How to integrate counselling and coaching: The clearest blueprint yet

I’ve been asked by the Chair of BACP Coaching to prepare an overview of the Fusion Model for an upcoming CPD day.

I am always privileged to be a part of the emerging discussions on integration. It’s such a ground breaking and significant area of mental health and one where, I’m pleased to say, BACP is at the vanguard. It’s also presented me with a great opportunity to bring together a clear picture of how the Fusion Therapeutic Coaching Diploma and Distance Learner Skills Certificate offer the longest established and most tried and tested training that connect the worlds of counselling and coaching, with the underpinning advantage of being a nationally recognised award from the prestigious accrediting body, NCFE.

Ultimately this is for our clients. They are the ones who deserve to have access to highly trained and skilled practitioners. If you want to be part of the professional discussion, this is a link to the Therapeutic Coaching Professionals Face book group.

Here’s the overview from my notes so far.

I hope it helps…

The Fusion® Therapeutic Coaching Model

Fusion’s innovative therapeutic coaching model is an integration of advanced counselling and coaching skills in a holistic framework. It was created by Frances Masters.

Frances is a BACP accredited counsellor, a coach, trainer and founding Principal of The Integrated Coaching Academy. She is also author of the book PTSD Resolution; a unique fly on the wall account of a single therapeutic coaching session outlining the imaginal exposure technique known as Rewind to de traumatise a war veteran.

The Fusion Model is theoretically underpinned by recognition of the significance innate human needs and the important role of emotions in prompting us to get those needs met by moving us away from threats and towards opportunities in the environment.

No matter age, colour, creed, gender or status, human beings have the same needs and emotions, making Fusion the ultimate multi cultural model.

The model brings together a wide range of professional tools drawn from person centred counselling, cognitive behavioural therapy, human givens psychotherapy and neuro-linguistic programming, enabling the practitioner to make each session bespoke for their client, wherever they present on the Continuum of Wellbeing.

Frances did not consciously make a decision to move into coaching. The transition happened organically in response to her clients’ needs. As her professional practice developed, Frances found that, although core conditions and empathic listening were essential skills greatly appreciated by her clients, they were not always sufficient. More and more clients were saying they wanted practical tools to help them manage their mental health. Rather than a diagnosis, many wanted an explanation and a clear treatment plan. They also wanted to have restored hope of feeling better quickly so they could just get on with their lives.

Frances realised that, rather than simply following the client as she had been originally trained, she would have to give herself permission to start to lead the session, so she sought out further training in some of the more solution-focused paradigms. Her new, proactive approach worked well and accelerated her client outcomes dramatically, to the point where clients would often return on session 2 without the original presenting pathology but still wishing to retain their pre booked sessions, ensuring there was a block of support in place as their confidence in their mental health returned.

This was the birth of the 5 session framework which evolved into the Fusion Therapeutic Coaching practitioner manual used to establish the mental health charity Reclaim Life in 2009.

Let me tell you a story

The best way to illustrate the model is with a case study. So let’s take a look at Jo who came along with panic attacks and loss of hope about her future. Jo is based on a true client, anonymised for ethical compliance.

Describing what happened with Jo will give an illustration of how the model moves effortlessly from counselling into coaching and provides a blueprint and toolbox of skills that allows practitioners to safely and easily integrate two previously separate paradigms.

Jo

Jo described herself as a successful makeup artist with her own business but, as she started to tell her story she broke down as she recounted increasing numbers of panic attacks now dominating her life and taking away her ability to work.

Problems began after her mother unexpectedly died of a stroke on her way to work. Now Jo found that, whenever she got behind the wheel of her own car, her head pounded, her breathing got tight and she thought she would pass out. She’d had several dramatic trips to A&E. Tests revealed no physical problem and no issues with her brain, heart or blood pressure. But she was now having up to 8 episodes a day, avoiding driving and putting off family outings and holidays. She feared for her health, her sanity, the future of her business and her relationship.

The starting point for working with Jo was to ask her to fill out Fusion’s Continuum of Wellbeing feedback sheet, which links unmet needs to subjective wellbeing, giving an ‘ok or ‘not ok’ overview that helps the practitioner quickly assess whether the work is likely to have a stronger counselling or coaching bias.

The Model

Based on Abraham Maslow's Hierarchy of Needs, the Fusion Model acknowledges that all human beings have a range of physical and emotional needs and, if those needs are met in balance, life feels good.

The Fusion SAFE SPACE algorithm cites Safety and security, the receiving and giving of Attention, Fun with family and friends, Emotional intimacy, Status, Privacy, Achievement, Control and Engagement with life as essential for emotional wellbeing.

Jo’s Continuum of wellbeing feedback showed she was currently in the ‘not ok’ zone. She did not feel safe in her own body, was not giving attention to others, had stopped having fun with family and friends, lacked her previous status, had little sense of achievement and felt she had lost control of her life; all because of the distressing daily panic attacks.

Fusion sessions pace, turn and lead in smooth succession using essential counselling skills to uncover the story before comfortably moving into solution-focused coaching territory. The Fusion session manual offers a series of questions and work sheets that begin reflectively and move seamlessly to more interactive and proactive interventions.

