A Review of Chris Kresser’s ADAPT Health Coach Training (Part 1): The Pre-Practicum

December 20th marked the end of the ADAPT pre-practicum. A major milestone. We’re now on a two-week break over the holidays before the practicum begins. I’ve been thinking for a while about what I might say about the program at this, the midway point. Following is my review of the pre-practicum.

The Functional Health Track

I think most people are attracted to the ADAPT program because it’s a functional health training. I certainly was. I’ve been eating an ever-evolving version of a Paleo diet since 2013 and have gathered tons of information from podcasts, books, and blog posts. I saw the ADAPT course as both a means of deepening my understanding of functional and ancestral health principles, as well lending an air of legitimacy to my attempts to help my friends.

If, like me, you have been studying ancestral health for a while and are interested in the ADAPT course primarily to deepen your understanding, I would advise you to pause before putting your money on the line. There is very little you will learn in the pre-practicum that you couldn’t learn from doing a systematic study of Chris Kresser’s extensive archive of blog posts. In fact, Chris goes into more depth in his blog posts than he does in most of the ADAPT content.

That said, I’ve found the pre-practicum to be a useful way to consolidate and contextualize what I already know. Still, the pre-practicum is more of an introduction to ancestral and functional health principles than it is a deep dive. Eye-opening for someone new on the scene, but nothing really new for someone already steeped in this stuff.

Before you draw any hasty conclusions, though, be aware that the pre-practicum is preparation for the practicum. The practicum promises to place an emphasis on client case studies, something we’ve already gotten a taste of in some of our teacher assistant sessions. These case studies are a great way to apply what we’ve been learning to real life scenarios and are designed to prepare us for working in collaboration with licensed providers (which is really what the ADAPT coaching model is all about).

The Functional Health Content

The most useful and interesting part of the Functional Health track was a five-week course on micronutrients. It covered the whole spectrum of vitamins and minerals, taking them one at a time. We looked at the role that each micronutrient plays in the body, what the appropriate daily intakes are, how to supplement when necessary, how to avoid toxicity, and, most importantly, how to source adequate levels from food. I’m slow to commit this kind of information to memory, so this is content that I’ll be going back to again and again.

Other practical content involved systems for counting calories and measuring macronutrient ratios. I’m admittedly not well versed in either. My own approach to eating does not involve counting calories; I practice 16/8 intermittent fasting and eat twice a day to satiety. Also, I’m aware of the macronutrient ratios on my plate, but am by no means precise in my measurements; I tend toward low carb, sometimes drift into moderate carb territory, and don’t think much about it. That said, I think it’s important for a health coach to be prepared to calculate calories and measure macronutrient ratios with some degree of accuracy. So this too is material that I will revisit as we move through the practicum.

If you’re concerned about the nature of the functional health content, I’d encourage you to have a look at my previous posts, wherein I detail what we’ve been studying from month to month. If you don’t have time for that, here is a rough outline of the pre-practicum content:

– An introduction and overview of Paleo and nutrient-dense eating;

– Macronutrient ratios;

– Micronutrients and optimal nutrients;

– Diet variations: Intermittent fasting, carb cycling and backloading, Low-FODMAP, Autoimmune Protocol, Keto, higher-carb Paleo, Paleo for women, Paleo for athletes, Paleo for pregnancy;

– Shopping and food prep;

– Physical activity, sleep, stress management;

– Environmental toxins;

– Introduction to lab testing;

– Mental health issues.

The Art & Practice of Coaching Track

As I’ve said before, the APC track is the heart and soul of the ADAPT course and the true best reason to enroll. Chris Kresser has assembled an excellent faculty for this track, including some topnotch mentor coaches. If someone were to go through the ADAPT course and decide that they didn’t want to be a health coach after all, the APC track would have them well prepared for being a life coach or a career coach or any other kind of coach.

We saw a lot of Ken Kraybill throughout the pre-practicum. He delivered all of the video content on motivational interviewing, provided coaching demos with his staff, and led some great instructor sessions. My understanding is that we won’t be seeing any more of him during the practicum, as we shift gears into other material. Mr. Kraybill has left us with a treasure chest of information to integrate throughout the practicum.

The other prominent pre-practicum faculty member was Robert Biswas-Diener. Robert is the author of Positive Psychology Coaching, The Courage Quotient, and The Upside of Your Dark Side. As I discussed in my October report, Robert’s style is quite different than Ken Kraybill’s. Robert is a little more confrontational (in a productive way), whereas Ken Kraybill’s style could be described as “spacious.” Robert relies heavily on powerful questions, whereas Kraybill is a master of reflective statements. They are both excellent coaches and complement each other nicely. Chris Kresser did exceptionally well by recruiting both to the ADAPT course. I’m looking forward to learning more from Robert Biswas-Diener during the practicum.

