Executive Coaching for the Normal “Non-Clinical” Population:

Fact or Fiction?

Dr Travis Kemp & Dr Suzy Green

Hosted by the Coaching Psychology Unit, University of SydneyFourth Australian Conference on Evidence-Based Coaching 2010

Once upon a time, back in 2004…

TK: Thesis ExaminerSG: Doctoral Student

• Key research finding: 52% of people presenting for a life coaching intervention reported significant levels of psychological distress on the BSI!

• The start of an interesting journey!

Our history…• Our background, experiences and context• Many long conversations around clinical issues

in organisational settings…• Complementary peer supervision…• Highlighted the importance of knowledge and

skills from both organisational psych and clinicalpsych in executive coaching!

• But there’s more that we’re still learning …

Our aim today• Name and introduce the elephant• Put assumptions to bed• Encourage proactivity

What is Coaching?• Coaching Psychology involves the

application of the research, theory and practice of the behavioural science of psychology to the enhancement of life experience, work performance and personal growth of normal (i.e., non-clinical) populations.

• Coaching Psychology Unit website

What is Coaching?• Coaching psychology is an applied psychology,

draws on and develops established psychological approaches, and can be understood as being the systematic application of behavioural science to the enhancement of life experience, work performance and well being for individuals, groups and organisations who do not have clinicallysignificant mental health issues or abnormal levels of distress.

• Interest Group in Coaching Psychology (APS)

Fact or Fiction?• Is this a BIG ASSUMPTION?

Fact or Fiction?• What evidence do we have to suggest these

definitions (or assumptions) are correct?

• What are your subjective experiences?

• Turn to the person next to you and discuss!

A bold study…• Exploratory study to examine the assumption

of “normality” of executive coaching clients

• Brief Symptom Inventory (BSI)(Derogatis & Melisaratos, 1983)

• A brief psychological self-report symptoms scale

• Nine subscales– Somatization, Obsessive-Compulsive, Interpersonal

sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, Psychoticism

A bold study…• Three Global Scales

– Global Severity Index (GSI) – weighted frequency score based on the sum of the ratings the subject has on each symptom (Boulet and Boss, 1991)

• Widely acknowledged as sound indicator of psychological suffering

– Positive Symptom Distress Index (PSDI) – reflecting the intensity of distress, corrected for the number of symptoms endorsed (Boulet and Boss, 1991)

– Positive Symptom Total (PST) – a frequency count of the number of symptoms the subject reported (Boulet and Boss, 1991)

A bold study…• Quasi-randomized convenience sample of 132

leaders (M=82, F=50)• All “clients” and “participants” were consulted

and consented to participate within strict boundaries of confidentiality

• Private, Public, Government• Wide cross section - First line leaders to

Enterprise leaders• Combination of self-presentation and directive

participation– Directed participants more likely to “fake good”

With disturbing results…

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With disturbing results…• Overall, 37.9% (n=50) of the sample were

classified as having caseness, which is substantially higher than that observed in the general Australian population (Andrews, Henderson & Hall, 2001)

• Men had slightly higher rates of caseness than females (39% v. 36%), though this difference was non-significant (t(130)=0.35, p=0.73).

With disturbing results…

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Preliminary Findings..• When compared to the gender norms

(Derogatis, 1993), highly significant differences were found between men and women on Depression (t(130)=-3.79, p<0.001), Anxiety (t(130)=-2.99, p<0.001) and Phobic Anxiety (t(130)=-5.84, p<0.001), such that men scored higher than women

Preliminary Findings..

•The distribution was higher amongst somatisation, depression, anxiety, phobia and paranoia

•Less so on psychoticism, interpersonal sensitisation

Preliminary Findings..• Results DO NOT support the assumption of

‘normality’ within the executive coaching population

• Significant and disturbing levels of psychological distress exist within executive populations

• The source of this distress is broader than depression and anxiety

• Men and Women do not suffer from the same conditions

Preliminary Findings..• Males recorded significantly higher scores than

Females on Hostility, Depression and Psychoticism

• Females recorded significantly higher scores than Males on Anxiety

• There were no significant gender based differences on global severity scores

Serious Implications…• The results of this preliminary analysis

present confronting evidence that the prevalence of mental health issues within the executive population is more than double that of the general population (Andrews, Henderson & Hall, 2001)

• This is even higher than previously thought (Baumeister & Harter, 2007; Cavanagh, 2005).

This is not new information…• Jenkins (1985) previously examined the

mental health of an executive population and found similar results

• This sample was not engaged in coaching

This is not new information…• Berglas (2002), noted dangers inherent in

executive coaching.• He warned when an executive’s problems

stem from undetected or ignored psychological difficulties, coaching can actually make a situation worse.

