The wellness paradigm in counseling developed from several early concepts rooted in medicine, physical science, education, and psychology (Dunn, 1957, 1959; Hatfield & Hatfield, 1992; Hettler, 1984, 1998; Travis, 1978). Early definitions of wellness emerged in the medical field in an attempt to find a “more holistic approach to health” emphasizing physical, mental, and social well-being (Larson, 1999, p. 126). In 1947, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (United Nations, 1984, as cited in Larson, 1999, p. 126). This definition influenced the medical field; using the theme of wellness as a construct to define the notion of positive health (Miller, 2005). The work of Halbert Dunn (1957) further influenced the construct of wellness, stressing the influence of mental, spiritual, and social factors as either promoting or hindering higher levels of wellness (Miller, 2005). He defined wellness as the interconnectedness of mind, body, and spirit as working in harmony with each other (Miller, 2005).
Building on Dunn’s work, John Travis (1978) added the notion of personal responsibility as a catalyst to improved wellness and health. In addition, the work of Donald Ardell (1985) suggested that people who are ill could still make good lifestyle decisions that can lead to greater satisfaction and life enhancing behaviors (Miller, 2005). Ardell’s concept of wellness, however, abandoned the idea of spirituality as a contribution to wellness (Miller, 2005), a concept that is today essential to holistic wellness (Myers & Sweeney, 2005).
Bill Hettler, a college campus physician, is recognized for bringing the concept of wellness to University campuses and co-founding of the National Wellness Institute (Hettler, 1998; Miller, 2005). His development of the Lifestyle Assessment Questionnaire was widely used as an assessment tool across college campuses (Miller, 2005). It became the first step in the creation of the first wellness model. His hexagonal model of wellness became the foundation for the creation of more evidence-based models today (Myers & Sweeney, 2005, 2008; Sweeney & Witmer, 1991). He defined wellness through six dimensions: physical, emotional, social, intellectual, occupational, and spiritual (Hattie, Myers, & Sweeney, 2004). According to Hettler (1998), having a healthy balance of time and energy between the six dimensions leads to increased wellness.
Contributions from the Psychology field were also major influences in the wellness movement. Abraham Maslow’s (1954, 1970) concept of self –actualization and Gordon Allport’s (1955) concept of self-esteem and having healthy social/emotional connections with others began to create what we know today as the “building blocks of mental wellness” (Miller, 2005, p. 91). Alfred Adler also influenced the wellness paradigm in psychology. Adler stressed a strength-based holistic approach to viewing people, believing that people strive to contribute socially and have the skills and courage to overcome obstacles to attain their goals (Adler, 1956, 1998). These early influences called for a more proactive counseling orientation based in wellness through (a) spiritual development, (b) physical fitness, (c) positive physical development, (d) stress management, and (e) social skills training (Carlson, 1979). Similar to Adler’s view, Emory Cowen (1991) described wellness as a state of satisfaction with one’s life, as well as having a feeling of purpose and belonging. Positive self-care also influenced the wellness paradigm, emphasizing life-balance and people being active agents in their own development of well-being (Hatfield & Hatfield, 1992). Hatfield and Hatfield (1992) defined wellness as “the conscious and deliberate process by which people are actively involved in enhancing their overall well-being- intellectual, physical, social, emotional, occupational, spiritual” (p. 164). These early works and concepts of wellness began to culminate into a unified direction for the field of counseling.
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