ADVERTISEMENT
Coaching May Be a Worthwhile Investment for Therapy Professionals
Therapists want to continually improve in their work, but they get little help doing so today. The mainstay of performance improvement for clinicians is continuing education. This is grounded in a belief they must stay current on clinical knowledge. Yet, therapy entails utilizing skills more than possessing knowledge. If the goal is to maintain or grow those skills, continuing education may need an overhaul.
Executives regularly invest in their people, their human capital, and this involves everything from health and wellbeing benefits to training and education. The problem is that therapists are not typical employees. They are professionals who perform complex services. Their training needs may exceed didactic lectures—coaching may be more relevant for keeping their skills sharp.
Executives might be better served thinking of their professional staff as comparable to athletes. Sports professionals are coached throughout their careers. This is even true for top-performing athletes. Basketball players return from the offseason with a new shot, and golfers use swing coaches to perfect new strokes. Acquiring new information is of secondary importance to performance improvement.
A sensitive issue must be addressed here regarding therapists. Do licensed therapists naturally improve in their work as they gain experience? No evidence supports this idea, even though many therapists insist it is true. Nonetheless, is the proper goal not to improve continuously and become the best one can be? How is this achieved if it does not happen normally during most careers?
There is no definitive answer to this, but it is worth remembering that new trainees in most healthcare disciplines learn through case-by-case supervision. This is not to suggest that licensed staff need further supervision, but rather that coaching is the mature form of this model for professionals.
Healthcare professionals may not find this sports analogy compelling. It might help to hear an esteemed clinician endorse it. Anyone needing persuasion should watch a TED lecture on the topic by Atul Gawande, MD. He is a surgeon and prolific author who reluctantly engaged a respected colleague to coach him on his surgical work. His reactions are honest and powerful.
He finds coaches to be “external eyes and ears providing a more accurate picture of your reality.” While he found himself improving in his surgical outcomes, “it was painful.” He admits, “I didn’t like being observed—at times I didn’t want to have to work on things.” However, he concluded coaches help break down a complex process into component parts and then “build them back up again.”
Psychotherapy relies on core skills and yet is unique every time. This seems true of most complex professional performances. Therapy may be ideal for coaching, but how might it become the norm? The answer is tied to the changing healthcare landscape and where our field is headed.
Modifying the Employee Benefits Package
If coaching is the best way to produce better therapists and improved outcomes, it must become part of an employee’s benefit. Executives manage these benefits carefully and will need more evidence than offered here to budget coaching as a benefit for every therapist. They must believe funding this perk (likely to be resented by many clinicians initially) will pay dividends in client improvement.
The salaried therapist is considered the norm here because employment is steadily replacing independent practice for therapists. Consider physicians today. Roughly 75% of physicians in the US are salaried already, and this is likely to increase due to ongoing consolidation in the healthcare industry. This should be taken as a barometer of the future for professionals in behavioral healthcare.
If this vision of therapist coaching were to become real, continuing education would need revamping. Coaching would not be tied to particular therapy models like cognitive behavioral therapy or EMDR, but would rather be grounded in well-established, common findings from outcomes research. For example, this might include focusing on the therapy relationship since alliance and empathy drive results regardless of the therapy model.
Many therapists are unlikely to resolve their ambivalence about coaching on their own, so including it in employment agreements would be necessary. Should therapists pay for coaching on their own? After all, they personally retain all gains from coaching. This idea makes some sense today but not when most therapists are salaried. In any case, coaching will grow only if executives advocate it and fund it.
Executives continually assess how to cultivate their human capital. People are surely the most valuable asset in the behavioral industry. Coaching is a time-honored practice for many professionals, and it may be a worthwhile investment for behavioral executives to consider. At the very least, we should stop assuming clinicians naturally achieve top performance. There is no shame in that, just room to grow.
Ed Jones, PhD is currently with ERJ Consulting, LLC and previously served as president at ValueOptions and chief clinical officer at PacifiCare Behavioral Health.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
References
TED. Want to get great at something? Get a coach | Atul Gawande. YouTube; 2018.