Jo’s goal was to try and reduce the panic attacks to something more manageable; perhaps one a day, she said.

Case conceptualisation

The essence of the problem was that Jo had been traumatised by her mother’s sudden death and also by her own experience of frightening panic attacks which her brain had interpreted as a life threatening situation. She was now misusing her imagination with cognitive distortions and playing horror films of a bleak future. The subsequent high anxiety was severely restricting her life and preventing her getting her needs met, resulting in the depression often co-morbid with long term, chronic anxiety. Although not meeting the full criteria for Post Traumatic Stress Disorder, there was sufficient ongoing pattern matching to keep her emotional centres on red alert, making her hyper-vigilant and keeping her base stress level high, with little spare capacity (emotional resilience/poor vagal tone) so that she was never far away from a full blown panic attack.

The essence of the solution was to break the trauma pattern, calm the anxiety and restore hope of a preferred future.

The focus for the therapeutic coaching would be to relieve trauma symptoms with the Rewind Technique and help her control her anxiety with The STOP® System. She would then be guided to construct a detailed picture of a positive future life in the absence of the pathology, using the holistic wheel of life as a helpful passport to communication. The setting of detailed SMART goals would stimulate her brain’s Reticular Activating System to be open to supportive habits and opportunities. Visualisation would be used to form new neural pathways, embed positive self talk and promote insight through therapeutic story, imagery and metaphor.

Pattern breaking

Jo had been pattern matching her symptoms to those of her mother and, more to the point, once she had had a major panic attack whilst driving, every time she got into the driver's seat of her own car, she now had an unconscious negative expectation. Trauma-focused guided visualisation would be able to quickly dissolve the pattern match, allowing the emotional centre of the brain to settle. This would restore the sense of safety so essential for the cognitive brain to activate, as underpinned by the new understanding of the ventral vagal nervous system cited in Dr Steve Porge’s Polyvagal Theory. 

The STOP System

Fusion Model’s STOP® System accesses controlled breath work, mindfulness and scaling to take a step back into the Observing Self and buying essential time between a super-fast emotional reaction or a slower, and more rational, response.

On the first session, Jo’s trauma was swiftly resolved and she returned one week later having had no further panic attacks at all. She was very relieved but wanted to keep her remaining sessions in place.

Fusion clients are generally recommended to book 5 or 6 sessions to have a block of support in place to allow sufficient time to implement the full holistic coaching programme. Jo would certainly need some help refocusing on her future as she had been struggling with anxiety for so long, she said, she’d lost sight of who she really was and what she wanted from her life.

This is real coaching territory and Fusion’s holistic wheel of life is perfect for the task. The client is encouraged to scale key areas of life before considering what the perfect life would look like if failure was not an option.

Jo’s outcome was excellent. She was a highly motivated client and worked collaboratively with her therapeutic coach to quickly resolve her presenting inward, downward, backward viewpoint to a more psychologically healthy and robust outward, forward, upward mindset.

Practitioner skills

Although the underpinning theory is simplicity itself; there are an extraordinary range of skills, tools and interventions available to the Fusion Therapeutic Coach.

This is why the Fusion session manual is so useful, with its intervention check-lists, outcome monitoring forms, psycho educational hand outs, visualisation scripts and interactive client work sheets. The session manual frees up head space for the therapeutic coach, allowing for more opportunities to make the work both creative and bespoke.

Some choose to stay close to the structure offered by Fusion and achieve the same positive client outcomes achieved by the author of the programme. Others choose to integrate the tips, tools and techniques acquired in the training into their current working practice, making Fusion both an open or a closed model; whichever fits most comfortably for the integrating practitioner.  

Therapeutic Coaching Professionals

If you are a coach who counsels, a counsellor who coaches, a teacher, doctor, nurse, mentor, priest or hypnotherapist; if you work or any of the helping professions or are interested in studying in a helping profession, you can be invited to join the 'Therapeutic Coaching Professionals' private Facebook forum, by clicking 'like' on the Fusion Therapeutic Coaching Face book page).

'Therapeutic Coaching Professionals' is a supportive professional group where we share tips, tools and the kind of interventions that really help our clients move forward quickly.

Fusion training  

Motivation, resolving depression, the Rewind Technique, Mindfulness Based Mind Management (advanced MBSR), worrying well, solution focus, guided visualisation, resolving addiction, epigenetics, mapping the connectome, polyvagal theory, the reticular activating system (RAS), secondary gain, trauma resolution, coaching for kids, treating depression, worrying well, working SMART, therapeutic stories, insight, psycho education, suicide prevention, affirmations, positive mental rehearsal, imagery, dissociation, goal setting, new paradigms, reframes, fast track learning, perception shifting, self actualisation, positive psychology, reframing, metaphor, personal empowerment, motivational thinking, resilience and resourcefulness, human flourishing, anchoring, rewiring your brain, the STOP System, the SAFE SPACE happiness recipe, holistic coaching and working on the continuum of wellbeing plus many other professional theories, tools and techniques underpin the content of the fast paced, fast track, Fusion training programmes.