Are coaches qualified to help with mental health problems?
Everywhere you look, the coaching industry is offering expensive services to help people with mental and emotional health problems.
I hear stories often about people losing thousands of dollars to coaches who claim to be able to help these problems.
I also hear people mention therapy and coaching together all the time, as though they are interchangeable, or comparable. But therapists and coaches are really NOTHING alike.
Anyone who is a licensed therapist, even newly graduated, has successfully met a tremendous amount of educational, training, and testing requirements to practice.
In contrast, ANYONE can call themselves a "certified" coach, a practitioner, a specialist, and it means absolutely nothing. No qualifications required at all.
The unregulated coaching industry is overflowing with people who lack any legitimate qualifications or expertise, but who use marketing to make themselves appear qualified to the public.
Licensed mental health professionals, in contrast, are legally and ethically prohibited from misrepresenting themselves and doing work outside of their scope of practice.
When industries are unregulated, deception and exploitation is common. It's important for the public to be informed, because there are no consumer protections in the coaching industry. When it comes to coaching, there are no standards, rules or boundaries that are enforced.
That means that anyone can sell coaching services for anything, and the burden is on you as a consumer to know what you are getting for your money, and who you are paying to help you.
You should have the right to accurate information about someone's qualifications, but coaches are under no obligation to provide that to you. In fact, being honest would potentially hurt their business. Would you pay thousands of dollars to someone with an associates degree in marketing (if that) and 36 hours of online training to help you with your trauma? I would hope not.
According to a recent article in STAT magazine about the recent onset of health and wellness coaching (cited below), "People without proper training, education, or experience disguise themselves as qualified experts."
So, what is a coach, specialist or practitioner? How are they different from a licensed professional? Are coaches competent and qualified to advise people with mental health issues like low self-esteem, trauma, anxiety, addiction, ADHD, emotional or relationship problems? Is it legal? Is it ethical? Is it safe?
The short answer is, ABSOLUTELY NOT!
The most important thing to know is that a coaching "certification" means absolutely nothing in the mental health world. Anyone can become a "certified coach," even without a high school diploma, in just a few hours online. That lack of consumer knowledge is being exploited, so let's take a look behind all the deceptive semantics and marketing.
Understanding what's happening
To illustrate what's happening with coaching in the mental health field, here is a short story.
Martha had always thought she might like to be a plastic surgeon. She understood that many people are deeply unhappy with parts of their bodies, and wanted to help them. Plastic surgeons make a lot of money, and command a lot of respect, which was also appealing.
For one reason or another, Martha never attended medical school. Maybe she didn't have the grades or exam scores to be accepted, maybe she didn't want to take on the student loan debt, maybe she didn't want to wait through all those years of school and training to be able to work and make money.
Maybe Martha only finished high school, or maybe she finished an associates or bachelor's degree, but doesn't like her job options. Maybe she isn't making much money. Maybe she's been a stay at home mom and doesn't have a work history (important work, but not the same thing as medical school). She still daydreams about being a plastic surgeon.
One day, Martha sees an ad on social media that says, "Become a certified body reshaping and restructuring practitioner in only 36 hours online! Unlimited income potential! No pre-requisites required!"
Martha is immediately intrigued, pays the $3000 fee, and signs up for the virtual program. In the program, they teach her how to cut the flesh of some fruit away to reshape and restructure it. They tell her that she just has to give the disclaimer that, "This is not surgery" and that she cannot use the credentials "MD." She CAN use "coach" or "practitioner" or "specialist," because those are not legally protected or regulated terms, so anyone can use them for literally anything.
36 hours of online training later, she gets her certificate and opens her own business.
Martha rents an office, learns a meditation she found for free off the internet to help people relax, and then beings to advertise her services to the public on social media. She sets prices that match the income she wants, and decides to charge $10,000 to reshape a nose, $12,000 to reshape a chin, and $8,000 to remove body fat.
Now YOU see her ad on social media:
"Are you unhappy with your body? Try NON-SURGICAL body reshaping and re-structuring with a certified practitioner!!"
