Thursday, 31 December 2015

Life Coaching in a mental health context

Life coaching in a mental health context related to statutory services is not a new discipline.  However to date, the term ‘Life Coach’ has hardly been used, if at all.  A coaching approach for clients referred from primary and secondary care is usually delivered by external agencies working alongside statutory health teams.  Such agencies might offer coaching along the lines of a bridge building or recovery service.  Life coaching is poised to play a much larger role than hitherto.

Clients with long-term mental health conditions can often be ‘stuck’ and can suffer from poor motivation. Often this is down to the low expectations that surround the person who has a mental ill-health diagnosis. The client’s own expectations, hopes and goals may be positive and high but they will stagnate if not addressed by support teams.  Conversations about goals, hopes and aspirations are still rare in the statutory mental health field.

As a trained social inclusion bridge builder my role demands coaching dialogue and rapport.  The role also uses GROW techniques and life planning.  The initial assessment with client uses a wheel of life that deliberately incorporates mainstream social domains.  Bridge builders use this wheel or social inclusion 'web' because it is based on the belief that recovery takes place in mainstream.  The philosophy lies at the heart of social inclusion planning and has been promoted by Shepherd, Boardman and Slade (2008), the NDT (National Development Team) and influential mentors including Dr. Pat. Deegan.

An example of mainstream life coaching is my client David (name changed). He was referred to mainstream services through the community mental health team.  My first task with David was to establish rapport and for us to complete a mainstream wheel of life together. David took me through the social domains he had previously accessed and in what depth – a little, a lot or not at all.  Domains include areas such as education, employment, volunteering, the arts, sports, family and friends, cultural and faith communities.  We also noted down on the wheel names of significant individuals in any of the areas indicated by David.  The wheel started to look similar to the Recovery WRAP but with the social inclusion web there is less emphasis on harmony between different life domains.  This is because the segments are social domains related to the mainstream community. No one is expected to have an interest or experience in every single domain. 

The next stage of the wheel was to help David identify social areas where he wished to grow as a person.  This is how the coaching contract takes shape.  David identified up to three goals or areas that he wished to work on and I am contracted to write these up in order of priority.  I am also contracted to help enable David to access these areas within a specified time frame. 

David prioritised music practice as his main indeed, only mainstream priority.  He is a skilled guitarist and passionate about music with currently no mainstream outlets to back it up.  As the Arts bridge builder within the team, it is my responsibility to help David access a mainstream music outlet according to his requirements, as part of his recovery pathway. As bridge builder I also need to know which outlets exist locally and further afield. I give David as little or as much support as he requests in liaising with these venues.  Other areas of the contract are also discussed together – the question of disclosure, mainstream support, sources of funding if required. Again, the choice to disclose or not is up to the client when he or she accesses the venue.  I will never disclose on the client’s behalf.

I must stress that bridge building or mental health coaching is not mentoring.  In this case I happened to share a mutual interest with the client but I am not his mentor. Mainstream is the mentor.

Bridge building, life coaching in mental health can certainly help clients from being stuck. The contact with mainstream life based on their personal choices has a visible and measurable recovery impact.  This is not to say that relapses don’t occur but in almost every case where a client has sustained a relationship with mainstream over time, they have been able to pick up the mainstream activity again post-relapse. As Shepherd, Boardman and Slade put it: ‘Recovery takes place regardless of symptoms or problems’ (New Horizons research 2008).

I see life coaching in mental health as a non-support role.  A client needs as little or as much support as he or she requests.  A social inclusion life coach helps set up the process through which a client discovers a mainstream recovery pathway. If the client sustains this relationship independently that is all to the good. The bottom line is change but often all that is required for people with long-term mental health conditions is the opportunity to experience change.  Due to the culture of low expectation it is often the case that people 'stuck' in long-term health services are marginalised.  They can be excluded almost by default from simple processes of change and re-adjustment that the rest of us might take for granted. 

Mainstream life coaching allows a conversation based on personal goals, hopes and dreams.  Out of these conversations emerge SMART practical actions that take place in the mainstream community without stigma or prejudice

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