In week 18 we got a crash course in TTM (the transtheoretical model), which is kind of a map to stages of change. As a map, the TTM model is useful, but I wasn’t really impressed by the way this particular content was presented. Fortunately it took up only one week of our time.

The Mindfulness Track

Technically, the Mindfulness track is part of the APC, but it really is a lane of its own. I understand Chris Kresser’s thinking on including a mindfulness track. Chris sees the capacity for mindful presence to be an integral part of a coach’s skill set. The mindfulness track in fact is there more for us to integrate into our coaching than it is for us to actually go out and teach meditation.

As a longtime meditator and student of spiritual paths, I’ve viewed the mindfulness track with a scrutinous eye and had some critical things to say about it in my September report. Since then, I’ve given more thought to why I’ve found this part of the course so disappointing.

The Mindfulness track is presented in a secular context, but in reality it’s an introductory course on Buddhist meditation and loving kindness practice. I find the dishonesty of such an approach – a kind of sly proselytizing – to be off-putting.

Further, the kind of Buddhism presented is what I like to call “California-style Buddhism,” which is disproportionally focused on self-improvement and social awareness, as opposed to more traditional schools of Buddhist thought, which care far less about psychological well-being and much, much more about the undermining, or unraveling, of the ego structure.

In my September report, I criticized the mindfulness track for not preparing us to teach meditation to our future clients. On second thought, I think it’s a good thing that it doesn’t. I think it would be irresponsible to send out a bunch of new coaches to teach meditation techniques when those said coaches understand very little about meditation themselves.

To my personal relief, the mindfulness track ran its course in week 25. We still have a couple of instructor sessions with Forest Fein (the one-man mindfulness show) on the schedule, but no more video lessons.

One good thing about the mindfulness track is that it’s inspired me to write a blog post, The Irresponsible Promises of the Mindfulness Movement, with more such posts in the works. With the current popularity of meditation apps and the proliferation of mindfulness courses, I feel something of a karmic obligation to point out the potential pitfalls and traps.

The Professional Development Track

Professional development is going to be a prominent part of the practicum, but we did receive a sprinkling of information throughout the pre-practicum. Chris Kresser presented a series of video lessons on structuring client work, legal considerations, and steps to take when starting a coaching business. Packaged with these lessons, we received a substantial stack of handouts that will be very useful down the road.

We also had two instructor sessions with Keith Rhys, who is Chris Kresser’s personal business coach, during the pre-practicum. In his instructor sessions, Keith answered questions with infectious enthusiasm and gave us some journalling exercises to do in preparation for a deeper exploration of our coaching niche during the practicum.

There are a lot more instructor sessions with Keith on the practicum calendar. He inspires confidence. I’m looking forward to learning from him.

Scope of Practice and the Collaborative Model

One thing to understand about the ADAPT course is that Chris Kresser’s vision of health coaching is a collaborative model. He sees the role of health coaches acting in supportive/cooperative roles with licensed providers, be they functional health practitioners or registered dietitians.

Chris has made it clear from the beginning that ordering labs, diagnosing medical conditions, and prescribing treatment protocols are all beyond the scope of a health coach. And at the same time, the functional health track is providing us with some of the tools to do those very things –– the idea being that a good functional health coach should be prepared to understand protocols from the perspective of a licensed provider and also to explain the wisdom of those protocols to their clients.

When a health coach is working collaboratively with a licensed provider, the coach’s scope of practice broadens significantly. On the other hand, when a health coach is working independently, the scope of practice narrows. There has been a lot of confusion among our cohort around scope of practice issues and I was able to ask some clarifying questions on the subject during a recent Q&A session with Chris Kresser.

Again, the ADAPT scope of practice as I understand it is that we can not diagnose, prescribe, or recommend personalized dietary protocols. We can however educate, provide information, recommend general dietary protocols and work with clients to refine those protocols based on the client’s preferences and needs.

For instance, if a client who is 40 pounds overweight and pre-diabetic comes to us for help, we can educate them on the efficacy of a low-carb paleo diet. Or, if a client’s health has deteriorated on a standard American diet and they are highly motivated to clean up their act, we can coach them through implementing a 30-day Paleo reset, as outlined in Chris Kresser’s The Paleo Cure.

