Life Coaching and Mental Illness: A potential minefield?

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I recently read an intriguing article from one of my favourite Psychology Today contributors, Dr David Ley, on the rise of Life Coaching in mental health care. As a psychologist, he balanced the arguments for and against extremely well. However, he raised serious concerns about the role of life coaches in treating mental health issues. For example: “The majority of coaches are paraprofessionals who do not hold licenses or advanced education in the field of mental health”

If this is true, then it is also true that they are generally not held to the same ethical boundaries that licensed psychologists and counsellors are. However, Life coaching is on the rise and a quick search on Google for “life coaching for mental health” will bring up many pages from coaches whose claim is that they can help clients with serious mental health issues. Many of them say that “any support is good” and many of them are recovering addicts or people who have recovered from serious issues themselves. I can see the appeal of this approach but I clearly believe that given that coaching is presently unregulated and there is no need for a license, potential clients should be asking the coach some serious questions. Among my client base, there are clients who have been referred to me by life coaches who felt out of their depth and others who have good, bad and terrible experience (one who was diagnosed with bipolar via Facebook chat). I do fully recognise that Life Coaching can play a role in recovery. However, I fear that unqualified coaches will be putting people at risk due to lack of training and experience in vital areas.

If we take for granted that the amount of Life Coaching offers will increase (some also from disillusioned therapists), where could be the real potential for disaster in ethical terms?

Ethics and boundaries. The therapeutic relationship between client and therapist is regulated and upheld. This includes sexual contact, collection of payment and what a therapist can do to retrieve payment. Even though some coaching associations have a code of ethics, there is nothing to say it is mandatory. As there are no clear boundaries, coaches are free to do as they see fit especially concerning overdue payments and what they see as appropriate behaviour towards clients. On the ethical side, is it really right to be claiming that as a coach, you can deal with mental health issues without the training needed?

“Leaving a client”. Licensed mental health professionals can bring serious trouble on themselves if they are seen to abandon a client in need, for whatever reason. This goes even for the case that the “chemistry” is not there ( in which case, a referral should be made) or in the case of financial difficulty (where other resources can be found). Coaches are under no such obligation.

Privacy and Confidentiality. As coaching is not part of formal healthcare, there are no obligations under  HIPAA (Health Information Portability and Accountability Act). There is nothing, apart from self regulation to stop a coach talking openly about any case he or she is dealing with. It might even be the case that they are not aware of the subtle problems that surround confidentiality issues.

Suicide issues. As a therapist who has worked with suicidal patients before, I cannot claim to find it easy. Often the subtle clues that are given must be listened for by an experienced ear and even then, there is no guarantee that the right message is being picked up. Are coaches with their lack of high-end training the right people to be dealing with this?

Liability. Licensed mental health professionals must carry liability insurance. This is for the protection of clients who can have recourse for malpractice. I know for a fact that some coaches do have this but there is no obligation to do so.

There is no doubt that life coaching and other services of that ilk will become more and more popular as time goes on. As I said in a reply to a comment on one of my recent posts, I truly see a role for such services. However, roles should be clearly defined and for the good of the client, without overlaps or grey areas. I leave the last word to David Ley: Both the UK and Australia have tried to protect clients and ensure good outcomes, by setting up certification, monitoring and supervision requirements for the paraprofessionals.

Until such requirements come to pass in the world of coaching, if they ever do, it’s up to the coaches themselves and the informed consumers, to monitor for the above pitfalls. If you are a client seeking coaching, I encourage you to carefully interview a prospective coach, about their boundaries, their liability protections, the effectiveness and reliability of their methods, and make sure there are clear written guidelines around finances and confidentiality.

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Drnjenner

Dr. Nicholas Jenner, a therapist, coach, and speaker, has over 20 years of experience in the field of therapy and coaching. His specialty lies in treating codependency, a condition that is often characterized by a compulsive dependence on a partner, friend, or family member for emotional or psychological sustenance. Dr. Jenner's approach to treating codependency involves using Internal Family Systems (IFS) therapy, a treatment method that has gained widespread popularity in recent years. He identifies the underlying causes of codependent behavior by exploring his patients' internal "parts," or their different emotional states, to develop strategies to break free from it. Dr. Jenner has authored numerous works on the topic and offers online therapy services to assist individuals in developing healthy relationships and achieving emotional independence.

