Originally published by David Steele, May 1997
“Opportunity misses those who view the world only through the eyes of their professions” ~Gerald Celente
Change is a necessary part of our life, and our profession. It has been over 30 years since the establishment of marriage and family therapy as a health-based method of mental health treatment by pioneers who departed from the medical model. In this time, the stability of marriage and family relationships has greatly deteriorated. The U.S. divorce rate has tripled, half of all marriages now end in divorce, and 27% of all children live in single parent families. Prevalence of mental health issues has also increased, with 10% of our adult population using Prozac.
The MFT profession seems to have been carried along with these trends and swung back toward the medical model of the “expert doctor” healing the “suffering patient.” According to a 1997 survey conducted by the California Association of Marriage and Family Therapists:
- MFTs treat individuals for depression more than they work with relationship issues
- More than 50% of MFTs are on managed care panels
- 70% of MFTs bill insurance for their services (which means they must provide a clinical diagnosis)
The resulting pathology-oriented public perception of therapists does not encourage a reversal of this trend:
“Despite the increasing interest in all things psychological, the public picture of mental health treatment has been, and continues to be, based on a wide-spread belief that counseling or psychotherapy are only for people with serious conditions. In other words, if you go to a therapist, it means you are crazy” (Conley and Miles, 1997).
Professional Coaching has emerged as a promising development which has the potential to turn the MFT profession back toward its roots. Coaching can be defined as:
“a professional client-centered relationship where the client is the primary focus. The coaching relationship is unique in that the client is perceived by both the coach and the client to be healthy, powerful and an achiever of his or her goals” (Cohen, 1995).
Therapy and professional coaching have similarities and differences. Similarities include:
- An ongoing, confidential, one-to-one, fee-for-service, relationship
- Working with clients who want to change
- Assuming change only occurs over time
- Regularly scheduled sessions
- Use of verbal dialogue as the primary service activity
The following is a table of selected differences:
|Assumes the client needs healing||Assumes the client is whole|
|Roots in medicine, psychiatry||Roots in sports, business, personal growth venues|
|Works with people to achieve self-understanding and emotional healing||Works to move people to a higher level of functioning|
|Focuses on feelings and past events||Focuses on actions and the future|
|Explores the root of problems||Focuses on solving problems|
|Works to bring the unconscious into consciousness||Works with the conscious mind|
|Works for internal resolution of pain and to let go of old patterns||Works for external solutions to overcome barriers, learn new skills and implement effective choices|
Adapted from Hayden and Whitworth, 1995
Most therapists who examine the above differences will recognize they do coaching as well as therapy. Coaching is not foreign to MFTs once they are acquainted with the model. The primary skills and techniques of a coach include:
- Accountability; obtaining commitment to action items that the client chooses and accounting for the results.
- Challenging; requesting a client stretch beyond their self-imposed limits.
- Clarifying; questioning, reframing, articulating what is going on.
- Designing the alliance; assisting the client to take responsibility by deciding the form of support most beneficial to them. In therapy the therapist designs the alliance, in coaching the client does.
- Forwarding the action; using a variety of skills to move the client a step forward toward their goal.
- Holding the client’s agenda; probably the most important and distinctive coaching skill. The coach becomes invisible and without judgment, opinion or answers, which allows the client to access their own answers.
- Holding the focus; assisting the client to keep on-track when distracted by feelings, circumstances, etc.
- Powerful questions; an open-ended question that evokes clarity, deepens learning, and propels action.
- Requesting; forwarding the action by making a request based upon the client’s agenda
- Reflective listening
Professional Coaching evolved from corporate consulting in the late 1980’s. Currently, coaching is widespread in business and industry. In today’s competitive global marketplace, corporations realize that their people are their most valuable asset. Corporations commonly use coaches to work with CEOs, project teams, management/employee relations, and to develop internal talent for promotion.
The use of coaches in the workplace improves productivity, creativity, morale, and employee retention, and decreases turnover and the expenses involved with hiring and training new employees. The success of corporate coaching services over the last few years has resulted in an evolution of formal coaching models, training for coaches, the marketing of coaches’ services to the public, and the development of niches such as Life Transitions Coach, Creativity Coach, Entrepreneur Coach, and so on.
Presently there are tens of thousands of professional coaches worldwide, and training institutes graduate hundreds more each month. At this time there are no regulations, or educational or licensing requirements; literally anyone could declare him/herself a coach and start marketing their services and charging what clients will pay. Few therapists seem to be aware of the coaching profession, and when they learn about it, they are understandably concerned about the lack of regulations and increased competition for clients.
The good news for MFTs is that coaches don’t do what therapists do, and most coaches follow the guideline “when in doubt, refer it out.” Coaches do not treat clinical disorders such as anxiety, depression, addiction, and phobias. On the other hand, a therapist can do what a coach does, providing a choice of paradigms and methodologies for therapist and client. As the coaching profession gains more visibility many clients may prefer a coaching model to a therapy model. Clients who do not perceive themselves in need of therapy may be more inclined to see a coach, opening up new practice opportunities for therapists using the coaching model.
Coaching is well suited to goal-oriented therapists who prefer to enable clients to take responsibility for their process and outcomes. Therapy is ineffective when clients expect therapists to be experts who can fix their problems, a dynamic which does not occur in coaching. The pathology-oriented helplessness and stigmatization that occurs when a client associates therapy with the medical model also does not occur in coaching. The coaching paradigm seems aligned with the roots and purpose of the MFT profession:
“The true value of marriage and family counseling is in helping people recognize and develop new skills rather than defining or fixing pathology” (Conley and Miles, 1997).
- Celente, Gerald. Trends 2000. Trends Research Institute, 1997.
- Cohen, Judith. The Professional Coaching Course Manual, The Coaches Training Institute, 1995.
- Conley, Michael A., and Miles, Richard B. “Forging a New Trail: Emerging Trends for MFTs” (pp. 48-52). The California Therapist, Jan/Feb 1997.
- Hayden, C. J., and Whitworth, L. “Distinctions Between Coaching and Therapy.” International Association of Personal and Professional Coaches Newsletter, Oct 1995.
- Riemersma, Mary. “The Typical MFCC In California-1997 CAMFT Member Practice Demographic Survey” (pg. 6). The California Therapist, Jan/Feb 1998.
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