1.5 What Coaches Can and Cannot Do
Within their scope, coaches do a great deal of valuable work. They educate clients about general healthy habits, help them set goals and build routines, and provide accountability and encouragement along the way. They help clients follow the plans their own doctors or dietitians have given them. And they support behavior change across exercise, nutrition, sleep, and stress.
Outside their scope are tasks that belong to licensed professionals. These include diagnosing illness, ordering or reading lab tests, prescribing or changing medications or supplements, creating medical meal plans, and providing mental health therapy. These tasks require licenses and training that coaching certification does not provide. Respecting that boundary is not a limit on how much you can help. It is part of how you help responsibly.
Outside their scope are tasks that belong to licensed professionals. There is one helpful nuance, however. A coach who also holds another credential can do more under that second license. For example, a coach who is also a registered dietitian may create meal plans, because the dietitian license allows it. The coaching role itself, though, stays within the limits below.
| Coaches CAN | Coaches CANNOT |
| Educate clients on general healthy habits | Diagnose illnesses or health conditions |
| Help set goals and build routines | Order or interpret lab tests |
| Provide accountability and encouragement | Prescribe or change medications |
| Support clients in following their provider’s plan | Prescribe supplements |
| Share widely accepted, general nutrition guidance | Create medical meal plans or give nutrition therapy |
| Encourage general physical activity and well-being | Provide mental health therapy or treatment |
Knowing When to Refer Out
Referring out means sending a client to another qualified professional when their needs go beyond your scope. This is a sign of a skilled, responsible coach, not a weakness. Refer to a doctor when a client has warning signs such as chest pain, dizziness, or severe shortness of breath, or needs medical clearance before exercising. Refer to a registered dietitian when a client needs a meal plan for a medical condition. Refer to a mental health professional when a client shows signs of depression, anxiety, an eating disorder, or another condition that needs treatment.
Coach’s Tip
Build your referral network before you actually need it. Keep a short list of trusted doctors, dietitians, and mental health professionals you can recommend. When the moment comes, you will be ready to help the client quickly and confidently.
Explaining Your Scope to Clients
Scope of practice is not just a rule you follow quietly. You explain it clearly to every client from the very start. When clients understand what you can and cannot do, they trust you more, not less. A simple script during the first meeting works well: “My job is to help you build healthy habits and reach the goals you set. I’m not a doctor or dietitian, so I won’t diagnose anything, change your medicine, or write a medical meal plan. If something comes up that needs that kind of help, I’ll tell you and help you find the right professional.”
Putting this in writing is even better. Many coaches include a short scope-of-practice statement in their welcome materials or client agreement. Later chapters on ethics and professional practice will show you how to create these documents.
Coaching in Practice — Aisha’s Meal Plan Request
Aisha was recently told she has high blood sugar, and asks her coach to design a meal plan to manage it. The coach explains that a detailed medical meal plan is the job of a registered dietitian, and then offers to help Aisha find one.
Meanwhile, the coach supports Aisha with general habits, such as keeping a regular eating schedule. The coach also helps her follow the guidance her dietitian provides. In this way, the coach stays genuinely helpful while staying firmly in scope.
Pause and Reflect
A new client says, “My doctor put me on blood pressure medicine, but I’d rather just fix it with diet. Can you tell me what to eat instead of the pills?” What parts of this request are inside your scope, and what parts are not? How would you respond in a way that is both helpful and safe?
As you move through the rest of this book, keep the ideas from this chapter close. You will learn many skills, including goal setting, nutrition basics, exercise design, and behavior change. Each one works best when you remember that it is applied to a real person with a full life. Remember, too, that your role is to guide rather than command.