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This Post Has 17 Comments

  1. pinkagendist

    Life coaches are popular here in the suburbs and to be honest I find the concept very disturbing. It’s a gimmick and a dangerous one at that. I’ve heard (many) people talking about how they’ll help with diet/exercise/dress-sense/childhood trauma/relationship advice/finances etc. Anyone offering this hodgepodge of services is highly irresponsible, or deluded.
    The life coach, not being a professional, can only base his help on his own (anecdotal) experiences. This opens the door to a monumental spectrum of dangers. I’ve seen people spend fortunes on ‘changing their lives’ by following generic advice, only to realize they still felt exactly the same as they did before.
    In one of the more egregious cases a recent divorcee was told she had to emulate success to be successful. This meant living far beyond her means and not just squandering what she had accrued during her life but being saddled with a mountain of debt. And once the ship has sailed, here’s no recourse.
    It reminds me of the ‘gurus’ of the 70’s…

    1. Dr. Nicholas Jenner

      Thanks for the comment. The examples you gave are horrific. However, regulation would stop all of this.

  2. kkennard

    I agree with this. A few years ago, after my last attempt to take my life a friend recommended I see a hypnotherapist. Not sure if I was ever hypnotised, but that’s not the point. After a few sessions she asked me how I was feeling and when I said “dreadful” she replied that I was wasting her time and ended the therapy there and then. I was devastated and full of despair. I thought “I’m incurable!” Fortunately my GP referred me to an excellent registered CBT psychotherapist and I made good and lasting progress with him over about 10 sessions. I don’t know why the hypnotherapist treated me that way. I do know that it made me feel miserable at a time in my life when I needed a lot of support.

  3. suzjones

    I read this with interest – thankyou.
    I have just enrolled in a Life Coaching course here in Australia. I am taking the more advanced course as I believe the higher qualification is better. But, I just want to go on record by saying that life coaching in no way takes the place of professionals. That is my view and I doubt that would ever change. Life coaching can be used by a client in conjunction with the assistance of a medical professional. And in my opinion, life coaches do not have the experience or ability to diagnose mental illness.
    I am studying this because I believe I can help others just as I have been helped. But in my journey, I have visited professionals and taken medication. All things work together for a good outcome.

    1. Dr. Nicholas Jenner

      I wish you well in your studies. Your attitude is responsible and that is what is needed. However, as you can see from some of the other comments, that is not always the case.

      1. suzjones

        Which really is a shame.

      2. suzjones

        I was reading through my introductory materials last night and several paragraphs jumped out at me as they reflected our discussion.
        The first discussed one sentence “Life Coaches do NOT give advice”. It went on to say that a coach is there to encourage a person in developing goals and realising their dreams.
        It then went on to say that if at any time during coaching sessions, a client continues to bring up something in their life that is holding them back then it is the responsibility of the coach to refer them on to a registered professional for treatment.
        It also talked about how new coaches may be enthusiastic and wish to share their knowledge with everyone but that they need to set boundaries and stay within those boundaries.
        Just thought you might be interested in this. 🙂
        Have a lovely day.

  4. shythom

    i’m neither a life coach or a psychologist, but i would agree that life coaches should not be used for those with mental health issues. i do actually know some life coaches and they reserve their services for those who are just looking to help achieve some personal or professional goals. it’s stated up front that their services do not and can not replace therapy of which can be given by a professional psychotherapist or psychiatrist. i respect them for stating that up front. perhaps they have to state this – maybe the laws from canada are different.

  5. geekgirlau

    I had a horrible experience with a life coach who was an acquaintance.

    Knowing that I suffer from clinical depression, she decided that the ‘cure’ was to put the blame for my mental state straight onto my shoulders – apparently I just wasn’t being positive enough. And her actions were unsolicited – at no time had I contacted her for assistance or coaching.

    She managed to trigger all of my issues with rejection and abandonment, and months later I’m still on medication and undergoing therapy to deal with the fallout.

    I believe regulation and a code of conduct would be beneficial. I’m astounded that someone who clearly feels themselves to be ‘enlightened’ could commit such a dangerous and harmful act. And unfortunately I can’t even report her to a regulatory body because there isn’t one!

  6. Jenna

    I’m concerned about life coaching after a conversation with a good friend, who, with no relevant experience or training, has decided to become a life coach and start a website/business. I’m not sure if it will take off, but as an LMFT, this is alarming to me. I hold her in high respect as a person, but this seems like a dangerous field to me. She says that she’ll refer clients with a mental illness, but it seems to me that much of the work we do as MFTs is overlapped, except that we have an extensive education and supervision, as well as ongoing education and licensure to which we are held accountable. We are also highly trained to recognize and diagnose a mental illness that may very well not be apparent to a lay person. I’m also concerned about the difficulty in turning someone away who you might not be able to treat as well as a professional, but you have the financial motivation to keep them on as a client because you have so many less clients than a licensed therapist/social worker/psychologist would, so the importance of keeping a client may be important to pay your rent! She also notes that many people such as a handy-man can do better work whether they’re licensed or not, but again, it’s hard for me to imagine that our education was meaningless and that any person could do the job without training. It’s hard to even list the 1000s of things that we learned in school, supervision, and clinical practice (employment) that are relevant to helping our clients. I suppose it comes down to not knowing what you don’t know 🙁

    1. Dr. Nicholas Jenner

      Thank you for your comment. I share these concerns and often deal with clients who have been let down by life coaches. I think you have ask yourself what qualifies someone as a life coach and why anyone would see them as opposed to a therapist who can normally do anything and more that a life coach can do. Their marketing is often very slick and often gives the obvious impre ssion that they are therapists of some sort. However, many are just as your friend….not qualified and not really aware of what it takes to deal with mental illness. However they do and the loser is the client. It badly needs regulation.