Would you let Martha reshape and restructure the body parts you are unhappy with? Plenty of people will - because it sounds like she knows what she is doing, right? She's a certified practitioner! And non-surgical actually sounds appealing, because most people would rather avoid surgery. And you are so desperate to have your chin reshaped that you give her the $12,000 you have in savings. You end up septic, in the hospital, on IV antibiotics and potentially fighting for your life. Don't forget the additional hospital bills you would end up with as an added cost. And now you need to pay for legitimate plastic surgery, because of the damage Martha caused by not knowing what she is doing.
No one comes to stop her, because she is not registered and licensed with the Medical Board as a surgeon, and she has the disclaimer she had you sign that she is not doing surgery - even though of course, that is exactly what she is attempting to do. She is leveraging semantics (using word choices to be deceptive), assuming the public won't know better, and practicing plastic surgery without proper education, training, or qualifications of any kind.
You have the option to give your $12,000 to Martha, and take your chances with what she is doing,
OR, you can take that $12,000, and go to a licensed plastic surgeon to have your chin re-shaped.
In this country, anyone can give their money to anyone for anything, but that requires consumers to be on alert for fraud and deceptive advertising - so buyer beware!
If you think this story is not feasible or realistic, think again, because this is EXACTLY what is happening with coaches selling their services to the public in the mental health field. Making impossible or unrealistic promises, for work they are not qualified to do, and don't even understand, at exorbitant prices.
Another example is, would you hire someone who is not a licensed attorney to represent you in court? Why or why not? What if they have a compelling ad or website, and lots of followers on social media, and call themselves a "legal expert?" Or would you know to check that they have the proper education, license, and credentials before giving them thousands of dollars?
In the professional arena, no one is considered an "expert" without an advanced university degree in their field and a license to practice in their field.
Board-licensed therapists have the education, training, qualifications and legal permission to assess and treat mental health and emotional issues legally, ethically, and safely. Coaches do not.
What is a Licensed Therapist?
Education
Requires a Master's or Doctoral degree from an accredited university
(6-10 years of higher education)
Legally protected credentials that indicate the person has the necessary education to be a mental health therapist:
MSW = Master of Social Work
MC = Master of Counseling
MFT = Marriage and Family Therapist
PsyD = Doctorate in Psychology
PhD = Doctor of Philosophy in Psychology
Some Psychiatrists also provide therapy, but they are medical doctors (M.D or D.O) who are licensed to assess, diagnose and treat mental health issues with medication.
Licensure
Typically, Professionals who provide services to the public must obtain approval from the State licensing Board to do so - such as a doctor, a dentist, an attorney, a physical therapist, an accountant, etc. State Boards verify an applicant's qualifications and perform background checks for criminal activity. The Board issues a license to practice only to candidates who meet ALL the necessary criteria.
There are very good reasons why working in the mental health/ emotional health field requires so many years of education, training and experience, as well as licensure. There are no shortcuts to doing this work legitimately.
A license is intended to be an assurance to the public that this person has completed the appropriate education and has demonstrated the basic knowledge, competence, safety and ethical standards to practice within their profession.
The State licensing Board provides regulation and oversight of people who are working in the field to ensure they are operating according to the law. Licensure is intended to protect the public from exploitation, fraud, abuse and unsafe practices when they seek a professional service.
An important requirement of licensure is working within your scope of practice, which means only doing work you are legitimately qualified to do. For example, a therapist is not qualified to prescribe medication, because although many therapists have some knowledge about that, they do not have the appropriate education, training, clinical skills, or legal permission to prescribe medication safely.
If a licensed therapist commits an ethical, legal, or administrative violation, they are investigated and sanctioned by the state licensing body. If the violation is serious enough, the therapist can lose their license to practice. This is called oversight - it's responsibility and accountability for their work. The coaching industry has none of this.
Therapists must obtain a state license to practice before assessing or treating even a single person for any mental health issue in their particular state. An associate-level license is awarded once a person successfully completes a graduate (Master's) program, is vetted by the state Board, and passes a rigorous national clinical exam demonstrating they know how to do this work. Associate licenses include:
LMSW - Licensed Master Social Worker
LAC - Licensed Associate Counselor
LAMFT - Licensed Associate Marriage and Family Therapist
A person with an associate or master's level license must then have their work supervised for at least 2 years and provide 3200 hours of supervised work experience under supervision of a Board-approved supervisor before they become eligible to apply for the highest level license - a license to practice mental health assessment, diagnosis, and treatment independently. In some disciplines, like Social Work, the person must pass a second rigorous national clinical exam.
