Individual Therapy: Clinician or Coach? Find the Best Professional

A person is his or her late twenties likes his/her current job, maintains a few friendships from college, has been dating someone for a few months but is not sure whether the other person is “the one”, and doesn’t have a clear picture of his/her future.   S/he decides to consult a professional for some short-term sessions; should it be a clinician or a coach?  The answer quite frankly is either. 

A colleague attempted to refer that friend to me but the friend sought a “life coach” rather than a therapist because “you only see a therapist when you have a disorder.”   It’s time to clarify that myth.   I certainly help clients cope with a wide variety of disorders; however, numerous clients have also presented with a smorgasbord of life matters without having a mental health disorder.  

Well respected therapists are able to decipher when clients need broad perspective approaches when the presenting concerns are not disorder based.   Counseling sessions are often highly beneficial for clients who want to enhance their life goals.  Whether one is a coach or a clinician, establishing a few appropriate attainable short-term goals is a critical aspect to begin the process to work with the client.

Another key to the coach or clinician question involves the primary catalyst for seeking assistance.   I received a call from a former client; about three years earlier, she was one of two partners who sought couples therapy when their partnership was in crisis.   They worked collaboratively on the changes needed for themselves and finished the couples work within a few months.   Recently, she was considering a career change and acknowledged experiencing some stress.  Rather than take the case, I referred her to an Executive Coach that would be much more adept at helping her with the career decisions.  The Coach also agreed to refer back to me for therapy if the stress symptoms became overwhelming.   At the end of her work with the Executive Coach, the client’s stress had all but disappeared and she boldly made the career change with “no therapy required.”

Years ago, I received a referral for an adolescent who had been working with an Educational Coach about school performance matters but was not achieving significant progress.  My initial assessment with the student provided immediate clues as the student admitted to his “recreational” drug use, whose frequency and complications truly was a case of substance abuse that required appropriate treatment.   Once the student ceased the drug use, he returned to the coach for the school performance matters and subsequently increased most of his grades by “two letters” during the next semester. 

As a clinician, I am disappointed when my credentials as a mental health counselor have me “ruled out” compared to seeking the services of a life coach.  Clinicians often bring a wealth of life experience and clinical expertise to their counseling sessions.  Clinicians often work with clients on present circumstances, and when necessary, make connections to past experiences or behavioral patterns. 

There are also several coaching specialists that offer specific experience that will result in goal achievement without a clinician needing to be involved.   Whether you are considering coaching or counseling, review the credentials of the prospective professional.   Ask them about their comfort zone to refer and consult with other clinicians and coaches.  Then make the best choice of a professional match for yourself.  

(Thanks to Dalia Marvin, Owner, Think BIG Tutoring and Coaching and to Scott Boozer, Director of Executive Development at First Data for their consultation and feedback related this posting.)

Couples Therapy: The Art of Compromise

Two spouses are really struggling with a decision related to their financial planning, and each person has a strong opinion that keeps them locked in conflict without any movement towards resolution.   What happens next?

Whether the precipitating event causing conflict is related to finances, parenting, extended family, career moves, sexual intimacy or spiritual beliefs, the key towards resolution is to have each spouse listen and understand the other’s perspective.  The ability to compromise begins when both spouses can perceive true empathy for their spouse’s viewpoint.  When an opposing viewpoint is held by the person we choose as life partner, it is critical to let down your guard and begin negotiating.

Negotiations result in one of three outcomes:  Spouse One’s recommendation is fully adhered to, Spouse Two’s recommendation is fully adhered to, or some combination of both party’s recommendations are agreed to.   Quite frankly, the third option may not always be the best solution.   At times, the art of compromise requires respecting and implementing the other party’s perspective. 

Couples therapy involves both having compassion for the spouse’s perspective and determining when joint decisions require each person yielding some of the control or outcome.   When the negotiation process gets adversarial, the role of the therapist is to help the voice of each spouse be heard, not necessarily to wear a referee’s uniform (truth be told, I have mentioned to a few couples that I was ready to pull out my referee’s whistle to reduce the tension in the room).   Eye contact and reflective listening are critical skills used in making joint decisions.  The therapist also reminds the couple the reason for being there: both parties love another and finding the method to resolving differences is a key towards “life-long happiness.”  

Early Recovery Group: Relapse Prevention Strategy

The catchphrase “cunning and baffling” is utilized at many twelve step groups and substance abuse treatment programs to describe the cognitive rationalizations that often lead addicts back to relapse.  The disease of addiction can lie dormant for months and/or years, but when presented with an opportunity to strike someone at risk for relapse, rationalization can be as quick as a rattlesnake.

The secondary drug of choice is a pattern that raises a red flag.  Some examples include the following:

• The recovering heroin addict who starts smoking marijuana "on occasion"
• The cocaine addict who goes out to a bar drinking beers with friend and finds a coke dealer
• The prescription medication addict who returns to drinking wine with dinner (a glass of wine quickly became a bottle of wine at the meals)
• The crystal meth addict who continues to use poppers during sex

Clients recalling the beginnings of their relapse histories often recognize that the road back to their primary drug of choice began with use of a secondary drug.  If one’s mind focuses only on avoiding the source of the primary addiction, that person is at risk for rationalizing use of another alternative.  Someone with a diagnosis of chemical dependency must refrain from all mood altering chemicals, not just the primary drug of choice associated with the addiction diagnosis. 

Confronting the grief associated with letting go of the belief that one can never engage in “social drinking” or “recreational use” remains a critical component of relapse prevention for clients diagnosed with chemical dependency.  Comprehension of this concept is critical to achieving long-term sobriety, let alone lifetime happiness.