"What if my client is in distress?"

This blog is intended for coaches and trainee coaches looking to deepen their capability and confidence in coaching. Each month we take a question, examine why it is important in coaching, some challenges we may face answering it plus pragmatic ways to engage with it.


Last time we explored why and how to steer clear of advising our clients. This month we explore how best to support clients experiencing psychological distress.





WHY IS THIS IMPORTANT?


We are living through a time of great uncertainty which is bringing stress to most of us and trauma to many. Whilst clients may come for coaching to clarify and navigate the next steps in their professional and personal development, it is not uncommon for them in the process to uncover areas of acute or chronic psychological pain. Why is it important for us to recognise both the benefits and limits of coaching in supporting those experiencing psychological distress?


Firstly, from the perspective of the ICF, it is a coach's ethical responsibility to encourage a client to seek help from a suitably qualified mental health professional if they are experiencing issues which interfere with their daily functioning. If there is imminent danger of someone harming themselves or others, you have a duty to call the emergency services or other appropriate support and stay with them until help arrives.


When initially contracting with your clients it is a good idea to include a caveat to confidentiality to allow for cases where for the sake of the safety of your client or another, you would not be able to keep information confidential - for example if your client confesses suicidal ideation. If you are contracted by an organisation it will be important to clarify with them the boundaries of confidentiality between you and the organisation and also then to ensure your client is aware of this so that you do not promise to keep confidential something which you are contracted to disclose.

It is also a good idea to have both emergency service contact details and contacts of trusted mental health professionals to whom you can refer clients.


Secondly, understanding the warning signs may allow us to raise awareness with our clients of the extent of their own distress, which may have been creeping up on them. Warning signs could include:

  • Marked changes in mood such as irritability, anger, anxiety, or sadness

  • Decline in performance at work or school

  • Withdrawal from social relationships and activities

  • Changes in weight and appearance, including negligence of personal hygiene

  • Disturbances in sleep (either oversleeping or difficulty falling or staying asleep)

  • Expressing hopelessness or suicidal thoughts

We might gently ask question or raise our observations in a way that allows a client to see for his/herself that they would benefit from seeking more specific help. We may also help normalise the idea of therapy for someone who would otherwise find the idea of therapy as challenging.


Thirdly, coaching and therapy are not an either/or: a client might benefit from working with a coach on how to function in their professional and personal lives whilst dealing with mental health challenges and at the same time seek specific help in alleviating those conditions. Having a coach who understands and appreciates what they are dealing with in addition to the challenges of every day life may be very supportive, especially if they are unwilling to share this information with a manager.


WHAT GETS IN THE WAY?


In the time that I have been mentoring or training coaches, many have voiced concern about working with clients who might be experiencing psychological distress because they lack the training or skills to support a client's distress and may cause harm or feel overwhelmed themselves. This may cause a coach to veer away from deeper issues, but we will better serve our clients if we resource ourselves to be able to attune to them, refer them when necessary and seek our own support in supervision if we feel we are 'in over our heads' or being affected by the issues that are arising in coaching our clients.


If the fear is that the client might not understand the difference between coaching and therapy and will expect a counselling approach from us, it might be good to prepare a distinction to share with a client in the initial discovery session. We might say something like, "In coaching our main work together is to explore areas in which you wish to move forward and get unstuck. If in that process you discover issues that would benefit from you working with a counsellor or therapist we can explore together what sort of support you need and how best to get it".


WHAT ARE SOME USEFUL DISTINCTIONS?


Coaching can offer therapeutic benefit to clients without being therapists. Providing clients the time and space to unpack and reflect on what they we are dealing with is crucial in facing stress, anxiety or mild depression.


This is distinct from helping a client who is experiencing issues that impair daily functioning to seek the help they may need. Indeed a trusted relationship with a coach might be the first step to uncovering and identifying issues for which a client would not otherwise seek support.


At this time access to therapists may be limited but coaches can offer a therapeutic service to our clients by providing space for our clients to feel heard and seen and know that they matter. We all have therapeutic relationships in our lives, both personal and professional. We might find relief in speaking to good friends, family or neighbours, a sports partner, a beauty therapist or hairdresser. What is important is to offer the appropriate amount of support according to the relationship boundaries and our capability and training.


A HELPFUL METAPHOR?


I often use the metaphor of being a yoga teacher helping yogis to understand through a practice of postures where their bodies might benefit from more detailed attention or where there may be potential injury that needs more than modifying a pose. A good yoga teacher will notice when a yogi is finding a pose difficult and rather than encouraging them to push through will encourage them to feel into what is happening in the body, take it easy and seek support for potential injury.


WHERE DOES INTEGRAL COACHING FIT IN?


Because Integral coaching is coaching the person not the problem, we explore more than the surface level of behaviour and goals. In supporting a client to surface what is going on at a deeper level than they usually enquire, we may come across obstacles to moving forward such as difficult emotions and parts of themselves carrying unhealed trauma. It is important for us as coaches to continue to work on our own capacity to face what author Mark Epstein calls "The Trauma of Everyday Life". We can resource ourselves with practices and a community of support that allow us turn towards our own pain and suffering with courage such that when we are confronted with distress in our clients we do not flinch but can sensitively attune and offer appropriate support.


EXERCISES AND PRACTICES TO TAKE AWAY?


- Here's a one page article from the ICF website exploring how and when to refer a client to therapy. Here's a longer white paper exploring guidelines for referral in more detail.


- You could use the infographic from our previous blog to help clients distinguish between coaching, mentoring, consulting, psychotherapy and training or work on developing a metaphor about the way in which you work with clients


- Join a supervision group or engage a supervisor/mentor to help you reflect on your practice, identify when you may be 'in over your head' or need support if you are affected by the distress of your clients and help you continue to deepen your capacity to hold space for distress in yourself or others












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