The key to educating and providing information while staying within one’s scope of practice is to always respect client autonomy –– empowering clients to make their own decisions. One of the motivational interviewing tools that we’ve studied with Ken Kraybill and practiced in our mentor coach sessions, is EPE (elicit-provide-elicit). In practice, this means that we elicit what a client already knows about a subject, we provide information, then elicit the client’s response.

An example of an EPE exchange might look something like this:

Client: “I’ve been thinking of starting a ketogenic diet.”

Coach: “What do you know about ketogenic diets?”

Client: (talks about what they know and why they are considering trying it)

Coach: “Is it okay if I share with you what I know about ketogenic diets?”

Client: “That would be great!”

Coach: Shares and then asks, “What are your thoughts about that?”

Elicit, provide, elicit.

Summarizing the Pros and Cons

Though this review is critical at times, I think it’s important to understand that I’m strongly of the opinion that the ADAPT program is the gold standard of functional health coach trainings. My instinct as a writer is to home in on the weaknesses of whatever I’m reviewing and to understate my praise. That’s my style. If you were to ask me point blank if I would recommend the ADAPT program, yes or no, my answer would be an emphatic Yes.

With that in mind, the following is a short list of what I think are the pros and cons of the ADAPT pre-practicum:

Pros:

– The faculty that Chris Kresser has assembled are leaders in their field;

– Likewise, the teams of mentor coaches and teacher assistants are knowledgable and generous both with their time during sessions and in answering questions in the community forum.;

– The Art & Practice of Coaching track is both educational and experiential. Weekly 90-minute mentor coach sessions have given us plenty of time for hands-on practice. Additionally, we’ve each been assigned peer partners with directions to meet for an hour of practice coaching once a week – something I’ve found to be time well spent;

– The Functional Health track, despite not going into great depth, is well organized and provides foundational information;

– The support staff (shout-out to Lyndsey and Dotty!) are exceptional;

– There seems to be much thought given to the timing with which materials are presented. One small example being the way we’ve received a slow sprinkling of Professional Development content in preparation for the practicum. I appreciate the intelligence with which information is staggered;

– We’re learning from Chris Kresser.

Cons:

– While the bulk of the Functional Health content is delivered via video format by Chris Kresser, there is not very much direct access to the man. It would be great if Q&A sessions with Chris were more frequent;

– With the exception of the five-week course on micronutrients, the Functional Health track feels stuck at the introductory level a lot of the time. That said, I get the feeling that it’s laying a foundation for us to dig deeper during the practicum (see my above comments about TA sessions and case studies). So this is not decisively a “con;”

– While weekly 90-minute mentor coach sessions have been one of the strengths of the course, our teacher assistant sessions have been limited to 60 minutes every other week. Our TAs are usually generous enough to stick around for an additional 30 minutes or so to answer questions. Still, weekly 90-minute sessions would not feel like too much. Our TAs provide a wealth of information and there are so many questions that arise;

– I understand Chris Kresser’s decision to include a mindfulness track. But I’ve found the Mindfulness track to be redundant at best and misguided a lot of the time. Though some students seem to love the Mindfulness track, to me it’s by far the weakest part of the course.

Looking Forward to the Practicum

We’ve been given some information as to how different the practicum will be from the pre-practicum, but a lot remains to be seen. What I know is that MC sessions will be reduced to once every other week and TA sessions, while remaining every other week, will be 90 minutes long and will center around cases studies. The focus is going to shift more heavily to experiential learning.

We will continue meeting with our practice partners once a week, but most of us have been assigned new partners. My original partner deferred his participation to the next cohort for personal reasons, and so I was assigned a new partner just a couple of months ago. The two of us are the only students in the Asian time zone, so we will continue working together through the practicum.

As I’ve already reported, Ken Kraybill has finished his work with us on motivational interviewing. We are going to see a lot more of Robert Biswas-Diener as he continues his work with us on positive psychology and strengths-based coaching –– something I’m excited about, as I feel his particular approach to coaching matches well with my inherent strengths. We’re also going to be seeing more of John Kinyon, who has already started introducing us to the principles of nonviolent communication.

The biggest change though is that we are going to be taking on practice clients in preparation for our PSA. The PSA is kind of a final exam for which we will need to submit a recording of a 30-minute session with a real client, to be graded pass/fail by a mentor coach. One of the major hurdles to receiving certification. Real bullets about to fly!

If you are interested in being a practice client, please see my Coaching Services page for details.

Oh, and I completely forgot. The midterm exam consisted of two separate exams –– 50 questions for the Functional Health exam, 50 questions for the APC exam. Some students were nervous about passing. It was a piece of cake.