall life satisfaction.
Coaching works to improve well-being and it does so in phases
This research suggests humans show patterns in how they tend to build mental health. In other words, there is an order of operations to improve well-being. In the first phase, coaching can help lay a foundation for mental health through improving self-understanding. Once people have better self-awareness around their emotions, their future and goals, and their capacity, coaching builds upon that foundation. Stress management skills, improving relationships, and resilience are all able to shift relatively rapidly. Ultimately, these improvements in mental health allow people the space to refine a sense of purpose and make the changes that elevate levels of satisfaction with life.
By helping people move through these phases of well-being improvement, coaching helps people leave languishing behind and shift to a better place on the well-being continuum.
In fact, BetterUp Members see a 38% decrease in languishing in the first three months with a coach.
The bottom line? An investment of time and resources in personalized professional coaching is effective to improve mental health. Coaching helps build the skills to adapt, recover, and grow from challenging situations, as well as predicts an improvement in life satisfaction.
For many wellness or mental well-being interventions, how, when, and on what outcomes impact can be expected is unclear. With the mental health revolution upon us, we expect that to change. In this case, BetterUp Labs led the way to build the science around coaching for mental health. Through this research, we have uncovered what the process of improving mental health through coaching looks like. And it’s nothing short of inspiring.
Dive deeper: About the research study
This study used a longitudinal research design to evaluate individual changes in the personal and professional mental health and wellbeing outcomes of BetterUp Members. The research sought to answer the questions:
- What aspects of mental well-being can improve with coaching?
- How long does it take?
- And, what does progress look like over time?
To answer these questions, BetterUp Labs examined 391 BetterUp Members who completed a coaching program between July 15, 2019, and June 24, 2020. Most were managers living and working in the US. Members represented a cross-section of industries.
Each Member was given a personal BetterUp coach through their employer. Coaches were drawn from a pool of over 2,000 ICF certified or licensed expert coaches across 60 countries. Coaches reflected a wide breadth of expertise with training from the fields of clinical psychology, positive psychology coaching, organizational development, leadership, mindfulness, and motivational interviewing. After a 5-step screening process, only 9% of applicants are accepted into the BetterUp coach pool. All coaches must maintain a 4.5 out of 5 rating to remain in the pool. Coaches also had continuing leading-edge training on the latest evidence-based practices and were able to receive in-house certificates in the areas of Diversity & Inclusion training, Conscious Business, and Happiness Research. Furthermore, individual feedback to coaches was also provided.
Members were matched to a coach from a pool of over 2000 coaches globally to optimize Member-coach fit by using BetterUp’s 150-factor matching algorithm. The result of the matching process for this study resulted in 315 coaches being matched to 1-14 Members each. Members were tracked for 8 months and spent on average 6 months working with their coach. The exact length of the program varied slightly between people because Members had flexibility in how often they scheduled coaching sessions. Coaching is designed to meet people where they are and so by its nature, usage varies from person to person. In this case, that very variability allowed us to examine different time windows for change.
The primary outcome was positive mental health. This was defined by measures that aligned to 6 dimensions of mental well-being outlined by Ryff (1989):
- Emotional regulation (ability to maintain control of emotions)
- Self-efficacy (believing you can achieve what you want in life)
- Self-awareness (knowing what brings you joy)
- Social connection (regular interactions with supportive others)
- Purpose and meaning (feeling what you do makes an impact)
- Prospection (thinking about how to make the most out of the future)
Three other important dimensions were measured. These were included because they have been identified in past research to buffer against negative mental health:
- Stress management (stress and tension experienced in daily life)
- Resilience (recovery, coping, and growth after stress)
- Life satisfaction (fulfillment in life)
This BetterUp Labs research used proprietary measures of these mental well-being dimensions that were developed in-house. The scale development process followed the highest scientific standards in psychological and behavioral assessment to confirm validity and reliability.
Members were tracked across three time points: onboarding (baseline), time 1 (about 3 months into coaching) and time 2 (about 6 months into coaching).
Then, patterns of growth were examined across all outcomes measured.
What’s really powerful about this research is that changes in mental well-being over time were examined within-person. What that means is rather than averaging across the entire 391 Members and tracking the mean change for the group as one unit, researchers tracked the changes within each individual taking into account that person’s unique set point. In other words, researchers calculated the set point on each measure of mental well-being for each individual person. Then, they tracked the trajectory of each person’s growth relative to their own set point. This technique allows us to understand what trajectories of improvement look like, accounting for the fact that we each have a different “normal”. For the statisticians, the analysis used was mixed linear effects modeling.