Credentials that indicate the person has met the standards to practice independently as a therapist are:
LCSW = Licensed Clinical Social Worker
LPC = Licensed Professional Counselor
LMFT = Licensed Marriage and Family Therapist
When a therapist has reached this independent level of practice, the state is placing a tremendous amount of trust and responsibility on them to practice safely, legally, competently, and ethically with the public. No other credentials or certifications are needed.
What does a license qualify a therapist to do?
A therapist is licensed to assess, diagnose and provide treatment for mental health issues, emotional and relationship problems.
What is a mental health issue or diagnosis?
One in 4 people live with a diagnosable mental health condition in the U.S.
Mental health and illness require competent clinical care and attention.
A mental health issue is ANY diagnosis or code contained in the Diagnostic and Statistical Manual of Mental Disorders. This includes hundreds of mental health conditions and life circumstances, such as:
-Anxiety Disorders
-Depression or Mood Disorders
-Trauma, PTSD or Complex Trauma
-Developmental or Attachment Disorders
-Complicated Grief
-Eating Disorders
-Substance Use Disorders
-Adjustment Disorders
-ADHD
-Symptoms of complex trauma such as low self-worth, imposter syndrome, an inner critical voice, a pattern of unhealthy or toxic relationships, etc. These are mental health issues that require competent clinical care.
Many coaches are picking one symptom of a larger mental health issue, such as "a pattern of unhealthy relationships" or "imposter syndrome" or "self-defeating behavior" and claiming to provide help for that. But these cherry-picked issues don't happen in a vacuum, they are symptoms of complex trauma - unhealthy relationships or negative experiences in childhood - and they can't possibly fully understand these issues, nor how to safely, ethically, and effectively treat them.
Furthermore, since a coach is not in any way qualified to assess ANY of these issues, how can they possibly know whether or not they relate to a mental health diagnosis and require competent treatment? The answer is - They can't.
What if they call themselves a "specialist" "practitioner" or "coach" for these issues?
None of these terms have any standards for what they mean about a person's qualifications. Anyone can use them for anything.
If they lack an advanced university degree and an appropriate state license, and they are providing a service for a problem a psychotherapist would work with, they are:
1. Infringing on the practice of psychotherapy, and
2: Quite likely attempting to practice psychotherapy illegally without a license.
State Licensing Board discipline reports reveal many unlicensed people being sanctioned and fined for providing services that fall under the scope of psychotherapy, even if they call it "coaching," or call themselves a "practitioner" or a "specialist."
Some therapists provide coaching services
Working as a licensed therapist has many requirements and responsibilities. Sometimes licensed therapists add coaching to the list of services they provide. If they do this, they have to be able to demonstrate that they are NOT practicing therapy with coaching clients and the two services are completely separate and different.
Some coaches were licensed therapists in the past, and have surrendered their licenses for the easier work of "coaching," with no requirements or professional responsibilities. If a therapist surrenders their license to practice, they are similarly not allowed to provide services that fall under the scope of psychotherapy, and are no longer allowed to provide assessment, diagnosis, or treatment for mental health or emotional issues.
More concerning, some licensed therapists have had their licenses removed for ethical, legal or safety violations, and they can then easily just market themselves and continue working as coaches instead. So, buyer beware!
What is a Coach?
The History and legal scope of Coaching
Coaching has traditionally been used to help already high-functioning people refine and improve their performance, such as athletes or executive coaching. The appropriate scope of coaches is helping people who are doing well, become better.
According to the International Coaching Federation, "a coach is responsible for discovering, clarifying, and aligning with what the client wants to achieve; encouraging client self-discovery; eliciting client-generated solutions and strategies; and holding the clients responsible and accountable for meeting goals and creating outcomes. For these reasons, coaching often relates to career development, achievement, and advancement."
