The Fine Line Between Leader Coaching and Therapy

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

“Where do you draw the line between coaching your staff and doing therapy?” This is a question I have been asked many times recently by frontline nurse leaders as they work with younger staff with very high anxiety levels and seasoned staff still traumatized by the COVID experience. There can be a fine line between coaching and therapy, but leaders must avoid crossing it when possible. The International Coaching Federation has issued a whitepaper for coaches providing helpful guidance.

Part of the ICF guidance is to ask yourself this question about conversations you have with nurses – “Do the issues we discuss interfere with their ability to manage their daily activities and perform their work responsibilities?” If they have recurrent panic attacks and emotional meltdowns – the staff member probably needs a referral to a mental health referral if they are not already under treatment. There is a difference between coaching and therapy.

When coaching, you do the following:

• Help the staff member vision success.
• Help the staff member plan for their professional future.
• Help the staff member maximize their personal and professional potential.
• Help the staff member develop skills to manage their personal and professional growth.

When therapists work with clients, they do the following:

• Help the client explore reasons for emotions.
• Help clients examine their past and the impact it has on current behaviors.
• Help clients to work on emotional healing and trauma recovery.
• Help clients to develop skills to manage their emotions.

As nurses, most of us have at least some behavioral health education. We learn to have conversations with emotionally distraught staff and patients. This is helpful in our leadership but can also make the boundaries less clear about coaching versus therapy. From a dimensional mental health perspective, healthy functioning can be seen on a spectrum instead of present or absent. Leaders need to take action and make a referral when a staff member displays signs of loss in their mental health and functioning.

Many nurse leaders tell me they know when they have crossed the line, but it can be hard to pull back without looking like you are rejecting the person. If interactions with a staff member cause concern or discomfort, you are probably past a point where coaching will be of value. If the emotional problems keep resurfacing and the staff member is not progressing after a reasonable time, you need to refer the staff member to therapy.

Once you have determined that the staff member might benefit from seeing a mental health professional, you should bring up the subject in a supportive way. Your role is to provide support, offer options, and identify resources. Become knowledgeable about your organization’s employee assistance program before you make the referral. You want to normalize mental health issues and treatment, but be firm about the need by telling the staff member – your well-being is my primary concern, and you need more help than I can professionally provide. The choice to seek help must be the nurse’s decision, so keep the lines of communication open.

 

 

 

 

 

 

 

Other Programs/Books Your Leaders May Find Valuable

From Traditional Nurse Leader to Nurse Leader Coach – Click Here for the Flyer

For new leaders and emerging leaders, consider doing The Nuts and Bolts of Nursing Leadership Program – Click Here for the Nuts and Bolts Flyer Final

New Leader Development Option in 2023 – Team Coaching Designed to the Unique Needs of Your Organization  Leader Coaching Brochure

Read the Nurse Leader Coach – Available at Amazon and Other Book Sellers

Recommended Book by the Association of Critical Care Nurses – The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success