  7. Just in general lol

    Hi, thank you so much for the article. I am searching for more resources to try to determine if intervention is needed. I’m concerned about a very impressionable mentally ill family member who after several years of “studying” under a personal development trainer is now publicly dressing up in costumes of “characters,” taking on different personalities and publicly and quite seriously referring to themselves in the third person while “playing” these different characters in imitation of the coach. At first we laughed, but it’s fully blown, we are talking over 100 costumes, now he’s making videos, I mean, the works. We are a little bit horrified because the person who is an adult, was not doing anything like this before this “training” and is now doing so in a very public way that indicates a severely false confidence we think is coming from the trainer who I am concerned also has some mental health flags going on.

    It seems like any professional would have a little more responsibility than to send a mentally ill person with a social disorder out into the world to do these things under the impression this would improve their reputation or business professionally. If that coach is unable to see the illness that is apparent to most people or doesn’t care, and there is no training or screening for mental illness and the person may be unaware of how deeply he is impacting the family member, where are the lines there? He has obsessively attended dozens of expensive courses a year and seems to be molding his life around these ‘trainings,’ and encouraged to engage in behavior which most would consider quite bizarre and disturbingly comical if not just straight up mentally ill. Which to me seems to be seriously exacerbating the his mental health status by compounding already very fuzzy and delusional social lines for someone who the family guesses is narcissistic and/or borderline with delusions of grandeur.

    He already struggles to socialize appropriately with deep interpersonal struggles due to the ongoing illness and unawareness or inability to acknowledge that illness despite the trauma it has caused. I’m just really concerned that the family member is not capable of seeing he is making a fool of himself and that people think he is crazy and it makes me sad to think that someday, he is going to have a really bad reaction when he realizes that people see him as mentally ill on full public display because he wouldn’t even understand why. He really believes everything the coach says so if the coach says, great idea, go act like 3 different people at a public meeting with costume changes, he does it, and people let him because everyone’s jaw is dropped in disbelief. The coach says he’s doing great, he believes it. But it really seems to be just giving a platform to the illness and asking this person to further compartmentalize their personality which already seems to be extremely disordered. Do we celebrate their unique brand of mental illness and support their crazy costume changes? Or do we say, oh my God, somehow, someway, we have got to get him some psychotherapy or what?

    Truthfully it’s humiliating the family member professionally and personally, who is unaware the behavior is disturbing and bizarre and lacks the critical thinking skills to assess the situation. Sometimes we think, maybe it’s not hurting anyone and he seems very proud of himself, he is choosing to make up and act out all these scenarios, but I’m worried about the long term effects of failing to get to the bottom of the illness in the first place and about the social perception damage to his psyche when someday he realizes that other people see him as a joke or mentally ill. We accepted that he would probably always be this way and never agree to help as of course he thinks he is intellectually superior to most people and overly competent.

    But I’m concerned this is actually making it worse. Is this just giving him more instability, fracturing his personality into all these different characters, continuing to script out the person he thinks he is supposed to be in all his already tremendous insecurity? When what he wants to be is always changing because he doesn’t have a strong sense of self to begin with? Harvard Business Review has a really good article on the dangers of executive coaching which express a lot of my concerns about this kind of primary approach to wellness through training which is a far more palatable life improvement path in his mind than actual therapy. I would really appreciate your insight because, I mean, I’m concerned this could be really damaging to his long term psyche and is certainly does not seem to be helping. But if this was going to happen anyways at some point, if this was underlying the whole time, at what point do you try to intervene when it’s a grown adult who isn’t physically hurting anyone? And at what point does the trainer need to be held at least morally responsible for taking an already mentally ill person with a personality disorder and further distorting their view on the world?? What regulations can fix that? Because I want to support them.

  8. Maggie

    I found this article as I am completing an online course for Counselling & Psychology which I am really enjoying but the last 10 lessons are about Life Coaching. I would never ever want to be a Life Coach and I am finding it very soul destroying as I want to become a Counsellor and have done for years. Why would they put all these assignments in with Counselling & Psychology. It has taken me longer to complete this part than any of the other 2. No interest in it at all and after reading your article I find it very shocking as I have had Counselling in the past. Luckily I had the treatment I needed and I now want to help others.