Research Paper By Carol-Ann Furminger
(Life Coach, GERMANY)
When asking the average Joe on the street ‘what is mental health?’ The answers may include schizophrenia, depression, anxiety etc. However this is not a definition of mental health but is in fact a list of illnesses, disorders or conditions that can cause mental ill health.
This misconception is also often carried over to the coaching arena, I have personally heard coaches and ICA instructors state that ‘Mental Health is the area in which therapists/counsellors work’.
The World Health Organisation (WHO) defines mental health as: a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Rethink a mental Health organisation in the UK has a very simple yet descriptive definition of Mental Health Everyone has ‘mental health’ and this can be thought of in terms of: How we feel about ourselves and the people around us, our ability to make and keep friends and relationships, our ability to learn from others and to develop psychologically and emotionally. Being mentally healthy is also about having the strength to overcome the difficulties and challenges we can all face at times in our lives – to have confidence and self-esteem, to be able to take decisions and to believe in ourselves. Another way of phrasing mental health would be one of mental well being, as explained by Sarah Stewart-Brown, professor of public health at the University of Warwick “Feelings of contentment, enjoyment, confidence and engagement with the world are all a part of mental wellbeing. Self-esteem and self-confidence are, too. So is a feeling that you can do the things you want to do. And so are good relationships, which bring joy to you and those around you. Good mental wellbeing does not mean that you never experience feelings or situations that you find difficult. But it does mean that you feel you have the resilience to cope when times are tougher than usual.”
When taking these definitions into consideration, life coaching is perfectly suited to promote, support and maintain mental health. As coaching empowers a client to: acknowledge their strengths, investigate options, spend time on self care, set goals to reach their full potential then taking action to reach those goals. As summed up by Whitmore (2002) Coaching enables people to cope with life challenges, achieve their goals, improve performance and have a better quality of life. The coach works with the client not for the client. The Coach seeks tools and exercises, for coaching to support and assist the client. It is a collaborative approach based on equality within the coach/client relationship. A coach facilitates the coaching process but the client is ‘in control,’ as the client is the expert of their own lives. During the sessions, the coach uses mindfulness and active listening to be fully in the moment. They suspend judgement, as their opinion is not important and can in fact be detrimental to the client’s self exploration and burgeoning self awareness. Powerful questions, curiosity and intuition assist the coach in supporting the client to look deeper and discover underlying beliefs and values, that may affect decisions and undermine goals. Coaching empowers the client by giving them a safe confidential space to explore options, to try different perspectives regarding a situation. To trust and respect themselves in the choices that they make and therefore be able to always take responsibility for their actions. As Bora R (2010) explains The coach provides and holds a safe space within which the client can explore issues, hopes and goals, thus creating a healthy emotional environment. The concepts of choice and responsibility are central to coaching. By implementing coaching principles the coach is already promoting mental health even if this is not the intended outcome. As Kirby SD et al (1997) mention to promote mental health means to carry out any action that enhances the mental well being of individuals.
Unfortunately in many cultures there is still stigma associated with being mentally unwell. As noted by Bloch and Singh (1997) mental disorder and mental ill health stand world wide as being one of the most stigmatised of all human conditions. Now take into consideration that Joe Public doesn’t differentiate between mental health and mental ill health, it is easy to see why people are concerned about seeking support. This stigma can cause people to not pursue help or support in the form of talk therapy/counselling when symptoms or concerns are first noticed. At this point the person often just needs a supportive space to deal with issues such as: a difficult situation, dealing with stress, increasing self esteem, dealing with self doubt, making changes etc. However coaching does not have the same social stigma and as described above coaching is well equipped to support a client in working through these type of issues, as well working to increase self confidence and much more. It is also important to be mindful of cultural differences regarding mental health and mental illness. In one culture hearing voices may be seen as a symptom of mental ill health where as in another, it may be identified as a spiritual experience. As cited by White G and Marsella A. (1982) and Sheikh (2000) there is a growing number of sociological and psychological studies that emphasise a person’s perception of mental health and mental illness are governed by cultural ‘theories’ of illness and social behaviour generally. For coaches working cross culturally. They need to be be very aware of the cultural beliefs of the country where the client spent their informative years, as this can have a considerable impact on deciding whether coaching is appropriate.
There are several styles of coaching that lend themselves better to working with clients regarding mental health. These include: Cognitive Behavioural, Narrative, Recovery and Positive Psychology. Even though these approaches are different in delivery, there are still the common skills of: building trust, powerful questions, partnership, active listening, suspending judgement, mindfulness, working inline with clients strengths and values etc that are needed for these approaches to be successful. As these are all extensive approaches in their own right, the descriptions below are only a brief overview of two, to give an idea of why they can be beneficial in: supporting, maintaing and increasing mental health.
Cognitive Behavioural approach
In basic terms CB concentrates on the here and now and working towards a more fulfilling/happier future. Neenan & Palmer (2001) describe Cognitive behavioural approach as being based on a collaborative relationship that helps individuals to focus on problem-solving in a structured and systemic way. By exploring thinking patterns both helpful and unhelpful, seeing how those thinking patterns affect behaviour in daily life. Making the thought process a more conscious activity. Acknowledging and reflecting on positive thinking styles, while identify negative or unhelpful thinking patterns and seek out alternatives. It is important to remember that it is the client’s thinking regarding a situation or event that they have power over to change. Being able to identify and make this change of perception empowers the person to feel more in control and less anxious or stressed.
It is not until the client can maintain the new thinking style and behaviours that long term change will occur.
