We’re sitting with a coachee, either in a first exploratory meeting or further along in the coaching relationship, and it dawns on us that the individual in front of us is contemplating suicide. Maybe it’s been stated openly, or maybe we’re getting the feeling that the coachee is moving in that direction. What should we do?
This may be an extreme situation, but as coaches we cannot know if and when such a dilemma will confront us. We can, however, be prepared if and when it does. Suicidal coachees or individuals dealing with other kinds of crises which affect their mental capacity deserve that we’ve thought through how to handle such situations, and it’s our ethical duty to make sure we’ve done our homework.
That’s why this time I’ll be highlighting two recent documents produced by the International Coach Federation (ICF). They were prepared with the express intention of ensuring we have guidance at our fingertips to clarify the most helpful options, as well as proven pathways to follow which we can be assured will help our coachees optimally. I’d recommend we read both of these documents carefully as soon as we can, and have the reference sheet with us at all times:
- When and How to Refer a Client to Therapy or Other Helping Professionals (reference sheet)
- Referring a Client to Therapy. A Set of Guidelines (the more detailed white paper)
A blog post can’t possibly do justice to all the valuable material presented, so here I’m focusing on 4 important topics:
- Things to remember about the guidelines
- Staying within our competency
- The key role of the coaching contract
- The Cluster of Signs model for spotting when coachee psychological distress demands referral to a mental health professional
1. Things to remember about the guidelines
The white paper makes it clear that the guidelines are a general set of recommendations based on the expert opinions of mental health professionals and coaches from specific countries: Australia, Canada, South Africa, the Netherlands, and the United States. Knowing this matters. As the foreword says:
Each individual is unique and it is important to tailor your support to that person’s needs. These recommendations will not be appropriate for every person. The guidelines are designed for providing assistance in developed English-speaking countries and may not be suitable for other cultural groups or those in countries with different health systems.*
It’s crucial always to be aware of the context of the coaching as well as of the coachee. So if you’re dealing with someone from a cultural group or country for which the guidelines may not be completely appropriate, or you’re based in such a culture or country, take this blog post as a prompt to do your homework in finding out what is appropriate in your context. If that means beginning a conversation with other coaches and/or professionals from other helping services (mentoring, consulting, counselling, psychotherapy…), then so be it. Coachees who are suicidal or in some other crisis situation can appear in any society. Be prepared.
2, Staying within our competency
We must always remember we are coaches. What we are trained to do is focus on “visioning, success, the present, and moving into the future” (as the white paper puts it). We are not trained to deal with “psychopathology, emotions, and the past in order to understand the present”. That is for mental health professionals such as psychotherapists. Coaching works with well-functioning individuals whereas therapy tends to make a difference for individuals with some level of dysfunction or disorder.
We need to be very clear as coaches that if we find ourselves out of our depth, facing something which we have not been trained to deal with, we need to invoke a strategy of working with the coachee to identify and implement a referral to another more suitable service. The ICF recommends maintaining an up-to-date list of other helping professionals for reference when needed, and as a resource for clients.
That said, if we are unsure or we need to discuss these matters in more depth with a trusted source of ‘wisdom’, we should take the opportunity to do so. It’s certainly an appropriate topic to raise with our coach supervisor, whether in relation to a particular coachee we’re dealing with or more generally. Our supervisor ought to have the insight to help us think it through, and should be able to point us to other sources of reliable information and input if we need them.
3. The key role of the coaching contract
Much confusion about what is a coaching issue and what goes beyond the remit of coaching can be avoided by crafting a well-thought-out coaching contract. Used skilfully, the coaching contract can be a tool for coach and coachee to set the parameters of what will be addressed in the coaching. Discussing this right at the beginning, along with the process of identifying the specific goals, can help reveal whether there are other issues below the radar which mean it might be better to refer the coachee to a different service.
The ICF white paper presents an example of the kind of clear statement setting out what the coach intends the scope of coaching to be which, if included in the coaching agreement, can open up right at the start a conversation about which service is most appropriate for an individual client:
Coaching is not therapy. I do not work on “issues” or dig into the past. I leave that work up to you. I assume my clients are whole and completely functional. We will look at where you are today and I will help you remove the obstacles, move forward, set personal and professional goals and take action to create the life you desire. If for any reason I feel other therapeutic professional services are required, I will request you get the help you need.*
Whilst we don’t need to use the exact wording, considering this example can open up for us a process of thinking through what exactly we are intending to provide for our coachees in terms of service, and the kinds of things we do or don’t want to work with. Including such a section in our own coaching agreements, and making a point of discussing it in the first exploratory meeting, can clarify aspects of how we intend to work with our coachees as well as put the issues they present within the wider context of what is currently happening for a them relative to their mental health generally.
4. The Cluster of Signs model for spotting when coachee psychological distress demands referral to a mental health professional
The white paper includes a list of signs of psychological distress, plus checklists of what to look for to identify when a coachee might need referral to a mental health professional in relation to common issues coaches may meet. These include:
- anxiety
- depression
- eating disorders
- post traumatic stress disorder (PTSD)
- substance abuse or addiction
- suicidal ideation
- thought disorders
A key point to understand is that as we work with a coachee, we can be looking for a cluster of signs pointing to the existence of each of these issues which can indicate the level of distress being experienced. We need to notice the duration, frequency and intensity of these symptoms because if the coachee is having ongoing distress, persisting symptoms, and repeating negative patterns, that’s when we need to be taking steps to make a referral to a mental health professional.
Many clients may be experiencing one of more of the signs and symptoms relating to a particular issue, but at a level where they can be appropriately addressed in the coaching. We need to draw a line for referral to a health professional when we feel our qualifications and experience are not at a level to help the coachee, or our contract does not cover the extent of what is being revealed.
For those of us who may find it difficult to introduce the idea of referral to a coachee in need of specialist help, the ICF has provided a checklist of ways of approaching the task, including special advice on what to do in emergency situations. This input is especially helpful, since it provides guidance from professional sources on tried and tested methods in which we can have confidence.
I hope this brief dip into the ICF’s material on referring clients to therapy will spur us on to think through carefully how we prepare for and deal with coachees in extreme situations. We owe it to ourselves and to them to be sure we’re well prepared.
These quotations are taken from the ICF white paper Referring a Client to Therapy. A Set of Guidelines, which is copyright the International Coach Federation April 2018. The second quotation was obtained by the ICF from Tina Elliot’s 2017 statement in Frequently asked questions about personal coaching retrieved from http://synergycoaching.org/general-faq.htm#g3.
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