June 30, 2022 by Lauren Gombas
While it’s rare, there may come a time in a coaching session where a referral to counseling needs to be made. This doesn’t necessarily mean that the coach needs to discontinue the coaching program, though there may be extreme cases where that may be the best course of action.
Coaches should look for the following red flags as signs to refer to a counselor:
It’s worth it to note that this is not an exhaustive list, but any of these circumstances should elicit a referral from the coach. Knowing when to refer a client can not only help them be better prepared for coaching, but could also be life-saving. Coaching is an extremely effective tool in aiding people, but it is not a replacement for counseling. The significant differences in training for counselors enable them to be prepared to address and help people struggling with trauma, mental health issues, and more.
In certain circumstances, the coach may need to take additional action. For example, suppose a client reports self-harm or suicide attempts or consideration. If possible, the coach should call the suicide prevention hotline with the client immediately after the client discloses this information.
Another situation in which additional action may be required is if an adult client reports that they experienced abuse as a child or a minor client mentions experiencing abuse. In this circumstance, coaches may be ethically and legally required to report abuse to legal institutions, such as child protective services. This is especially true if the coach serves as a mandatory reporter in another capacity in their life. Here, regulations vary by coach's and client's locations. Additional research on your state or country’s legal requirements is highly recommended.
Regardless of the situation, a coach can determine which actions to take by asking open-ended questions to understand the context. With context in mind, coaches should ask the client if they are already seeking help for the referrable problem. If so, the coach should reestablish coaching/counseling boundaries and ask the client if they’d like to continue in a coaching capacity.
Context is extremely important as there are ways to misinterpret situations. For example, a client who discloses using marijuana may be doing so for medical purposes. As another example, hearing voices can sometimes be related to stress or trauma, and not to a serious mental health condition.
When a client expresses a mental health concern, it is advisable to get more information on how it impacts them and what they would like to do. It is never a coach's job to diagnose or prescribe treatment. Instead, coaches can prepare themselves tospot mental health concerns and make an educated decision on referring a client.
Some patterns a coach should look for include:
Clients may continue to refer back to a moment in their lives that was painful or traumatic or experience lingering grief or regret. If a client seems to get stuck on something and it seems to interrupt their ability to work toward goals, they may need a referral.
There may be times when the client realizes that they are not ready for coaching. Coaching requires trusting the client to know what's best. In this situation, coaches can thank the client for having self-awareness, help the client find a therapist if needed, and remind the client that they are welcome to come back whenever they are ready.
Consider how Abdullah, a fictional coach, makes a referral for his client Dominique below.
Abdullah: "I've noticed you've mentioned experiencing insomnia and intense and frequent panic attacks each meeting. Unfortunately, this is outside the scope of my abilities as a coach. While I can continue to coach you around the goals we started with, I’m wondering if you have someone in your life you speak to about these more complex concerns?”
Dominique: "I haven’t really told anyone. Why wouldn't this be something that we can work through together?"
Abdullah: "In coaching, I don’t have the ability to diagnose or manage mental health concerns. My primary focus as a coach is to help you achieve your goals, but it seems like these larger issues may be getting in the way. A counselor will be much more equipped to help you manage your mental health. Based on some of the concerns you’ve presented lately, I think it’d be best for you to at least reach out to a counselor. What are your thoughts?"
Dominique: "Okay, I would like to work with someone who could help me figure out why I'm struggling. Does this mean that we can no longer work together?"
Abdullah: "Not necessarily. It is possible for the two of us to continue working together. What would need to happen first is for you to feel that the insomnia and panic attacks aren’t interfering with your ability to work through the action items set out in our coaching sessions. What do you think?"
Dominique: "I think I should work with a therapist first."
Abdullah: “Okay. I am happy to send a few referrals, but please feel free to reach out to people in your life who may have connections, as well. I also want to let you know that regardless of where you are in your journey, you're welcome to continue to use me as a resource and reach out."
Like Abdullah, a coach should provide information about why the client is receiving a referral and refrain from diagnosing the client. However, Abdullah also continues to ask the client open-ended questions to check-in and does a great job of reminding the client what is outside the scope of coaching. (It’s important to note that it may not always be possible to refer to a counselor, especially if you are in a different state or country from your client. However, having a few referrals in your back pocket is never a bad idea.) He also reassures the client that they are welcome back to coaching when they are ready.
Knowing when to refer a client can feel tricky, but the best advice is to stick to your gut. If you have the slightest inkling that a counselor may be beneficial, having the conversation about a referral is best practice. If done well, a referral is another way to show your client that you care about them, their wellbeing, and their success outcomes.
It's incredibly important to establish firm boundaries between what you can do as a coach and what a trained, professional counselor can do. As a coach, attempting to diagnose and treat problems and conditions that should be dealt with by a counselor can have lasting, damaging consequences on a client. These damages can range from addressing a symptom rather than the root and never resolving the issue, to causing irreparable harm to someone's psyche due to ineffective methods of treatment.
Understanding your boundaries as a coach established within the life coaching certification and scope of practice guidelines is critical in your daily practice.
*Disclaimer: The information mentioned in this article is for informational purposes, doesn't represent a complete list, and does not replace legal advice. Each client situation should be on a case-by-case basis.
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