Is the Prophecy Coming True? Psychiatrists as Coaches During the Pandemic

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

Way back on May 18, 2015, I wrote an article for Psychiatric Times titled “Life Coaching and the Stigma of Psychiatry.” Back then, life coaching had emerged as a popular and much less stigmatized new mental health field, though psychiatrists were not formally doing much of it. It had—and still has to some extent—loose standards as to the requirement for any licensing, educational requirements, and malpractice insurance. Often, life coaches’ training was their own lived experiences and challenges that they successfully overcame.

Perhaps the newfound popularity of such coaching had to do with our rapid changes in social norms and expectations. Of course, coaching historically has filled an important role in sports in order to guide and develop the athletes.

In the article, I mentioned a rare colleague of the time who switched late in life to coaching as a second career. He especially liked the emphasis on a positive therapeutic alliance and relationship. As a psychiatrist, you can completely switch to coaching and even give up your medical license, or designate part of your work to coaching, being careful to clearly distinguish the difference in process and responsibilities between coaching and psychiatric medical care. You would not prescribe medication very much, if ever at all, during coaching.

In many ways, psychiatrists should be ideal coaches. Our traditional knowledge about supportive psychotherapy principles is at the crux of coaching.¹ Specifically, supportive psychotherapy was thought to be an essential component of helping the most serious and chronically mentally ill, and those of us in community psychiatry often supervised the case managers and peer specialists who did this work. Moreover, the depth of our knowledge about psychodynamics, including overcoming unconscious resistance to change, can add special expertise to the process.

I closed that article with the vision that a subspecialty of “psychiatrist coaching” was liable to emerge someday. Maybe now is that time as I informally hear of more and more psychiatrist coaches during the pandemic. No wonder. The pandemic, now approaching its third anniversary, disrupted so many life plans and structures, rather than having unique personal vulnerabilities and conflicts causing the problems.

People often felt adrift or trapped in deciding who they are, what they now wanted, and how to proceed during the pandemic. Surveys indicated an increase in undue anxiety, depression, loneliness, trauma, and substance abuse. Besides, our own psychiatrist epidemic of burnout needs other work options, and burnout has not been reported to be a major problem for coaches. Why not? Coaches often work independently without the systemic obstacles to healing that psychiatrists now encounter. It is not deemed a medical service, so insurance is not involved. Usually reimbursement tracks reputation, and may often not be much less, if not more at times, than routine psychiatric care.

In sports, the best coaches contribute to winning teams. Psychiatrists have the potential to be among the best coaches in mental health care.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.

Reference

1. Battaglia J. Doing Supportive Psychotherapy. American Psychiatric Association Publishing; 2019.