According to the California Association for Marriage and Family Therapy, legally coaches may not delve into the past, provide a cure to a mental illness, or relieve mental and/or emotional suffering. Coaches may not seek to resolve the deeper underlying issues that cause serious mental and/or emotional problems. A coach who addresses issues of mental health or relationships without being appropriately licensed may be unlawfully practicing psychotherapy without a license.
So, coaches are NOT qualified or legally allowed to:
1. Work with problems such as anxiety, depression, ADHD, trauma, or relationship problems.
2. Ask questions about the past or explore the past with clients.
3. Attempt to relieve mental or emotional suffering of any kind.
4. Attempt to resolve underlying issues that cause the problems the client is having.
Think of it this way. If you wanted to start working out on a regular basis, it might be appropriate to hire a coach. But if you injure yourself, are you going to go to that same coach to evaluate and provide treatment for your injury? Hopefully, you'd go to a licensed medical doctor. That's the difference between coaches and licensed professionals. Coaches may help people improve performance, but licensed providers help people with problems.
To make things even more shady, many people who call themselves coaches, specialists, or practitioners actively discourage people from seeking therapy - Many coaching websites state ridiculous things that are myths and untruths about therapy and about therapists. They are discouraging the public from seeking appropriate care for their problems, and that is just downright unethical and wrong.
Coaches suddenly are experts at anything and everything - No degree required and no regulation
Now, suddenly there are self-declared relationship coaches, life coaches, trauma coaches, health or wellness coaches, anxiety coaches, nutrition coaches, a whole litany of coaches or supposed practitioners who have no legitimate education or qualifications to do the work they are claiming to do. That doesn't stop them from claiming they have solutions, and using marketing and buzzwords to give you a hard sell. They are disguising themselves as experts.
The coaching industry, precisely because there are no basic qualifications, no regulation, no oversight - is BOOMING. And people are deciding on their own that they can help people with all types of mental health problems under the guise of "wellness" - with no proper education or training.
Without proper education and training, they don't have a deep and competent understanding of these problems, they don't understand the risks and dangers to avoid, how to proceed safely, or even how to fix problems they may cause. Without proper education and training - from the outside, therapy might LOOK EASY to people - and they think to themselves, "I can do that!" But this viewpoint is out of ignorance.
When you watch a skilled juggler work, juggling looks easy, doesn't it? You might think the same thing to yourself, "I can do that!" But what you don't realize is the countless hours of training and practice it took to make it look easy.
When it comes to mental health problems, emotional problems, relationship problems, people need professional advice and guidance. "Client-generated solutions" is not applicable for mental health problems - just like it's not applicable for legal or medical problems - because if people could figure out these problems themselves, they would. Advice and guidance is exactly what coaches are legally prohibited from giving - because they are NOT QUALIFIED. But many coaches are providing exactly that - and consumers have no idea the risks and danger they are in, OR that they are working with an unqualified person.
Spoiler alert...if their superficial and simplistic solutions don't work for you, it will be framed as your fault or your shortcoming. You didn't "do the work" or "dedicate yourself" enough to get the results you wanted. Any unprocessed feelings of shame you are carrying around will lend themselves quite nicely to you taking the responsibility. Even though, wait for it... feelings of shame might have been what they promised they could help you with. I often hear clients blaming themselves for coaching services they purchased for thousands of dollars that "didn't work" for them.
But here is the reality...at best, you'll receive a superficial level of Information and tools that are readily available as self-help on the internet, such as re-packaged and re-branded Cognitive Behavioral Therapy (which is absolutely a type of mental health treatment).
Is information you could find yourself on the internet or in a $15 book really worth thousands of dollars? And here's the truth about self-help...it's not that helpful. It can't replace therapy or do what a good therapist can do. If self-help were effective, licensed therapists would have become obsolete decades ago.
At worst, it's potentially dangerous and can cause unnecessary hospitalizations and destabilization. An unqualified, inexperienced person delving into the past haphazardly can render people unable to function - because people are using intervention tools when they don't know what they are doing. It can also reinforce feelings of being "broken" or hopeless for clients when it isn't effective.
