Instagram and TikTok are go-to social media platforms for mental health advice, some of it dispensed by influencers who call themselves coaches.
Through pricey courses or one-on-one meetings, the influencers often promise clarity, motivation, and healing that leads to a new lifestyle — the one you've always chased after. But whether or not they have any formal training, in mental health care or coaching, is another matter. Unlike psychologists, psychiatrists, and other licensed mental health professionals, anyone can call themselves a mental health coach.
Experts say the mental health coaching trend is relatively new, and that consumers should beware of empty guarantees made by people with few or no credentials aspiring to build a business or social media following. But what influencers aren't wrong about is the difficulty of accessing mental health help, or even the support of a trained professional with expertise in coping, habit formation, and behavior change.
Sometimes you don't need a therapist; you just need a skilled guide who can help you better manage conflict or your sleep habits and hold you accountable.
The fields of mental health and behavioral coaching have taken notice of the trend and the problem it claims to solve. That's why Headspace, which got its start as a meditation app more than a decade ago, launched direct-to-consumer, text-based mental health coaching in April, after providing the service through employer and health plan partnerships.
Lyra Health, a digital mental health company, also offers mental health coaching, but only to employees of companies that pay for it. Some companies, like BetterUp, provide career, communications, and life coaching that could improve mental health, but they don't specify that area of focus.
Headspace's service is a compelling example of what mental health coaching can look like when practiced by trained professionals. For $99 per month, members get three text-based, 30-minute coaching sessions per month.
Before a member begins coaching, Headspace screens to identify whether the person might be in crisis or need urgent mental health treatment, in which case coaching on its own may be ineffective. An onboarding process attempts to set a clear expectation that coaching isn't therapy. Coaches work with members to set defined and achievable goals, like going to bed 30 minutes earlier or adding more movement to their daily routine.
The company employs the majority of its coaches as staff, and all coaches receive regular training and oversight. Coaches have daily access to a licensed on-call clinician, who they can consult when a member needs more than what's offered. In these cases, the coach transfers the member to a referral team that provides resources for finding an outside therapist or psychiatrist.
Dr. Vaile Wright, a psychologist and senior director of health care innovation for the American Psychological Association, says that high-quality mental health coaching could be exactly what some people need to move through lower-level challenges and ultimately thrive.
"It's a great place to start when you know you need some help, but you might not have an official diagnosis of, say, depression or anxiety," she says.
How mental health coaches get credentials
Jennifer Lundman, a licensed clinical social worker and a National Board Certified Health and Wellness coach, doesn't agree with the mental health coaching trends she sees on social media — specifically when they involve influencers with questionable credentials and aggressive sales pitches. And, instead of partnering with a client to help them understand what behavior changes work best for them, some coaches hawk exercise plans and supplements, which is not something certified professionals do.
Lundman believes that so-called coaching that's popular on TikTok and Instagram "does jeopardize this really, really important work that can be done to support people's health and wellness."
The National Board for Health and Wellness Coaching (NBHWC), where Lundman works as director of program approval and continuing education, is trying to professionalize the unregulated industry.
Since 2016, NBHWC has collaborated with the National Board of Medical Examiners, a nonprofit that provides assessment of many health professions, to provide a rigorous exam that aspiring health and wellness coaches can take to achieve board certification. More than 11,000 people have since received it since the first exam took place in 2017.
The exam was developed in collaboration with the National Board of Medical Examiners, a nonprofit that assesses health professionals. Another professional organization, the International Federation of Coaching, also offers certification; Lyra Health requires that its coaches go through that program.
Passing the NBHWC exam requires learning about behavioral change, and how to facilitate it as a coach, as well as motivational strategies and basic health and wellness. Exam applicants must first complete a training program approved by NBHWC, which could be offered in an academic, private sector, or healthcare organization setting.
Headspace offers one of those approved programs. Its six-month certificate course, which costs $5,995, awards successful participants with a certificate in mental health coaching, after they complete 20 weekly live and synchronous education and training sessions, among other requirements. Most of Headspace's staff coaches have completed this program, and it can be used outside of the company.
Dr. Jenna Glover, chief clinical officer of Headspace, says the company's coaching style incorporates motivational interviewing. The technique, which licensed mental health professionals may also use, is a cornerstone of behavior change. It's meant to help people identify both stubborn challenges to their well-being and the skills they need to overcome those roadblocks.
In coaching, however, there is no deep discussion about the family dynamics or relationship troubles that may have contributed to unhealthy habits. Importantly, for Headspace coaches, Glover says there is also an awareness that members face immovable or unchangeable obstacles that interfere with their well-being, like experiencing racism at work, needing to work multiple jobs, or living with student debt.
Headspace coaches, according to Glover, are trained to validate such stressors and guide members toward factors within their control, like putting their phone away well before bedtime to get better rest, or spending higher quality time with their child when they're not at work.
"A coach can really help guide [a client] and say, 'What are you able to work on right now?'" Glover notes.
What else to know about mental health coaching
Understanding whether mental health coaching improves people's well-being, compared to therapy, for example, will take a lot more research, says Vaile. Currently, there's little robust research indicating that it leads to desired behavior change and mental health improvement.
Wright says there are advantages to working with mental health coaches employed by a well-known digital health company, such as Headspace or Lyra. Coaches are typically trained, if not certified. They also receive supervision and feedback on their performance. The platforms themselves can provide referrals for therapy to members who might need them. Should a coach act inappropriately, their client can report it to the company.
Consumers should be aware, however, of how companies use their personal data, including for marketing or research purposes, Wright says.
She adds that companies should make clear whether artificial intelligence is part of their coaching product. Wright says that while AI may be able to improve coaching experiences, perhaps by matching clients and coaches or identifying trends in a client's performance, it needs to be incorporated ethically and responsibly. Currently, Headspace doesn't use AI in its direct-to-customer coaching program.
Though Wright practices healthy skepticism about new digital mental health products, she is optimistic about the potential of high-quality coaching to make an important difference in people's lives.
"We clearly have an extensive mental health crisis in this country, and we need to be thinking about how we can get people the support that they need in innovative and responsible ways," Wright says. "I do think that certified health and wellness coaches can be part of that solution."
Topics Mental Health Social Good