In order for a client to change how they feel about a situation, they have to change how they think, this involves taking a step back and questioning the thoughts and feelings they have about a situation and deciding where the truth is? How they would react if this situation was happening to a friend? Where is the evidence for what they currently believe? what is the worst case scenario and what is the best? By changing their thinking they also change the associated emotions.
Underlying core beliefs can affect how a client views a situation. Beck (1995) describes how to find an underlying belief by questioning each thought with “if thats true, what does it mean to you?” and to keep doing that with each thought until a “means that I am…..” statement is revealed this is the underlying belief. Once the belief is discovered we can then investigate the truth behind it and look at changing the belief to one that works in a positive way for the client.
Unhelpful thinking patterns include:
The thought patterns listed are some of the leading negative styles of thinking but not the only ones. Different books also give the styles different titles.
The Cognitive Behavioural Approach often includes ‘homework’ for the client, whether this be keeping a journal, practicing thinking patterns or exercises for looking at alternatives. The homework is important as it integrates the new styles of thinking and behaviours into everyday life and not just as an exercise within a coaching session. This is crucial if the client is going to maintain the change.
Positive Psychology Approach
Positive Psychology is a strong approach in coaching, as it takes the stand point that the client has strengths and positive attributes. The coach assists the client in discovering their strengths even the underlying ones, to use them in moving forward to fulfil their goals. Kauffman et al (2009) suggests that the coach views the client as whole and that the coach focuses on strengths, positive behaviours and purpose. Moore states there are two ways for improving our wellbeing: one is to rid ourselves of the negative things in our lives, the second is to strengthen those things that are positive, Positive Psychology emphasises the second.
This approach does not ignore negative emotions or issues but encourages a greater focus on the positive, through a perspective shift, looking at strengths of the client to produce a solution. By pursuing a more positive perspective the client is able to see the problem differently which makes it easier to navigate a path around the obstacles or change the goal. By being able to find the solution or change the goal the client is empowered, which increases positivity. Biswas-Diener (2007) describes how if a client has a set back it is not seen as a failure but as a way of building resilience, by learning from the situation. It is important to not overlook client set backs but to use them in building resilience. This is an important point as it further personal development and learning. Positive psychology is quite reflective in approach as the client reflects on their strengths and the positives in their life.
Similar to cognitive behavioural approach PPC relies on homework for the client to continue focusing on the positive outside of the session, such as gratitude diaries and each night listing 3 good things that have occurred during the day. By focusing on the positive away from the session it becomes a daily habit and a natural mindset.
As mentioned earlier there are many approaches and tools for supporting mental health, the two described do not need to be used exclusively or for the whole coaching journey. This is one of the benefits of coaching as the coach’s tool box is unlimited in the variety of tools available.
Ethical considerations
As coaching is not currently a licensed profession, clients do not have the normal recourse if they have concerns regarding issues such as confidentiality, data protection etc. This means that coaches have to be very aware of these ethical considerations, work to best practice and follow guidelines from organisations such as International Coach Federation or The European mentoring and coaching council.
Coaches who specifically work with clients regarding mental health also need to be aware of ethical of the importance of working within their own competence and capabilities. Having the knowledge and experience to be able to identify when mental health is changing into an area of ill health but not stepping into a mode of diagnosis can be very difficult. Knowing when to advice the client that coaching is no longer appropriate or needs to be in conjunction with other services but not having the professional ability of being able to make referrals. As Buckley (2007) explains what the coach needs is an ability to recognise when coaching may not be an appropriate solution to an individual client’s needs and to know how to proceed in a way that covers the best interest of the client and legal and ethical issues in place locally. This can become even more of a dilemma for coaches who work through another medium such as Skype and do not practice in the same country as where the client resides.
Buckley & Buckley (2006) advice coaches to ask the question“can coaching help?” not “can I help?” This subtle difference helps the coach with boundary management and reduces the possibility of inadvertently moving into a counselling mode. This will also support the coach in deciding whether coaching is in fact appropriate for the client.
The International Federation (ICF) has on its website for members a list of mental illness indicators. It advices coaches that if there are several indicators being presented by the client or the indicators persist for an extended length of time, a recommendation of seeking support of a therapist/GP/mental health services should be made. If the client appears suicidal then immediate action should be taken.
Conclusion
The aim of this paper was to question the general perception of what is mental health, to differentiate between mental health and mental ill health and to present the idea that coaching is a perfect method for promoting, and maintaining mental health. Even more so as coaching is seen by the general public in a positive light without the stigma associated with therapy.
After reading extensively for this paper, I am aware that coaching is already integrated into mental health services in both the USA and UK for issues such as addiction, in the form of recovery coaching. These services are being extended to assist recovery with many issues of mental ill health. Mental Health Services are trying to move away from a medical model to one where the client is empowered to be in control of their own lives. (Future Vision Coalition 2009) I have not discussed these developments within the body of this paper as I wanted to focus on mental health not mental ill health.
As poor mental health can affect physical health it is in society’s interest to promote and maintain good mental health/well being in the same way as is encouraged for physical health. This was not discussed within the body of the paper as it is an extensive topic and one that warrants greater attention that it could be given here.
Buckly (2007) states that one of the more important tasks facing the coaching industry is to develop a realistic and positive approach to the mental health/mental ill health boundary. I agree with this statement as I believe coaching has a vital role in assisting clients with mental health, the skills and tools used by a life coach are naturally conducive to this role. However, I think when mental health becomes mental illness then coaching can still be a very important approach but needs to be carried out by coaches who have furthered their skills and competence in this area.
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