A Professional Emphasis Group of the Society for Human Resource Management Volume 6, Issue I

Reprinted with the permission of The Advisor, a publication of the Consultants Forum, an SHRM Professional Emphasis Group, and published by the Society for Human Resource Management, Alexandria, VA.
When Coaching Is Not Enough

Sometimes a personal coach may recommend that a client seek therapy.
How is this decision made?

BY PATRICIA N. HUNTER AND JEFFREY BLUM
As the coaching industry continues to grow, individuals and organizations are increasingly turning to personal coaches to help them advance performance and achieve higher levels of success. Emotional intelligence factors are recognized today as being critical to successful leadership. As a result, coaches often work with clients to improve their self-awareness, motivation, empathy and social skills.
When working with leaders and executives in these areas of emotional intelligence, professional coaches can find themselves in situations where they suspect that clients may need more emotional help than can be provided in the coach/client relationship.
Coach or Therapist?
How can a coach assess when it is appropriate to refer a client to a psychotherapist? First of all, it may be helpful to differentiate professional coaching from psychotherapy by identifying some specific goals associated with each field.
Professional coaches help with:
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 Issues related to work transitions, work performance or business direction.
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 Issues related to achieving a satisfying personal balance between work life and family life.
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 Goals clarification, action plans and direction.
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 Taking action quickly once direction is fine-tuned.
Therapists help with:
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 Issues related to relationships, family, personal life or substance abuse.
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 Personal issues that may be related to the psychological impact of early life experiences, emotional trauma or illness.
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 Exploration of overwhelmingly painful feelings.
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 Addressing feelings and the underlying reasons for behaviors such as the inability to take action.
Generally speaking, professional coaches should refer their clients to a therapist when they find that coaching alone can't help them. However, this may be hard to determine in a first session.

The decision to refer a client to a therapist might happen after the following has occurred:
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 The client has outlined his or her difficulties.
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 The coach has suggested various approaches for improving the situation.
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 The client has been unable to follow through on the suggestions.

Such a pattern would suggest that the client is deeply conflicted over goals — business success or changing careers, for example — or that there are personality problems (depression, interpersonal anxiety, paranoia) that interfere with following through on the coaching suggestions.
If the coach recommends therapy, will the client be offended or afraid that his company will learn about it and consider it a black mark against him? A therapy recommendation would, of course, be confidential. It is up to the client to decide what information, if any, he/she shares with the employer. We believe that it's a disservice to withhold information from clients that may be of significant help to them. Depression, for instance, can be a fatal illness. We must do anything we can to prevent that.
Examples
One executive who is referred by her company for coaching on work relationships may be highly motivated to understand how she is creating conflict with her peers. She may be receptive to feedback from the coach and, with practice, may be able to incorporate the coach's behavioral suggestions at her workplace.
Another executive referred for the same problem may be defensive and take feedback very poorly. He may not be ready to engage in the coaching process and may have an unusually hot temper. If this client's job is in jeopardy and he is unable to use the coaching process, the coach may recommend that he see a therapist to explore the underlying defensiveness and inability to use constructive feedback about his behavior.
Sometimes clients make the decision to seek help. For example, a young attorney who was passed over for partner and was therefore unhappy at his current firm sought professional coaching when he decided to leave the legal field. Through careful exploration, the coach discovered that the young lawyer really enjoyed his work and seemed to be quite good at it.
The client's unhappiness with the law as a profession was, in fact, more about his relationships with the firm's partners, his tolerance of their abuse and his personal approach to getting the work done. This client tended to procrastinate on certain key tasks such as writing, which can create havoc in deadline-driven legal work.
The coach found that the lawyer's life from childhood on had exhibited a pattern of procrastination as a result of his underlying perfectionism. Some of the behavioral steps suggested in this case included making written lists of easy-to-complete and difficult-to-complete tasks. He was advised to break the work down into small, achievable steps and put them on his calendar in designated time slots. Then, he could go to the partner who needed the work done and tell him how much time it would take to complete it.
The coach also suggested that the lawyer write a little script in advance of any new interaction. If asking for more time seems impossible, write it down first and practice saying it! Some perfectionists fall into the trap of all-or-nothing thinking and set up expectations for themselves that are not shared by others.
In addition, the coach referred the attorney to a therapist with good results. While the coach and lawyer continued to address behavioral action steps and plans related to his work, the therapist helped the attorney explore the deeper, underlying reasons behind his tolerance of situations that made him miserable.
In the end, the attorney stayed in the field of law, to which he was well suited, and handled some of his problems by switching firms. We recently learned that he is now a partner in his new firm.
It is our experience that everyone falls somewhere on a continuum between healthy and sick. The clients we have described were successful in many areas of their lives and were by no means dysfunctional.
We have had cases in which clients worked well with coaches and then reached a point at which psychotherapy was helpful. While working with a therapist, they continued to work with their coach on business matters. We also have had the opposite situation. Sometimes patients in psychotherapy consult with professional coaches while they continue to work with their therapists on personal and interpersonal issues.
In short, there is no hard and fast line between the people that need coaching and those that need psychotherapy; keeping an open mind to all available options is the best approach for helping clients achieve their highest personal and professional goals.
the advisor First Quarter 2001
Patricia N. Hunter is a consultant and coach with more than 30 years of experience. Based in New Canaan, Conn., her firm specializes in leadership development, executive coaching and career management. She can be reached at (203) 966-6114 or pat@patriciahunter.com.

Jeffrey Blum, Ph.D., is a licensed psychologist in private practice in New Canaan, Conn. He has published extensively on topics including couples therapy and relationship issues. He can be reached at (203) 966-7166 or signorblum@aol.com.
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Patricia N. Hunter Consulting LLC
11 Burtis Avenue
New Canaan, CT 06840
203 966-6114

email: pat@patriciahunter.com