When questions arise over the mental wellbeing of a client, it is vital that the coach and the coaching-scheme organiser know how to act in the client’s best interests
“Mental illness affects all of us at some time, either directly or through friends, family or work colleagues. It is no respecter of gender, wealth or position,” says Dr Mike Nowers, consultant psychiatrist, in his book A Guide to Coaching and Mental Health. Indeed, it is not uncommon to find that many people in the early stages of a severe problem or with a ‘grumbling’ issue are active in the workplace. Yet there is still a stigma around mental ill-health and psychological issues, so individuals may not acknowledge that they are struggling. Statistically, coaches are more likely to encounter depression than stress. Depression can lead to a long period of low moods, and poor decision-making and performance; in severe cases the person is almost incapacitated and may even contemplate suicide. Neither the coach nor the purchaser/provider of coaching services should attempt to make a clinical diagnosis – this needs to be done by a medical specialist. It may be helpful, however, to make a preliminary assessment: Does the client show any of the following signs?
- Markedly depressed mood
- Loss of interest or enjoyment in usual activities
- Feelings of worthlessness
- Reduced confidence
- Ideas of deliberate self-harm or suicide
- Disturbed sleep or appetite
- Diminished libido
- Feelings of fatigue
- Poor concentration
Is coaching appropriate?
Coaches should always consider whether coaching is appropriate in these circumstances. They need to evaluate whether psychologically the client can engage in and benefit from the coaching, or whether more medically orientated help is appropriate. The coach needs to understand that certain people will have temporary or more permanent mental health issues that will prove to be barriers to effective coaching. They have to be able to recognise the signs that the client is psychologically unfit for coaching. Key indicators include:
- Is the client’s appearance unkempt?
- Is their body language hostile?
- Is their behaviour agitated, uninterested or evasive?
- Could their mood be described as apathetic, sad or hopeless, inappropriately optimistic or overly pessimistic?
- When expressing thoughts are they preoccupied, fixated, irrational, or delusional?
- Does their perception of life appear unreal or do they manifest an abnormal viewpoint?
- Has their intellect changed or do they appear not ‘present’?
Alternative help
Coaches need to reflect on the ethics, legalities, practicalities and circumstances and answer the question “Is coaching appropriate?” If not, they should signpost the client to alternative help. Once the coach has identified a definitive sign, check if there is any substance to the problems and any rational explanation. One approach is to use the PPP questioning system. This is based on:
Past
- What is the history of this behaviour or feeling?
- How long has the client had similar feelings?
- Has this happened before?
Pervasive
- How much of the client’s life is involved?
- Is this a home issue that has crossed over to work?
- Is it a work issue affecting home life? Or are all parts of the client’s life affected?
Plan
- Does the client have a plan?
- Is it positive and realistic and is there commitment to carry it out?
This method covers history, the extent of the problems and any plans that may help the client return to a more ‘normal’ function. Finding the answers to the PPP system will help the coach proceed. The coach may then choose to:
- continue – but with care and caution;
- continue – but with support from the client’s GP or a therapist;
- stop coaching or, in extreme cases, call for emergency help.
Case Study: Robert
Scenario 1
Robert seems really low and shows signs of possible depression. He says: “This all seems so pointless, I don’t know why I’m here.” Questioning using the PPP system reveals that he has broken up with his girlfriend, has left their shared flat and is now living with a friend. When you ask about coaching he says it is helpful as it focuses on the future and the way things could be (at work). Work seems to be providing a sense of belonging. You decide to continue coaching, with the knowledge that the progress may be slower than expected as Robert comes to terms with his new circumstances. Robert is ‘grieving’, a perfectly normal process, and the expectation is that over the next few months he will return to normal.
Scenario 2
Robert comes to his next session looking dishevelled and very depressed. You discover he has left his friend’s place because of his drinking. He says he has stayed with another friend, slept at work and walked the streets all night. When you express concern, Robert says: “What’s the point, there’s no future for me. All my life was supposed to be with her.” You are now seriously concerned. Robert is severely depressed, if not suicidal, and it is time to take action. You may be able to contact a family member, bring in HR, welfare or a medically trained person. If no other route is available then get him to his GP or even an Accident & Emergency department. The views of the coach, client and any sponsoring organisation need to be considered in any such scenario. A business may feel it is an inappropriate use of resources for a coach to work with a client who has mental health issues.
The coach also needs to consider any code of ethics and good practice subscribed to as part of professional membership, which all include items concerning referring on and not working beyond competences. Coaches need to remember when dealing with a client with a mild mental health issue that signs of mental illness are all around, particularly if specifically sought out during conversation. However, it is prudent to take a balanced approach before deciding if action needs be taken. The coach needs to view the client holistically, before forming an opinion while recognising that the unusual, even the bizarre, may have a rational explanation.
Further reading and practical resources are available at: www.cipd.co.uk/coachingatwork
Andrew Buckley is a coach, accredited by BACP as a counsellor and psychotherapist. See also, Buckley, A and Buckley, C A Guide to Coaching and Mental Health – the recognition and management of psychological issues Routledge (2006)
Tel: 01263 862286
Email: andrew.buckley@kipepeo.co.uk
www.kipepeo.co.uk