Research Paper: The Coaching Client And The Capacity For Autonomy: An Exploration

Research Paper By Radhika Bhalerao
(Wellness Coach, INDIA)

Introduction

‘There exists no standard by which to measure, diagnose, and study the presence of mental health; science, by default, portrays mental health as the absence of psychopathology’ (Keyes, 2005, p. 539). Discussions around mental health have rarely pivoted around improving life experience or personal development.

When coaching enters the arena of conversations around mental health and well-being, the constrained definitions tag along. This effectively blurs the boundaries between coaching and therapy. The International Coach Federation guidelines (Hullinger& DiGirolamo, 2018) stress the importance of coaches staying within their scope of work and their area of expertise. However, the blurred boundaries make it difficult to determine what this area constitutes of. Current research on the relationship between coaching and mental health is wanting. While many studies look at how coaching is performed, there is little focus on who the coaching client is.

This paper attempts to scratch the surface of defining the relationship between mental health, mental illness, and coaching. In doing so, the author identifies the capacity to be autonomous and the impaired capacity to be so as significant in classifying this relationship. The paper first looks at the concept of mental health, then the concept of autonomy, and finally ties the two together in the context of coaching. As such, this paper is an exploratory inquiry into the capacity of autonomy of a coaching client and its role in unblurring the boundary between coaching and therapy.

Understanding Mental Health

We know a lot about mental illness. It is a sustained and significant divergence from normal functioning that causes immense emotional anguish and obstructs a person from performing their social roles (Spitzer & Wilson, 1975). Yet how much have we focused on mental health?

Health, according to the World Health Organisation (1948), is not merely the absence of disease or infirmity, but a complete state of well-being (physical, mental, and social). Further, WHO (2005) defines mental health as “a state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community”. Keyes (2002) defined mental health as a state consisting of emotional vitality and positive feelings towards one’s life, adding that it also contains measures of positive functioning.

Keyes (2005)also makes an evidence-based assertion that mental illness and mental health are not the opposites of each other, instead, they are placed on individual but correlated axes. Therefore, he suggests, that mental health should be deemed as a complete state. Keyes (2014) additionally identifies components of mental health as being emotional, psychological, and social well-being. These include measures of life satisfaction such as interest in and management of daily activities, appreciating one’s personality, cultivating good relationships, social contribution, and integration, among others. Positive mental health has also been construed as including the ability to exploit one’s full potential, having a sense of mastery over the environment, and having a sense of autonomy, which is the ability to identify, confront and solve problems (Jahoda, 1958).

An important critique of hedonic (focus is on happiness, presence of positive affect and absence of negative affect)and eudaimonic (focus is on living life in a full and deeply satisfying way)perspectives on mental health is the non-inclusiveness of certain groups such as adolescents, migrants or populations facing discrimination (Galderisi et al., 2015). Here, it is also essential to note that it is Western understandings and cultural traditions that have informed most of the theory and practice of mental health and well-being (Gopalkrishnan, 2018; Vaillant, 2012).

Culture is pivotal in delineating what is to be considered as a problem, how it is to be understood, and subsequently solved (Hernandez et al, 2009). For example, different cultures may place specific events as normative while others may consider them to be stressors. So also, particular qualities may be considered to be emanating from the community itself.  (Aldwin, 2004; Hechanova and Waelde, 2017; Gopalkrishnan 2018). An example could be that of resilience, which is the capacity to do well in the face of adversity. For instance, in the Aboriginal Peoples of Canada, resilience is rooted in cultural values, whereas in mental health literature it is often considered in terms of an individual’s attributes and qualities (Kirmayer et al., 2011; Dawes &Gopalkrishnan, 2014).

Thus, keeping in view some elements having universal importance (Vaillant, 2012) for mental health and leaving room for “imperfect functioning”, Galderisi et al (2015)have proposed a new definition, as follows:

Mental health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one’s own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.

Hedonic, eudaimonic, and definitions that aim to overcome the limitations of these two, have a few things in common. Emotional, behavioral, and cognitive regulation, where autonomy is one of the core values.

The coaching client and capacity for autonomy

Enrichment of human functioning is the bedrock of coaching. Coaching is often seen as a cooperative process for problem-solving and goal-attainment. Yet it is the underpinning quality of catalyzing growth and facilitating development that is crucial to the process. The coaching process goes through a cycle of self-regulated behavior based on monitoring-evaluating-configuring current and projected experiences. The coach’s role is to accelerate the progress of the coachee through this self-regulatory cycle by using coaching skills and competencies to set goals, develop action plans for and manage progress towards these goals.

As such, applications of coaching are exceedingly diverse. Coaching has not only decisively taken root in organizational settings but also expanses of personal development (Grant, 2013). It is getting clear that many people seek out processes that enhance life experience and foster personal advancement (Grant, 2003). According to Stober& Grant (2010), coaching is a systematic process focused on promoting the continuing self-directed learning and personal growth of the coachee. The coachee is identified as an autonomous individual who, based on her personal experience and knowledge, is capable and willing to participate in an introspective process.

The capacity to be autonomous is an indicator of the functionality of an individual. Mental health and the capacity for autonomy are interconnected(Edwards, 1981). In his definition of mental health, Edwards (1981, p. 312) states, ‘only those desirable mental/behavioral normalities and occasional abnormalities which enable us to know and deal rationally and autonomously with ourselves and our social and physical environment’. Further, he delineates autonomy as, ‘making one’s own choices, managing one’s practical affairs and assuming responsibility for one’s own life, its station and its duties’ (Edwards, 1981, ibid).

