A student asked me recently “Is there any disease/disorder (e.g. depression or else) where we as coaches shouldn’t work with someone or would need to advise them to first see a doctor?”.

This is a big question and probably warrants a more in-depth exploration than a short blog piece, However I am sharing here what I believe is the approach to take, which in short means, it really depends! Firstly, as coaches I don’t think we should ever be claiming that we can work directly with mental health conditions, such as depression, anxiety, trauma, etc. Coaching is not therapy. However, coaching can be therapeutic, and especially the approach we use, eg ‘Clean’ Coaching, can help shift long standing negative patterns of thought / experience, which can emerge during a session rather than brought as the main focus of the session. This draws a fine distinction and for each of us we need to decide / define what the ‘edge’ of our competence is, and know the scope of what we can do to help.

In any event, I would always be seeking to establish whether this person is still coachable, given their mental health condition. This is about the severity of their condition, whether it’s been diagnosed, whether they are on any medication, whether they have good coping strategies in place, existing support mechanisms, etc. It’s good to know all this up front, and useful to ask such questions as part of your intake process, then you can make an informed decision accordingly. This might mean ensuring they have some medical support in place in addition to the coaching. Or. you might decide to refer them on to a coach you know is also trained specifically in working with their particular mental health condition.

As one in 4 people are likely to have a mental health challenge at any one time, it’s hard to avoid completely in coaching. And bear in mind things could emerge during the process – the self-reflection involved in coaching could bring such issues previously ignored, hidden, and/or undiagnosed, to the surface. This means we need to continually review whether coaching is right for this person and recontract accordingly.

More on this question of being ‘coachable’: I believe it usually becomes quite apparent once you start to work with a client. So agreeing to an initial ‘trial’ session can help to establish whether coaching is suitable for this particular person. Below is my personal list of questions I ask myself, to decide whether the person is coachable or not:

  • Can they articulate a desired outcome? Can they focus at least some of their attention, some of the time, towards what they want, not just on what the problem is?
  • Do they believe change is possible? Eg they don’t perceive themselves as ‘hopeless and helpless’?)
  • Do they have the ability to self-reflect? For ‘Clean’ Coaching, I feel it’s important that the coachee is reasonably comfortable checking in with inner feelings, experiences, etc without instant blame of self or others. With some mental health conditions this is more of a challenge, again depending on the severity
  • Do they do what they say they will? Not possible to assess until session 2 or beyond, but this is a key one for me. Are they actually taking some positive steps as a result of the work we are doing together? That’s a tangible measure that the coaching is actually effective
  • Finally, how do I feel when I am coaching them? Are they bringing out the ‘Rescuer’ in me and hooking me into their pattern somehow? That would be a strong indication to me that it I need to question whether I am the right person for this coachee

Sometimes, feeling the answers to these questions are somehow ‘off’ are the only clue I have to an underlying mental health condition, as clients might chose not to tell me, or might themselves not know. It’s NOT our job to ever diagnose, however we can make a suggestion if we feel another kind of support would serve the client better. I would add:

  • If you have any emerging concerns (could be an intangible ‘gut feeling’), do take it to supervision. As the above shows, it isn’t always a clearcut yes / no decision and unpicking what’s going on with the help of a supervisor can help you make the right choice in service of your client / coachee. For instance, to suddenly decide to stop working with a client because they’ve just opened up and shared with you about their depression, or anorexia, or any other mental health condition could feel like a huge rejection to the coachee.
  • I wholeheartedly recommend a book “A Guide to Coaching and Mental Health” by Andrew and Carole Buckley. It’s a great reference book to explore potential ‘red flags’ to watch for with various mental health conditions and what to do about them. In many cases they advocate a coaching ‘alongside other support’ way forward, with appropriate contracting in place. They also have a general benchmark question around the degree to which the condition is affecting the person, which is “Is this person able to function relatively normally in the world?  eg they have a job, they have family and friends, etc. When a client is so affected by their condition that they are unable to work, go out etc, that would be a huge warning to me that this person requires something different to coaching.

Finally, the Clean Coaching approach I use and teach is especially helpful when coaching someone with a mental health condition for a number of reasons, which I will write up in a blog post soon.