Everyone has felt the terror of a blank page—for new health coaches, the prospect of leading their first sessions can provoke the same fear. What do I say first? How do I build trust? What if there’s an awkward silence? What if I forget something important?

Early sessions can feel like high-stakes moments. You want to establish credibility, create a connection, clarify goals and demonstrate value, all while staying present and client centered. It’s no wonder new coaches sometimes overprepare scripts or, conversely, feel paralyzed by uncertainty.

The good news is that effective first and early sessions don’t require perfection; they just require structure. A clear, flexible framework reduces anxiety, supports professionalism and creates psychological safety for both the coach and client. When you know the purpose of the session and the general flow, you can focus less on “What do I say next?” and more on listening deeply, asking meaningful questions and building a strong foundation for change.

This article presents a simple, practical structure for first and early coaching sessions, one that promotes rapport, clarity and forward momentum while leaving room for authentic conversation.

Session Structure

Prior to a client’s first coaching session, it is helpful to provide a welcome packet. A well-structured welcome packet should reflect your coaching philosophy and approach to helping people change and grow. This resource also allows you to gather information ahead of time so that you don’t need to spend early sessions on procedural matters but instead can begin right away developing and maintaining rapport.

Just as importantly, a welcome packet sets the tone for the coaching relationship. It communicates professionalism, clarifies expectations and reduces uncertainty: three elements that help clients feel safe and supported from the very beginning. When clients understand how coaching works, what their role will be and what they can expect from you, they are more likely to engage fully and take ownership of the process.

There is no secret formula for what should be in a welcome packet but some important items to include are:

• Client welcome letter
• Lifestyle and health-history questionnaire, PAR-Q+, informed consent and medical release (as needed) forms (Note: ACE Certified Professionals can find these forms in the ACE Answers section of the ACE website.)
• Values in action assessment
• Expectations (confidentiality, openness, accountability, etc.)
• A coaching agreement (emphasis on agreement and not “contract”) (Note: ACE Certified Pros can access and download a sample coaching agreement by clicking on the bonus tool bar at the top of this page.)

A key to successful initial sessions with clients is to focus on client-centered coaching without getting bogged down in deciding which coaching skills to use and when. To find flow in a coaching session, it is helpful to have a basic structure to keep the session moving in the right direction.

Miller and Rollnick, the psychologists who developed and popularized motivational interviewing, use some helpful metaphorical language to help paint a picture of what should be accomplished during initial sessions with clients. This language can be reflected on and kept in mind while having conversations with clients. If you are thinking about what you should be doing while trying to coach a client, it can be difficult to be truly present and have an uncluttered mind. Instead, have an idea of where you are heading by keeping the focus on the fundamental tasks of motivational interviewing and answering these four questions:

Watch: Using Motivational Interviewing in Early Coaching Sessions
Learn how the four tasks of motivational interviewing—engaging, focusing, evoking and planning—can help health coaches create structure, build trust and support client-centered change.

ACE Certified Professionals: Use the button at the top of this page to access a First Session Flow worksheet that will help you prepare for early coaching sessions and guide client-centered conversations with more structure and confidence.

Depending on the length of your coaching sessions and the client’s readiness to change, all four of these questions may be answered in the first coaching session. For others, however, it can take multiple sessions to walk with clients as they determine a direction to move, reasons for heading in that direction, and how they would like to move in that direction while also increasing their readiness and motivation for change.

Whether it occurs in the first or fourth session, when the client begins the goal-setting process, a new element is added to subsequent sessions: checking in. Remember, you are acting as a guide on this journey, and now that goals are being set, it is important to know if they are being reached and, if not, to explore the how or why behind the changes and what adjustments could be made.

Here’s a helpful analogy: Imagine you are literally guiding a person on a trip, and an agreed-upon goal is to travel by car from California to Florida. This long-term goal would be broken down into smaller goals, for example, by first determining that you would like to be in the car for no more than 6 hours per day and to visit as many national parks and historic landmarks as possible along the way. As the guide, you would want to check in with the traveler to be sure they are enjoying their trip and are happy with the stops and route you have been taking. You might even ask things like, “What is going well?” and “What made those stops enjoyable for you?” Or, if you knew the traveler was not having a good time, you might ask something like, “What got in the way of this being a great experience for you?” All the information gathered from this conversation would lead to adjustments being made for the next leg of the trip.

