Depression is a complex condition that can significantly impact an individual’s life, affecting their relationships, work, and overall well-being. While traditional therapeutic approaches have long been used to address depression, coaching, and approaches incorporating coaching principles, offer distinct perspectives and methods. This report explores how coaching for depression, drawing on techniques from modalities like Solution-Focused Brief Therapy (SFBT), Acceptance and Commitment Therapy (ACT), and Neuro-Linguistic Programming (NLP), differs from traditional treatment, its potential advantages, and its benefits for both clients and practitioners, with a particular focus on the importance of monitoring progress.
Differences from Traditional Approaches
Coaching for depression, as described in some approaches, often shifts the focus away from analysing the root causes of problems and instead concentrates on building solutions and enhancing positive emotions. Traditional psychotherapies may ask questions like “What is wrong here?” or “What is bothering me?”, which some perspectives suggest can lead to negative thought chains. In contrast, solution-focused questions aim to increase positive emotions by exploring how things will be when best hopes are met, what will be different, and reflecting on past successes and competence.
Another key difference lies in the perceived roles of the client and the practitioner. In traditional therapy, the therapist may be seen as the expert with special knowledge about anxiety or depression, providing advice that the patient submits to. Within a coaching or solution-focused framework, both the client and the therapist are seen as having particular areas of expertise. The therapist asks questions to elicit the client’s knowledge and resources. For example, in SFBT, the client defines the goal, much like a taxi driver’s passenger defines the destination. Similarly, some approaches emphasise that while the therapist offers guidance, proof of effectiveness emerges from the client’s perception and experience as a full partner.
Furthermore, the language and focus of the conversation differ. Some traditional approaches might focus on conversations about impossibilities, whereas coaching-inspired methods emphasise possibilities. There is also a distinction made between reducing problems and negative affect (a goal in some traditional treatments) versus increasing positive affect (which can be a goal in SFBT). Instead of asking “Where from?” regarding the problem’s origins, a coaching approach might ask “Where to?” focusing on the desired future state.
Some perspectives critique traditional methods for getting clients entangled in futile attempts to control or suppress their inner experiences, such as thoughts, feelings, and physical sensations. These efforts, like avoidance, escape, or positive thinking when in crisis, are sometimes viewed as unworkable emotion regulation attempts that can make anxiety and related content problematic. Coaching-informed approaches, such as ACT, focus on loosening the hold of these control efforts and helping clients accept feared and avoided private events.
Potential Advantages Over Traditional Approaches
Approaches incorporating coaching principles may offer several advantages. By focusing on solutions, strengths, and resources, they aim to build positive emotions and confidence. Asking about previous successes and competence triggers positive emotions. This positive focus can help clients transform the problem into something positive, leading to a new and better life.
Techniques like finding exceptions—times when the problem is absent or less severe—are seen as keys to solutions. By amplifying these exceptions, therapists help clients see differences they may have previously overlooked, shifting their perspective from the problem being primary to exceptions being primary. This contrasts with focusing solely on the omnipresence of the problem.
Externalising the problem is another technique that can be beneficial. This involves separating the problem from the person, seeing it as something that affects them but doesn’t define or control them. Giving the problem a name helps clients gain perspective and reduces the tendency to blame themselves or others. This technique is derived from narrative therapy.
Some sources highlight that continuously talking about anxiety or depression can be counterproductive, acting as an avoidance compulsion. While unloading might offer temporary relief, it often doesn’t fix the problem in the long run. Coaching approaches often steer away from excessive discussion about the problem and towards action and building a desired future.
Client Perspective
From a client’s perspective, coaching for depression can be highly preferable due to several factors. The stance of the practitioner is often one of acceptance and validation rather than confrontation or blame. Clients may feel more understood and less judged when their current experience, including doubts or previous therapeutic failures, is acknowledged and validated. One client appreciated a therapist who “just stay[ed] with me, no matter what was going on,” feeling blamed by other therapists when they weren’t improving.
The emphasis on the client as the expert in their own life can be empowering. Clients define the goals, and the process focuses on their strengths and competencies. This collaborative approach, where the therapist works alongside the client on their journey, stands in contrast to a model where the client submits to the therapist’s expert knowledge.
Focusing on possibilities and solutions instead of dwelling on problems and negative emotions can offer a sense of hope and agency. Techniques like imagining a preferred future or the “miracle question” can create positive emotions and expand a client’s ideas about what is possible. Creative hopelessness, in ACT, aims to help clients let go of unworkable solutions, ultimately leading to more hope that they can escape feeling stuck.
The use of compliments and highlighting competence also builds confidence. By noticing and playing back clients’ resources, SF therapists create an atmosphere where positive emotions flourish.
