Coaching for Mental Health: Ethical Dilemma or Ethical Development?


“Anxiety is a basic ingredient of vitality”. Emmy Van Deurzen (Existential Psychotherapist).
To be alive is to experience dissonance and consequent anxiety. To be fully alive and vital means actively embracing all life’s anxieties and developing both personally and collectively. The only distinction between mental good health and mental ill health is an internal attitude and an external diagnosis.

The coaching model has been used successfully for several decades in the fields of sport, business management and personal development, and I would like to propose that it now be applied professionally in the mental health field.

The existing state mental health provision is currently undergoing review in line with contemporary research, the results of experiential projects, and the burden of the increasing numbers of people needing its services. The definition of normal and abnormal mental health is being reconsidered and some therapeutic interventions are being challenged as to their long-term effectiveness.

The objective of assisting mentally vulnerable people back to independent health and well-being is at present mainly undertaken by a dedicated but an overburdened mental health care system, with its dependence on medication and therapy. The Mental Health National Service Framework, launched in 1999, recognises its limitations and the need for a holistic integrated strategy, drawing on the expertise of users as well as carers, and supporting new projects and training initiatives.

Within this assignment I wish to address the potential use of coaching to complement existing mental health provision for the depressed, worried, confused and psychotic; and also to advocate provision of training principles of coaching in all areas of the NHS and supporting services. I understand the reticence of coaching organisations that advise avoidance of some psychological conditions (LCT p8). Supporting such an apparently fragile state I have found to be time consuming, erratic and challenging, but the results are encouraging.

The Mental Health Foundation, states that “1 in 4 members of the UK population will experience some form of mental health problem in the course of this year” ( The Department of Health informs us that depression will be the No 1 burden of care by 2010. “By 2020 depression is expected to be the second most debilitating disease world wide” Understanding depression. Preface. Depression Alliance identifies some factors contributing to this increase – peoples’ unrealistic expectations of life as promoted by the media, lack of support systems, increasing work pressures and diminishing ability to cope with life pressures; there is also a worrying increase in the numbers of young people affected.

Being human is a complex and at times unrewarding experience. Everyone has times of deep sorrow and enormous joy, and for balance life skills are required. Skills for successful living are learned from parents, teachers, friends and intimates. Without support and challenge from other humans we can lack the knowledge and motivation to realize the potential of our individual human experience. Coaching offers practical one to one or group support, taking into account the person in context, offering management and developmental strategies, and above all respecting individual creativity and abilities. Coaching aims to identify the life skills and resources necessary for the coachee to meet their individual and collective requirements and to “recognise and manage their internal state, and have a clear sense of purpose” NLP and Coaching. (p.149)

Life coaching exercises the mind to optimum health, as personal coaching exercises the body.

Making coaching available throughout the health service, or at least offering information about it in the Doctors surgery, could turn a potentially chronic illness into a merely temporary problem, and support a breakthrough to becoming a more fully contributing and vibrant human being. This would provide both a personal development and life management opportunity. Furthermore, a modified coaching intervention, complementary to community psychiatric provision (for those already in the mental health system), would take into account the coachee’s existing psychological survival strategies and dependencies, apathy and lack of trust, and, although needing a longer and more intensive process, could be equally successful. Arguably such interventions could prove cost effective for both the NHS and the individual.

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