Now, back to the context of coaching, this same line of thinking for checking in with a client can be used to determine what has been going well, how the client is being successful and what strengths they have that are helping, as well as any barriers that might be getting in the way. All this information can be used to adjust the behavior-change journey as needed through collaborative goal-setting.

What to Do When Clients Get Stuck

Just like any type of journey, there are bound to be times when things don’t go according to plan. One thing that can happen during the coaching relationship is that clients may feel stuck or as though things are not working the way they thought they would. Progress may slow, motivation may dip or old patterns may resurface. At times, clients may even question whether they are capable of change.

These moments are not signs of failure; rather, they are a normal and often necessary part of the behavior-change process. Feeling stuck can signal that a goal needs refinement, that barriers have not been fully explored or that deeper beliefs and assumptions are ready to be examined. For coaches, these moments provide valuable opportunities to slow down, lean into curiosity and strengthen the partnership.

In this section, we will explore some practical and supportive options for helping clients get unstuck, reframing setbacks as learning experiences, and restoring forward momentum in a way that aligns with the client’s values and vision.

Setting and Agreeing Upon Expectations (A Preventive Measure)

As mentioned earlier, discussing expectations at the beginning of the coaching relationship is beneficial for both the client and the coach. Discussing expectations is also an important and ongoing part of coaching. For example, imagine that a client has a product goal—an outcome-based goal focused on the end result they want to achieve—of improving their cardiorespiratory fitness and has been setting process goals of adding movement snacks into their workday on three days per week.

These are great goals, but it is important for coaches to help inform clients about realistic expectations. If, for example, the client thought that after one month of doing this, they would be able to go from walking a 20-minute mile to running a 9-minute mile, they might feel like they are doing everything right but not making progress. Having clear and realistic expectations can help prevent feelings of being stuck. Agreeing on ways to track and measure progress can help prevent getting stuck in the first place.

Avoid Common Coaching Traps

When a client feels stuck, it can be uncomfortable for the coach as well. In those moments, there may be a subtle pull to shift from a guiding, collaborative style into a more directing one. While this reaction is understandable, especially for those who are natural “helpers,” it can lead to some common coaching traps.

One of these is the expert trap. This occurs when the coach assumes a more authoritative role, offering answers, prescribing solutions or attempting to solve the client’s problems for them. The intention is usually positive, as it stems from a desire to help. However, stepping too far into the expert role can unintentionally undermine the client’s autonomy and confidence. Effective coaching rests on the understanding that the client is the expert on their own life. The role of a health coach is not to provide all the answers, but to help clients access their own insight, strengths, values and capacity for change.

Another common pitfall is the persuasion trap. Here, the coach may feel compelled to convince the client to adopt a particular strategy, try something new or move in a direction the coach believes is best. This can show up as excessive advice-giving, overexplaining benefits or subtly steering goals. Yet, lasting change is far more likely when goals are self-selected and internally motivated. When we push too hard, even with good intentions, we risk creating resistance rather than momentum.

Staying aware of these traps makes it possible to pause, recalibrate and return to a stance of curiosity and partnership. Trusting the process and the client helps to preserve client autonomy, strengthen their self-efficacy and keep the responsibility for change where it belongs—with the client. They are experts on themselves.

What to Do When a Coach Feels Stuck

Coaches, like the people we serve, can sometimes feel stuck. There may be moments when it seems as though you have used every skill in your toolkit, and yet the client is not making measurable progress. If you have ever felt this way, pause and take a deep breath; you are not alone. These experiences are a normal part of the coaching process, not a sign that you are ineffective or unqualified.

When this happens, it can be helpful to gently reframe your own mindset. The decision to change rests entirely with the client. You cannot make someone change, and it is not your role to try. There may even be times when you feel as though you want change for the client more than the client wants it for themselves. That reaction is human. It reflects your care and personal investment in the person with whom you are working. However, sustainable behavior change is fueled by the client’s own readiness, values and motivation, not the coach’s desire for progress.

In moments when you feel stuck, consider reorienting both yourself and your client. Return to the shared vision. Revisit values, long-term goals and what truly matters to them. Sometimes, a “lack of progress” is actually a signal that something needs clarification, the goal may not be meaningful enough, the action steps are too ambitious or an unaddressed barrier is standing in the way. As a skilled guide, you can only make informed decisions when accurate and honest information is available, and that insight must come from the client.

