Therapy Referrals (Ed Batista)

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It's not uncommon for coaching clients to request a referral to a therapist, and on occasion I proactively suggest working with a therapist in addition to or instead of coaching. A list of therapists I recommend can be found below. While coaching is in some sense related to therapy, it's important to understand the limitations of coaching as a methodology, the situations in which it's not an appropriate or effective form of support, and the ways these two distinct forms of helping can complement each other.

The Distinction Between Coaching and Therapy

My own understanding of the distinction between coaching and therapy has been informed by a set of experiences with both disciplines: My coach is also a therapist, and my work with her beginning in 2001 has encompassed a range of professional and personal issues; my wife Amy and I benefited tremendously from our time in couples counseling after we completed graduate school; my father has been a practicing clinical psychologist for nearly 50 years; and I talk regularly with colleagues in both fields.

While the primary focus of my practice is on my clients' professional fulfillment and effectiveness, we frequently discuss a range of topics that transcend organizational life, in part because what's happening in the rest of our lives affects how we show up at work--and, in turn, what's happening at work affects how we show up in other domains of life. In some cases these topics involve issues that a client should pursue with a therapist or in another helping relationship.

For example, I regularly talk with clients about anxiety, a common experience for leaders facing daunting responsibilities. Everyone is subject to anxiety at times, and coaching can be helpful in managing it at moderate levels. But severe anxiety (e.g. lasting for an extended period of time, pervasive across many domains of life, impeding normal functioning, accompanied by other physical or cognitive symptoms) requires treatment by a trained mental health professional.

I talk with all clients about their working relationships, and in some engagements I work with two or more members of a leadership team, most frequently a pair of co-founders who are experiencing difficulty. At times these clients are determining whether they want to continue working together, but even then our focus is on how the relationship can best meet the needs of the business, rather than on the participants' personal needs for fulfillment in the relationship.

And I talk with some clients about painful formative experiences, such as dysfunctional family dynamics, being bullied in adolescence, or early failures and struggles. Such events can have a lasting impact on our sense of self and our career, and in some cases clients raise these issues with me not seeking treatment or resolution, but because they want me to know more about their background so that I can better understand them and their current professional challenges. But in other cases these events result in trauma that needs to be addressed in therapy, not in a coaching engagement.

The Relationship Between Coaching and Therapy

When a client is considering both coaching and therapy, in some cases it's best to pause or defer coaching while the client completes a course of therapy. This may be because the issues appropriate to therapy are more urgent or problematic than the issues appropriate to coaching, and the former should be resolved before the latter can be addressed successfully. Or it may be that the client has a limited amount of time to spend in such conversations, and trying to pursue both simultaneously could leave them feeling "over-helped."

Also, in my practice I work with clients in long-term, open-ended engagements--the average tenure in my practice is currently 3 years--so it's likely that a course of therapy would be completed before a coaching engagement. (Although note that my practice is atypical in this regard--a report by HBR indicates that 90 percent of coaching engagements conclude within 18 months.)

But by no means is it necessary to pause or defer coaching in order to complete a course of therapy, and over the years I've worked with many clients who elected to pursue both simultaneously. In these circumstances the key is ensuring that the client is able to determine how these two helping relationships can complement each other. At times this is effected by drawing clear boundaries between the issues to be addressed in coaching and those to be addressed in therapy. As seen in the examples above, however, it may be unnecessary (or even counterproductive) to make such clear-cut distinctions.

I advise clients that we need to remain aware of the distinction between coaching and therapy in order to ensure that we're drawing upon my expertise as a coach and not trying to do work for which I'm untrained or unqualified. At the same time, if we interpret this distinction too broadly, we may fail to address important topics that transcend professional fulfillment and effectiveness--and as a result I may miss an opportunity to recommend therapy as an alternative or complement to coaching!

I never obligate clients to address any particular topics in the context of our work together--as a coach I'm not there to diagnose or even to propose an agenda. That responsibility is the client's. But a few years after launching my practice in 2006 I was working with a woman who was seeking to make a career transition. I thought we had successfully concluded our engagement when in one of our final conversations she disclosed that she'd been wrestling with a difficult personal issue that was much more important to her than her career. I felt that our work together could have enabled her to make progress in this area, and I asked why she hadn't discussed it with me sooner.

The reason was that her understanding of coaching presumed a sole focus on purely professional issues, and she didn't realize that our agenda could incorporate personal issues as well. Since then I've worked to ensure that clients understand that my approach to coaching is designed to support them as a whole person, and while there's never an obligation to discuss anything beyond their professional lives, there's always an open invitation to do so. This allows me to provide the help that will be most helpful--which may include recommending a therapist.

Therapists I Recommend

While the therapists I can recommend are based in the locations identified below, I believe they're all open to working remotely, so geography need not be a constraint.

San Francisco Bay Area

Beth Jaeger-Skigen, Psychotherapist

Chevalisa Bruzzone, Psychotherapist and Marriage and Family Therapist

Daniele Levy, Psychotherapy and Counseling

David Marcus, Silicon Valley Psychological and Consulting Services

Dietmar Brinkmann, Psychotherapy for Individuals and Couples

Jamie Bachman, LCSW, Psychotherapy and Consultation

Jay Sieff-Haron, Family Therapy San Francisco

Jenny Perini, Psychotherapist

Jessica Potter, LMFT, Integrative Trauma-Informed Therapy

Jodie Perelman, MFT, Psychotherapy

Jonathan Horowitz and his colleagues at the San Francisco Stress and Anxiety Center