This must be seen in the context of Keyes’s assertion that mental health is a complete state. So, the capacity to be autonomous cannot be unconditionally absent or present. Just like mental health, autonomy could also be placed on a spectrum.

Coaching and metacognition

However, it is not simply the capacity to be autonomous but to have the autonomous metacognitive capacity, which is crucial to the field of coaching. The capacity to reflect on one’s thoughts is metacognition (Metcalfe &Kober, 2005; Proust, 2007). The ability to set and plan for future goals, assess our capacity concerning those goals, predict barriers to achievement of those goals, to evaluate progress would all constitute metacognitive skills (Nelson, 1996, Proust, 2007). Shimamura (2000)has discussed different metacognitive skills in terms of executive control, which at its core enhances task-relevant processing and inhibits task-irrelevant processing.

Flavell (1979) defines metacognition has to know your cognitive processes. It includes self-regulation and self-reflection and develops strategies to maneuver through challenges or situations. This regulatory system encompasses knowledge, experiences, goals, and strategies (Flavell, 1979). All these, according to the author, constitute components in a well-equipped coaching commitment as well.

Discussion

As boundaries between coaching and therapy are continuing to cloud, more research is necessary to describe the association between mental health, mental illness, and coaching. Viewing it from the lens of the capacity of (metacognitive) autonomy in a client could prove to be useful. Research into the psychopathology of coaching clients could further aid the matter. Most importantly, a categorical approach would not justify the complexities of this association, thus, a dimensional approach should be adopted. In effect, allowing a coach to have a clear understanding of the ethical and legal obligations towards a client.

It is important to reiterate that this paper is a prima facie inquiry into the subject matter. In focusing on the capacity of autonomy, this paper does not discount the multi-layered nature of the topic. Moreover, it recognizes that autonomy is not easily discernible and can have many different interpretations and implications. This paper attempts to simply highlight the role of (metacognitive) autonomy in help demarcate the boundaries between coaching and therapy and make a case for further inquiry.

References

Aldwin, C. M. (2004). Culture, Coping, and Resilience to Stress. In Paper Presented at the First International Conference on Operationalization of Gross National Happiness, Thimpu.

Dawes, G., &Gopalkrishnan, N. (2014). Far North Queensland Culturally and linguistically diverse (CALD) Communities Homelessness Project. Cairns Institute, James Cook University.

Edwards, R. B. (1981). Mental health as rational autonomy. The journal of medicine and philosophy, 6(3), 309-322.

Flavell, J. H. (1979). Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. American psychologist, 34(10), 906.

Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., & Sartorius, N. (2015). Toward a new definition of mental health. World Psychiatry, 14(2), 231-233.

Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in public health, 6, 179.

Grant, A. M. (2003). The impact of life coaching on goal attainment, metacognition, and mental health. Social Behavior and Personality: an international journal, 31(3), 253-263.

Grant, A. M. (2013). The efficacy of coaching. Handbook of the psychology of coaching and mentoring, 15-39.

Hechanova, R., &Waelde, L. (2017). The influence of culture on disaster mental health and psychosocial support interventions in Southeast Asia. Mental Health, Religion & Culture, 20(1), 31-44.

Hernandez, M., Nesman, T., Mowery, D., Acevedo-Polakovich, I. D., &Callejas, L. M. (2009).

Cultural competence: A literature review and conceptual model for mental health services. Psychiatric Services, 60(8), 1046-1050

Hullinger, A. M., and DiGirolamo, J. A. (2018). Referring a client to therapy: A set of guidelines. International Coach Federation. https://coachfederation.org/app/uploads/2018/05/Whitepaper-Client-Referral.pdf.

Jahoda, M. (1958). Current concepts of positive mental health.

Keyes, C. L. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of consulting and clinical psychology, 73(3), 539.

Keyes, C. L. (2014). Bridging Occupational, Organizational, and Public Health.

Kirmayer, L. J., Dandeneau, S., Marshall, E., Phillips, M. K., & Williamson, K. J. (2011).

Rethinking resilience from indigenous perspectives. The Canadian Journal of Psychiatry, 56(2), 84-91.

Metcalfe, J., &Kober, H. (2005). Self-reflective consciousness and the projectable self. The missing link in cognition: Origins of self-reflective consciousness, 57-83.

Nelson, T. O. (1996). Consciousness and metacognition. American psychologist, 51(2), 102.

Proust, J. (2007). Metacognition and metarepresentation: is a self-directed theory of mind a precondition for metacognition?. Synthese, 159(2), 271-295.

Shimamura, A. P. (2000). Toward a cognitive neuroscience of metacognition.

Spitzer, R. L., & Wilson, P.T. (1975). Nosology and the official psychiatric nomenclature. In A.

Freedman, H. Kaplan, & B. Sadock (Eds), Comprehensive textbook of psychiatry (pp. 826-845). Baltimore: Williams and Wilkins.

Stober, D. R., & Grant, A. M. (Eds.). (2010). Evidence-based coaching handbook: Putting best practices to work for your clients. John Wiley & Sons.

Vaillant, G. E. (2012). Positive mental health: is there a cross-cultural definition?. World Psychiatry, 11(2), 93-99.

World Health Organisation. (1948). WHO Definition of Health.

World Health Organization. (2005). Promoting mental health: concepts, emerging evidence, practice: a report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. World Health Organization.