As an EAP counselor, I was constantly needing to find someone for my client to continue to talk to after our session limit had been reached. Sometimes it actually was necessary for them to go into psychotherapy, but often it wasn’t. Instead what they needed was an ongoing opportunity to talk to someone about how they wanted to deal with their problems, and how that process was actually unfolding in real time.
As an EAP person, not only was it my job to help them find the “help” they needed, but also to follow up, and stay on top of an ongoing situation. The effect it has had on me cannot be overstated. It’s not that I have any major beef with psychotherapy so much as a realistic, experience-based sense of the effect looking for, and finding, psychotherapy for my clients has had on their ability to cope better, solve their problems, and move forward.
The picture isn’t pretty. Not because mental illness doesn’t exist, or that therapists are frauds, or because the ideas underlying treatment are all wrong. Rather it has to do with the real world context within which those services are offered. I’m talking about diagnostic codes, treatment plans, insurance reimbursement, co pays, full caseloads, preferred provider plans, non-sliding scales, licenses, liability insurance, quality assurance – it goes on and on. So often what I needed was someone to interact with my client in an ongoing, productive, mutually agreeable process.
The paradox often was that EAP’s would emphasize “prevention” – don’t wait, no problem is too small, not every problem needs therapy – but aside from referrals to credit counselors or divorce lawyers, too often I was in the position of sending clients who simply needed an ongoing conversation about how they were doing to psychotherapists or substance abuse counselors. I often felt like a gatekeeper funelling people into the “system.” I really didn’t have many options under the best of circumstances, but there were stretches due to reliable provider shortages when I would barely know the person I was referring them to, and would have to make do with assuring them they weren’t stuck if the fit wasn’t right, and that I would continuously monitor the situation, get back to me, etc.
That’s when I discovered coaching – as a source of valuable service to my clients, and as a new way of doing what I do best – helping. Coaching has reached a level of credibility that only the most insular would deny. There are generalists and there are those who have a niche. Most do great work, and there is very little complaining about results. In part that’s because the process is so straightforward and devoid of clinical language. It’s either working or it isn’t, and the expectation is that clients are smart enough and mature enough to sort out what’s actually working for them. Coaches have ethics codes, professional associations, reputations to protect, and many, like me, have clinical credentials they are choosing to maintain in order to convey seriousness of purpose, and the ability to detect problems that might, indeed, require mental health services.