The goal-setting process in coaching is typically flexible and focused on what is “good or good enough” from the client’s perspective, rather than striving for an ideal state. Goals can also involve others important in the client’s life, reflecting a broader, more integrated view of recovery.
Practitioner Perspective
Coaching principles can also be beneficial for practitioners. Adopting an attitude of not needing to be the sole expert allows for a more collaborative and less burdened role. Instead of feeling the need to “fix” the client, the practitioner facilitates the client’s own problem-solving and goal achievement.
Approaches like ACT encourage practitioners to operate with a spirit of openness, creativity, flexibility, genuineness, curiosity, humility, sharing, respect, and investigative play. This posture is seen as necessary when working with suffering individuals. The focus on helping clients make a difference in their lives, with broad impacts extending beyond therapy, can be a deeply rewarding legacy for the therapist.
Drawing on different methods and adapting to client needs allows practitioners flexibility. Understanding what motivates a client and speaking their “language” (e.g., using language of suggestion or command, matching internal/external preferences) can enhance rapport and influence, making the therapeutic process more effective.
Working with challenging clients, particularly those who are skeptical or resistant, can be reframed by understanding their potential need to decide for themselves (Internal Pattern). This requires the practitioner to establish credibility rather than relying solely on rapport or direction.
Focusing on positive aspects, competence, and success can be more uplifting for the practitioner. Exercises for therapists themselves encourage reflecting on times they felt good about their work and what contributed to that success.
Monitoring Progress: A Core Element
A key element of coaching for depression, particularly within solution-focused and ACT frameworks, is the constant checking to see if progress is being made. This is not a static evaluation but an ongoing process integrated into sessions.
In Solution-Focused Brief Therapy, scaling questions are frequently used to measure progress. Clients might be asked, on a scale of 0 to 10, where 0 represents the worst point and 10 represents the goal or desired future, where they are currently. Crucially, follow-up questions delve into why the client is at that particular number and what a one-point increase would look like. This detailed exploration helps clients identify subtle changes and the actions or factors contributing to them. Scaling is also used to assess confidence, hope, and motivation.
At the beginning of follow-up sessions, a standard question is “What is better (since we last met)?”. The focus is then on getting a detailed description of these improvements, complimenting the client, and emphasising their role in achieving them. This directly monitors changes and reinforces the client’s agency.
In ACT, clients often track their progress towards valued living goals. Forms are used to record activities (mini-goals) committed to and completed, linking them back to larger values. This provides a tangible record of achievement on their path to the life they want. Regularly reviewing these records with the therapist serves as a way to assess progress.
NLP approaches also suggest tracking one’s challenge and keeping a record of progress with action steps towards a more positive outcome. Using a continuum scale is another way clients can visually represent and measure their perceived progress.
This continuous monitoring process helps to keep the client and practitioner focused on forward movement, identify what is working, and adjust strategies as needed. It reinforces the idea that change is occurring and highlights the client’s active role in their recovery.
Key Concepts and Techniques
Coaching for depression incorporates various techniques aimed at facilitating change. Focusing on positive emotions is central, aiming to build confidence and resilience. Techniques include using positive imagery, recollecting past successes, and finding “bright spots” or exceptions when the problem is less present.
Goal setting is fundamental, helping clients define what they want to achieve. Goals are often made S.M.A.R.T. (Specific, Measurable, Achievable, Relevant, Time-bound) to make them clear and trackable.
Behavioral activation, which involves engaging in positive or valued activities, is highlighted as effective for depression. This involves doing things that align with personal values, even when motivation is low, to demonstrate to the emotional mind that things can be good. This contrasts with waiting to feel better before acting.
Techniques like the chessboard metaphor in ACT help clients change their perspective on their internal struggles, seeing themselves as the context (the board) rather than being consumed by the thoughts and feelings (the pieces).
Self-help aspects, such as building positive thought habits, re-writing negative stories, or using self-coaching tools, also align with a coaching approach. Physical well-being through exercise, nutrition, and managing caffeine intake are also mentioned as supporting recovery.
Summary of Coaching for Depression Report
This report has examined coaching for depression, drawing on principles and techniques found in various therapeutic modalities. Coaching-informed approaches differ from traditional therapy by focusing on solutions and positive emotions rather than problems, viewing the client as the expert rather than the therapist, and emphasising possibilities over impossibilities. Potential advantages include building confidence, fostering hope, and promoting action-oriented strategies. For clients, coaching can be preferable due to feeling more understood, empowered, and less blamed. Practitioners may benefit from a more collaborative role and the fulfillment of helping clients achieve lasting positive change. A critical element in coaching for depression is the constant monitoring of progress, often done through scaling questions, tracking goal achievement, and regular check-ins to identify what is better. Key techniques include using positive focus, finding exceptions, externalising problems, challenging negative thoughts, setting SMART goals, and promoting behavioral activation.