Serious Implications…• Evidence suggests that self report

measures of mental health suffer from bias through positive impression management: Respondents have a tendency to “fake good”

• Assuming this, the current results may be a significant underestimate of the prevalence of psychological distress within executive populations

Serious Implications…• Evidence from those presenting for

coaching from the general population has highlighted the phenomenon of coaching being used as socially acceptable alternative to therapy

• This requires further consideration and investigation within executive populations

Serious Implications…• Coaches who fail to recognise the

symptoms of psychiatric distress may exacerbate problems, and ultimately do more harm that good.

• (Spence, Cavanagh and Grant, 2006)

Other Implications?• What are some of the potential

consequences of coaching someone with a “clinical” disorder?

• Coaching someone into a “depressive episode” or a “manic episode”?

• Suicide eg: Turning Point

Ethical Implications?• What are the ethical issues?

– As Psychologists? – Regardless of my title, my client group and my applied practice, I am a Psychologist… Do no harm

– As Coaches?.... Not so simple…

Legal Issues?• Professional and business integrity• Duty of care• Culpability• Others?

Another elephant in the room…

• Psychologist’s are ethically and legally bound to practice within the boundaries of their experience, training and competency

• This means that many psychologists may be unable to work with clients who have diagnosable disorders…

Solutions:Black & White?

• Black & White approach: Non-psych coaches never to work with any executive coachees with any psychological distress or clinical issues? Categorical vs dimensional debate….

• Outcome: Significant reduction in population to work with given Trav’s research?

• Highlights importance of assessment and referral

Solutions:Flexible Approach

• Flexible approach: Non-psych coaches to assess and seek supervision in regard to working with those with psychological distress or clinical disorders

• Work simultaneously with a coachee who is currently seeking mental health treatment

• Highlights importance of assessment and referral

More Solutions?• Another assumption? Should we assume that

all psychologists can work with anyone with any type of psychological disorder? NO!

• Should all psych trained exec coaches work with with all coachees? NO!

• In what situations should they refer on?• Again highlights importance of assessment and

referral regardless of whether a psych or non-psych exec coach!

Questions, Questions, Questions?• So, who screens/assesses?• Why isn’t assessment conducted more often in executive

coaching? Time pressures? Assumption it isn’t needed?

• When it is done - What tools are used?• What do you do if you assess mental health issues?

How do you debrief? Can you continue to work with a coachee assessed as having clinical issues?

• What are the ethical issues relating to the organisation as client?

• Is mental health assessment adequately addressed in coach training (exec and life)?

Assessment & Monitoring

• “Participants are not immune to psychological distress and this may occur at any time during the coaching period, particularly if a significant life stressor or traumatic life event was to occur.”

• “Hence assessment of a participant’s suitability for coaching is an important consideration together with continued monitoring of psychological health during the coaching process”

• Green 2004

So how do we assess?• Coachready® Coachsafe®

• Other assessment tools: DASS, SWLS, GHQ• Extensive assessment: MMPI• Coaching Engagement Interview (a work in progress…)

Coaching Engagement Interview?

• What is included in this?– Review screening instrument - are there any concerns?– Physical & Mental Health History/Family History– Have you ever consulted with a psychologist/psychatrist?– Current Health Status/GP name/Current medications?– Drug & Alcohol Use– Current Health & Fitness Regime– Family Genogram– GAF Score?– Readiness for Change/Reasons for Change?

Coaching Engagement Interview?

• How long does this take?• What can be done prior to the assessment session?• Should all coaching engagements begin with a 1.5 hr

minimum session to allow for adequate screening & assessment for coaching suitability?

• How would this change executive coaching practice? The process?

Referral?• Self management is critical (Kemp, 2006; 2008; 2009; in press) • What training have you had in mental health

assessment?• Do you know when to refer? Do you know when you are

working outside your level of practice or expertise? What ethical guidelines do you adhere to?

• Who do you refer to? Psychiatrists? Specialist Clinical Psychologists? Counselling Psychologists? Experts in specific disciplines?

• Who is in your referral network?• Do you need to expand your referral network?

Supervision• Highlights importance of having a regular

supervision practice.• Also a clinician you can “call on” when you need

quick advice.• Group supervision can also be helpful…

•Multi disciplinary teams•Coaching Psychologist/Coach

•Clinical Psychologist

•General Practitioner

•Exercise Scientists

•Personal Trainers

•Specialist Physicians

•Business Experts

•Leadership Experts

•and on and on….

A Complex Dynamic

•Know Thyself? What are the limits of my professional practice?

•Under what circumstances should I refer on or do I want to refer on?

•Who is my “on-call” supervision buddy?

•Do I have regular scheduled supervision?

•Do I need to upgrade my mental health assessment skills? eg Mental Health First Aid•http://www.mhfa.com.au/program_overview.shtml

Take-aways

THANK YOU…

For more info…Dr Travis Kemp

travis@thetelerangroup.com.au

Dr Suzy Green

suzy@positivepsychologyinstitute.com