The Quiet Coach 8
March 3, 2023
When do I refer a coaching client to therapy?
Let’s start with a pop quiz. In which of these situations would you refer your coaching client to therapy?
- R2-D2 is working through being laid off from her job three months ago. She cries often in your conversations with her and it’s difficult for you to move her into a space where she is thinking about options.<
- Wall-E feels easily intimidated by people in leadership positions. He feels a sense of fear every time he needs to go into a meeting with his manager.
Not easy to make that decision about our two robotic fictional clients no? The reason for that is that there is much that coaching and therapy have in common – both can focus on deepening awareness and supporting behavioural change. Both rely on inquiry and on creating safe containers for clients to explore their feelings and their experiences.
Easy hacks like “coaching is about thinking and therapy is about feeling”; “coaching is about the future and therapy is about the past” or “coaching is for emotionally healthy people” are overly simplistic. And the last one in particular gets my goat because of the unsaid implication of what therapy is for.
However, it is a core part of ethical practise as an ICF-trained professional (or otherwise) to recognize when you are unable to add value to the client and refer them to another supportive professional.
ICF’s Code of Ethics includes the following obligations for coaches: Section 3.18: Carefully explain and strive to ensure that, prior to or at the initial meeting, my coaching client and sponsor(s) understand the nature of coaching, the nature and limits of confidentiality, financial arrangements, and any other terms of the coaching agreement. Section 3.23: Encourage the client or sponsor to make a change if I believe the client or sponsor would be better served by another coach or by another resource and suggest my client seek the services of other professionals when deemed necessary or appropriate.
The ICF has two helpful resources – a white paper based on interviews with several coaches and therapists across the world (https://coachingfederation.org/app/uploads/2021/01/ReferringaClienttoTherapy.pdf) and a shorter reference checklist of the same(https://coachingfederation.org/app/uploads/2021/01/ClientReferral.pdf)
Please do read these; I thought we’d use this post to summarise some of the questions that come up often.
When do I bring up the topic of therapy with a client?
- When you see a repeated pattern that is interfering with the client’s daily functioning (taking care of themselves; working etc) such as signs of psychological distress:
- o Marked changes in mood such as irritability, anger, anxiety, or sadness.
- o Decline in performance at work or school
- o Withdrawal from social relationships and activities
- o Changes in weight and appearance, including negligence of personal hygiene
- o Disturbances in sleep, either oversleeping or difficulty falling or staying asleep
- When the client is unable to move past some unresolved emotional issues: again, it is important not to jump the gun. I remember one client who took over ten sessions to process a betrayal by her business partner. It did make me very uncomfortable but when I checked in with her, she felt she was making progress (and eventually was able to move past the incident).
All of us would experience some of these from time to time so it’s important that you look for either a cluster of these occurring together and/or for consistent recurrence of these over a period of time.
If the client seems stuck in a past incident and is unable to gain insight and move past it, despite enough exploration and empathy, then a referral is probably a good idea. For example, a client of mine a long while ago, who would keep talking about his manager blocking his promotion with a great amount of agitation, over and over again – with no reduction in intensity or increase in awareness over a period of time.
How much exploration? There’s no simple answer to that so the best thing would be for you to take this into processing with your supervisor or a fellow coach.
Please remember that we’re talking here about when you would bring up the topic of therapy with a client. Direct intervention is necessary when there is immediate danger to the client or someone else. If a client is talking about self-harm or a repeated sense of hopelessness, suicide or about harming another, it is important that you take steps to protect the client. This would include listening and staying with them till help can be got and contacting the stakeholder or a relevant authority.
Can a client work with a therapist and a coach simultaneously?
Absolutely possible – that the coach continues to work with the client on what was agreed upon in the contract while the client goes to a therapist to process their early decisions and work through formative events in their life.
How do I bring this up with a client without them feeling like I am judging them?
- First, make sure you’ve thought enough about whether bringing it up is appropriate; get supervision and prepare for the conversation. Blurting it out without adequate preparation could be very damaging for the client (been done, done that, learnt my lesson)
- Ask them if they have ever considered therapy and how they feel about it/what they know
- Explain how therapy could help them with specific examples of behaviour you have observed; be very careful to use neutral and specific language (for example “over the last few sessions, I’ve noticed that there appears to be a lot of anger you’re carrying about the authority figures who were not supportive of you in the past – a therapist can help you work through this anger and process is in ways that I, as a coach, am not trained to do”)
- Normalise therapy – I take every opportunity I can to talk about the fact that I am in therapy myself from early on in the relationship. I think it’s a super idea for all coaches to work with a therapist for atleast some time so you have a good sense of what you are recommending. If you have not had that opportunity, talk about other people in your life who are close to you who have benefited from therapy.
- Reassure them that you are there for them – it’s important for clients to not see themselves as beyond the help of coaching or that you are abandoning them.
- Offer to make a connection – it’s good to build a list of therapy practitioners whom you can refer clients to.
- Remember that ultimately, the decision to go to therapy is up to the client. They may not want to seek professional help, which is acceptable. Respect your client’s right to not seek help unless you believe that they are at risk of harming themselves or others.
- Express your concern and care by following up with them to see if they’re ok (if they choose not to continue work with you)
For more information about our ICF accredited coach training programs, please click here – http://www.navgati.in/icf-accredited-coach-training/.
Check out http://www.navgati.in/executive-coaching/ for more information about the leadership coaching we offer.