Background: Individuals with intellectual and developmental disabilities (IDD) are understudied in the field of health promotion. Additionally, health promotion programs need tailoring to meet the needs of this population to enhance participation and usability. This study explores coach reflections from an Integrative Health and Wellness Coaching (IHWC) program for individuals with IDD, emphasizing the demands of individualized, client-led work. Methods: Qualitative data were collected through coach debriefs and written reflections during the IHWC program and analyzed thematically. Results: Four themes were developed: coach perspectives and preparedness for working with individuals with IDD; recognizing and responding to client differences in IDD coaching; holding the frame: balancing coaching structure with individual adaptations; and coaching in practice: adapting, reflecting, and looking ahead. Discussion: Coach reflections revealed the need for flexibility, ongoing learning, and preparation to support neurodivergent clients. Direct experience helped coaches grow more confident in adapting IHWC to individual needs. Conclusion: IHWC for individuals with IDD requires reflective training and adaptable approaches that affirm neurodiversity and move beyond standardized models.
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