by David Steele
A common question of our coaches is “How do you know when an individual or couple needs therapy instead of coaching?”
Since coaching, and particularly relationship coaching, is in it’s infancy, it is not my intention or ability in writing this article to present comprehensive guidelines on this topic, but I will share what I have learned so far.
Most coach training programs teach; “When in doubt, refer it out.” This is a good guideline, however the issue can be more complex when:
- The client insists on COACHING and does not want to consider therapy
- The coach is also a therapist and feels able to address therapeutic issues
- The individual or couple is in therapy, or has tried therapy, and wants COACHING
- You see a need possible need for therapy, but assess the client is functional and could benefit from coaching
SCREENING FOR COACHABILITY WITH INDIVIDUALS
This may be a radical concept, but I believe that coaching, by itself, is harmless. How can it damage a client to help them set goals and close the gap between where they are and where they want to be?
In my opinion, there are three ways a coach can harm a client:
- Unskilled Coaching; giving advice, imposing judgment, prescribing interventions, doing therapy while calling it coaching, mixing coaching and therapy, and other activities that, actually, are NOT coaching.
- Continuing ineffective coaching
- Providing coaching instead of what’s really needed; such as therapy, psychiatric intervention, etc
In coaching we help functional people raise their level of functioning. Most clients that need therapy are also functional enough to benefit from coaching, and in many cases it would be beneficial to do both. In addition, coaching can be therapeutic! Being a therapist as well as a coach, I strongly believe in the benefits of therapy, but don’t believe in imposing therapy on unwilling clients.
- Pick and choose your clients; let’s be honest- chances are you would most likely encounter this question if you are considering taking on a client to pay the bills in spite of red flags, not because you really wanted to work with them. Accept the clients you want to work with and refer the others to an appropriate resource.
- Get more information; let your client know of your concern and partner with them to follow up by seeking assessment by a physician, psychologist, etc. This assumes their openness and cooperation.
- Reverse diagnosis; allows the results prove the outcome, rather than subjective impressions. You could contract with your client for 30-90 days of coaching, and if they benefit from coaching by improving their functioning, they are coachable!
- Regularly check level of functioning; if you are concerned about your client’s need for therapy, yet they appear to benefit from your coaching, keep tabs on their functioning by regularly checking in about their sleeping, eating, self care, moods, relationships, work productivity, etc. Let them know what you are doing and why. If they report impaired functioning in any of these areas, coach them to set a goal, strategize and implement an action plan to address their issue, which may include medical or psychiatric assistance.
- Establish conditions for coaching; contract to coach them only if they are addressing their therapeutic issues, and hold them accountable.
SCREENING FOR COACHABILITY WITH COUPLES
Much of the above applies to couples, with the added complexity of relationship issues and dynamics, usually manifested in their conflicts. “Communication,” or “conflict” is the presenting problem of the vast majority of couples seeking relationship help. These couples are sometimes attracted to coaching as a non-stigmatizing alternative to therapy.
In itself, conflict doesn’t mean the couple needs therapy and is not appropriate for coaching.
I suggest screening for the following:
- Spousal abuse; physical, verbal, etc. Relationships involving one or more uncontained, volatile, impulsive, controlling people are most likely not candidates for coaching.
- Chemical dependency; make sure they both are in active recovery before considering coaching them.
- Uncooperative partner; since coaching requires both partners to take responsibility for their life and relationship, a resistant (being “dragged”) or uncooperative partner means they are most likely not candidates for coaching.
- Intractable anger/resentment; clients that seem stuck in anger and blame, that seem invested in externalizing, being the victim, and avoiding responsibility, and are poor candidates for coaching. One clue is if the problems are severe and long-standing.
- Lack of impulse control; including multiple affairs, financial irresponsibility, trouble with the law, etc. These reflect low levels of functioning or character disorders and are most likely not candidates for relationship coaching.
As a Relationship Coach my goal is to work with functional couples. As a therapist, I worked for many years with dysfunctional couples in crisis, and realized that if they wait until the relationship is broken to put effort into making it work it is often too late. My ideal couple is a new couple who wants to be pro-active, conscious and intentional in building a great relationship. In spite of the clients you want to attract, couples will continue to seek support when they are in trouble, and if you screen for the above, the fact that they are experiencing difficulty does not in itself mean they are not functional or coachable.
- Meet for initial session. One method I have used successfully to screen for coachability with couples I was unsure about is to invite them to meet, do an intake, and if their conflict and communication is an issue (it almost always is!), to immediately teach them the Communication Map. Then, I would set up a follow up appointment, and coachable couples would return and report good, sometimes miraculous progress, while couples not ready for coaching would either not return, or if they did they would report no progress. This is an example of “reverse diagnosis” as described above.
- Listen to their initial voicemail. Here is a game I play with myself that you can try- listen carefully to their initial voicemail message. If you hear high stress, desperation, and/or depression in their voice, I have found they are usually not coachable and need therapy. If you hear functionality, that will usually be present when you follow up with them. This may be partly intuitive, but we tend to be good listeners, and I bet you will be able to pick up the cues of one or the other.If you are a coach, or a therapist who prefers coaching (like myself), and from the message or your initial telephone screening, the situation seems more likely to need therapy, you can pass the inquiry to a colleague who is a therapist. If you meet with a couple and you judge that they need therapy, you can refer them to your colleague, and/or contract with the couple to work with them only if they are in therapy.
Coaching vs. Therapy Audio Program
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