When ADVANCE chose to advocate professional coaching careers for occupational therapists as part of their march toward empowerment by 2017, we did it for several reasons:

• Coaching offers OTs the opportunity to work in private practice, for private pay, with high-functioning people who are looking to live life to its fullest-the very brand AOTA has adopted to represent the goals of OT clients.

• As yet there is no specific degree required for coaching, although the International Coaching Federation lists 11 competencies it looks for in its members. Occupational therapy students learn most of them. There are other certifiers that are less definite.

• Coaches apply their own educational and professional backgrounds, which are many and varied, to their work.

• Life coaching uses activities as its main modality.  

America's most famous life coach may be Rhonda Britten, star of daytime television's first reality show, Starting Over, who developed the Fearless Living program she wrote about in Change Your Life in 30 Days. She is founder of the Fearless Living Institute that trains coaches in her approach, which focuses on recognizing and overcoming the fear barriers that prevent people from taking the action that is necessary for their health and welfare.

The opportunity to create a distinct approach to coaching is one of its best aspects. The University of Southern California, for instance, has patented its Lifestyle Redesign® program. But getting paid as a lifestyle re-designer is another thing. One of the challenges that AOTA has in implementing the Vision 2017 scenario is finding emerging practice arenas that offer pay commensurate with the current OT pay scale, which averages more than $60,000 a year.

The USC program does get some medical reimbursement, but it has had to limit its clinical coverage to health issues that insurers support, such as smoking cessation or weight control. Private pay is the only answer to the dilemma.

In the regular physical or mental health arena, clients usually are not able to pay out of pocket for services. But coaching clients can. How much do they pay? Apparently it is completely up to the practitioner.

Coaching, by whatever name you choose to call it, involves a term commitment on the part of both coach and client. Flaven Clayton, a life coach based in Maui, Hawaii, coaches men and women from all walks of life, age 35-50 on the average, who are mainly professionals looking to grow in their own lives or in their professional careers.

Clayton's base coaching involves four 35-minute phone calls to anywhere in the world. The phone charges are included in her coaching fee of $1,200 for three months, or $2,200 for six months. Included are free e-mails and a five-minute "power-coaching" call. She states on her Web site: "You take on as much 'home work/home play' as you choose, and most of the learning/growth/action/results happen between the calls."

Executives and the corporations for which they work are the big clients in coaching, and networking is the key to getting them on board. According to life coach David Wood, PCC, owner of SolutionBox.com, Clayton had not been a coach very long when she signed up 16 clients from one corporation in 24 hours. It all happened because she offered services to people to whom she happened to be talking. One of them was the head of a real estate agency. The realtor was so thrilled with her session with Clayton that she signed up her whole team!

Clayton is a facilitator of the work of Byron Katie, who created a self-help program called The Work that uses reality-centered awareness to end depression. Clayton has studied and practiced in self-awareness for more than 15 years.

If you delve into life coaching on the Web, you find that many of the people who have become well known in this field have had life-changing experiences that created their unique approaches to coaching. Though coaching uses activity to heal, it doesn't use an occupational performance approach, since only OTs understand that approach. But the meaning in activity is intrinsic in coaching. It is distinct to every client because the "doing" fosters a change within him personally.

Clayton describes her clients as using the words "challenge, accountability, direction, inspiration, focus, sounding board, support and validation" to describe what they get from her.

If you choose to investigate life coaching, be sure to check the various types of certification out there. Not all of them are equal, and some of them may require extra coursework, usually available online. But you want to create a credential for yourself that will stand up to the rigors of future accreditors in the industry. Coaching is basically a new field, so it is in a state of flux. People with many backgrounds are grouping there. It will be important that states take on the fight to upgrade their practice acts to AOTA's model act, which allows OTs and OTAs to use their initials no matter where they practice, whether or not they are billing for OT.

Next round we'll investigate the various credentialing options in life coaching, how much they cost, where to get them, and which ones are best.

E.J. Brown is editor of ADVANCE.