This is where presence becomes essential. Be willing to slow down. Allow silence. Ask open, curious questions. Adopt a beginner’s mindset and let go of the pressure to produce immediate results. When you remain grounded, collaborative and genuinely curious, you create space for new awareness to emerge. Often, what feels like stagnation is simply the quiet before a deeper breakthrough.

Building Confidence

Confidence is perhaps something we have all struggled with at some point in our lives, and working as a health coach may be one of those areas where we could all use a little boost, especially when first getting started. It is also important to consider that perfection in a coaching session is not the goal; rather, the objective is to connect with the client and collaborate to create structure toward a valued goal. Reading information in a book or from an article does not always help build confidence in the same way that intentional practice does. So, what can be done about it? Here are some suggestions that may work for you.

Get Regular Feedback

Ongoing feedback—from yourself, your clients and your peers—can be one of the most powerful tools for growth as a coach. However, meaningful feedback requires that your coaching be observable.

For clients, this may simply involve intentionally inviting their input about what is working, what feels supportive and where adjustments might be helpful. Creating space for honest feedback strengthens the partnership and models openness to growth.

For self-reflection and peer feedback, observation may involve recording coaching sessions (with the client’s informed consent) and reviewing them later. Structured tools such as rating scales or behavioral counts can make peer feedback more specific and actionable, focusing on observable skills rather than general impressions. This type of deliberate review transforms feedback from vague opinion into practical guidance for continued development.

For example, understanding how many times OARS skills were used can help determine how often open-ended questions were followed by reflective statements, and can be an insightful way to understand how your skills are being applied.

ACE Certified Professionals: Use the button at the top of this page to access the  the ACE Behavior Change Practical Competency Grid for self-reflection, peer feedback and intentional coaching-skill practice.

Mentorship

Seeking mentorship is one of the most effective ways to build confidence and competence as a coach. An experienced mentor provides perspective, reassurance and constructive challenge, helping you normalize the doubts that often arise, especially early in your career. Through mentorship, you gain access to lived experience, such as how seasoned coaches navigate resistance, manage silence, recover from missteps and stay grounded in a client-centered approach. Mentors can also help you identify blind spots, refine your skills and celebrate growth you may not yet recognize in yourself. Perhaps most importantly, mentorship reminds you that coaching mastery is a developmental process. Confidence does not come from having all the answers; it grows from reflection, feedback and the steady accumulation of experience with guidance along the way.

Imposter Syndrome

Another common situation that can creep in at any moment during coaching is imposter syndrome. This represents a state of self-doubt, or the feeling that you may not actually know enough or be good enough to do the work you do. I think this is something many professionals can relate to across a variety of settings, and it can be even more common when first getting started in a new profession. The good news for health coaching is that a beginner’s mind is encouraged and celebrated. You are not expected to have all the answers or solutions for your clients. In fact, sometimes the more we provide as coaches (in terms of information and solutions) the more we can get in our client’s way. In health coaching, the client is the expert, and they are in control of the best path forward. This does not mean that you do not have to be skilled and confident to be a coach, but it does mean that the responsibility is shared. When negative thoughts find their way in, it can be helpful to catch those thoughts, challenge them and reframe them. Again, the expectation is not perfection but consistently seeking improvement.

Conclusion

By using a structured welcome packet and intentionally grounding your sessions in the core processes of motivational interviewing, engaging, focusing, evoking and planning, you can transform the fear of a blank page into a confident, client-centered experience. Structure does not limit connection; it supports it. When you know the purpose and flow of early sessions, you are freer to listen deeply, respond authentically and trust the process.

Early sessions are not about having the perfect question or producing immediate results. They are about building a strong foundation. Engagement creates psychological safety. Focusing clarifies direction. Evoking draws out the client’s own motivations and strengths. Planning translates insight into meaningful, self-directed action. When these processes guide your work, progress becomes collaborative rather than prescriptive.

Over time, what once felt intimidating becomes intentional. The blank page becomes an open space of possibility rather than a source of pressure. With preparation in place and a client-centered framework to anchor you, you can remain present, flexible and responsive, confident not because you control the outcome, but because you trust both the process and the person sitting across from you.