According to a recent article in STAT magazine (cited below), "There are no state or federal regulations around the term “coach.” Nor is there an authoritative, widely accepted accrediting body with educational or training standards. As a result, people without proper training, education, or experience disguise themselves as qualified experts to oversee the health concerns, plans, and goals or to address specific ailments, general complaints, or worries that people may have."
"Coach" is not a legally protected title or a regulated profession, which means that anyone can have a coaching business without meeting any requirements whatsoever. You could call yourself a certified coach today and begin marketing yourself as an expert in anything and charging people money. Many coaches charge even more than a licensed professional. I've seen coaching programs that cost almost $10,000.
There is no education or degree requirement, no state board exams to pass, no standardized demonstration of basic knowledge and skills, and no required supervision of work practices in order to market oneself as a coach. Coaches can literally say they do anything they want, and function however they want. But there are no guarantees of safety, confidentiality, or ethical practices for coaches.
What if a person says they are a certified coach and has lots of letters behind their name?
There is no regulation or universal standard of what coaching certification means. For-profit businesses have set up all kinds of "certified" coach training programs that are anywhere from 1 weekend long to 36 hours of training over 6-9 months. Some "certified" coaching programs require an associates' degree in any field (2 years of college), but many programs state there are "no pre-requisites required" (not even a high school diploma) to become a "certified life coach" in as little as 3 days at a cost of $1000.
It's all about marketing in the coaching industry, both by the businesses selling coaching "certifications" for thousands of dollars, and by the coaches themselves. They are selling simplistic solutions to complicated problems. And you've been walking around with your problems for a long time... you've tried lots of things. Why would anyone be convinced that someone without any relevant education or qualifications could have found the magic bullet to solve it? The answer is: Marketing techniques.
To make it more confusing (and deceptive), sometimes coaches have a degree or credentials in an unrelated field, but they use those credentials in their coaching practice to make themselves appear more qualified. Unrelated degrees are NOT relevant - just because someone has a degree in architecture or marketing, does NOT make them a relationship or a trauma expert! This is misrepresentation of qualifications, it is intended to deceive, and it is very unethical.
Coaches are doing a LOT of things outside their scope of education and practice.
According to the National Board for Health and Wellness Coaching about the scope of coaches, "Health and wellness coaches may support the implementation of licensed professionals’ treatment plans. On their own, however, coaches themselves do not diagnose, interpret medical data, prescribe or de-prescribe, recommend supplements, provide nutrition consultation or create meal plans, provide exercise prescription or instruction, consult and advise, or provide psychological therapeutic interventions or treatment."
However, if you google you will get thousands of websites of "certified" coaches who are marketing themselves as doing ALL of those things, sometimes very convincingly. Because when it comes to the coaching industry - literally anything goes, even when it goes against the statement of their "National Board."
Membership in this National Board is voluntary, and a very small percentage of coaches join. The obvious reason is, they don't want to have to abide by limits and ethical standards. They want to do whatever they think they can sell to the public, and they don't want to have to do the work to become legitimately qualified. They found a shortcut - but the public pays the price. To the tune of thousands of dollars.
If people who go into coaching want to help others, why do it through a loophole and under the radar? Why be deceptive to the pubic and disguise themselves as experts? Why not complete the education and training and meet the requirements to do the work they want to do legitimately? Why would someone not want to obtain the proper education and follow ethical and legal guidelines? All excellent questions to ask, as a consumer.
And why does any of this matter?
It matters because people with mental health and emotional problems are a population that is vulnerable to exploitation and fraud. People with problems are often desperate for relief or some quick fix. They are vulnerable to social media ads and shiny marketing that sounds so convincing. And in their desperation, they will part with thousands of dollars. That is exploitative and predatory. This is why state licensing boards and minimum standards exist - for protection of the public.
So, BUYER BEWARE.
Here are some links for further reading on this topic, and articles I used to inform this page:
Health care coaches are the next big thing. They’re also completely unregulated.
Coaching vs Therapy - legal opinion
Psychotherapy vs. Coaching: What’s the Legal Distinction?
https://www.goodtherapy.org/blog/Psychotherapy-vs-Coaching-Legal-Distinction/amp/
Therapy ‘coach’ facing charges in Utah County
https://www.deseret.com/2007/11/20/20054561/therapy-coach-facing-charges-in-utah-county