Help the Clients We Can't Help
by Steven M. Ledbetter
5 minute read
If you are reading this blog, it’s probably first and foremost because you want to help people. In 2010, I was helping people as a personal trainer and decided I wanted to expand my toolkit to help people change their behavior. So I started thinking about graduate school for Psychology. When I told my own therapist that, he had some words of advice, “be careful; many people in helping professions are there seeking their own salvation.” There’s an even more blunt warning from Mark Twight on his Gym Jones T-Shirts, “there’s a fine line between salvation and drinking poison in the jungle.”
This week, Jennifer Campbell, one of our Motivate Collective members, shared a disheartening story of gross negligence on her blog in a piece entitled, “The Most Disturbing Thing Happening in the Fitness Industry.” In it, Jennifer confronts an online trainer who is destroying lives in an attempt to help people well outside of her scope of practice. And I won’t mince words. However well intentioned, this is despicable.
James Mills, another Motivate Collective member and lawyer agrees. “From a legal perspective, most (I imagine all) states do not allow liability waivers to cover gross negligence. It is very likely that a court would find a coach grossly negligent for marketing and, in essence, treating people with ED as it is unequivocally outside the scope of a coach’s expertise or licensing.”
After 3 years of daily ethics training, I’ll tell you that ethics is rarely cut and dry. But that doesn’t mean we should be lenient, attempt to draft clear standards, or call people the fuck out when they are acting outside how we interpret our professional scope.
And if this was a simple problem, there’d be a simple answer. However, there is no One Problem so there’s no One Solution. Instead we have a lot of little, unsexy answers that few of us have the patience and courage (like Jennifer) to actually do. Like self-reflection on your scope of practice. Like advocating for higher barriers to entry for our profession. And engaging in some very important peer shaming to enforce professional norms. Let me be clear, I think peer shaming charlatans, fear-mongers, and the grossly negligent is not only good, but our duty as bearers of professional standards. And beyond that, I also think we have a responsibility to seek criminal prosecution, public education, and a million other little, unsexy things to make our professional practice more respectable.
What it means in practice is we, the professionals, need to be aware and active across the broad spectrum of ethics standardizations and enforcement. We need to talk with our peers about scope of practice. We need to talk about personal ethics in public (http://coachstevo.com/about). We need to advocate for appropriate barriers to entry to our profession. We need to shame people out of our profession. We need to report illegal shit and we need to invest in educating the public about these fucking con artists. And easiest of all, we need to GLADY refer clients out when they are beyond our skill set.
Creating a referral network that includes mental health services is simply a must. 24mil people in the US meet the DSM-IV criteria for an eating disorder. If evenly distributed, that means if you’ve had 11 clients, chances are high one has an eating disorder. And I have no doubt it’s higher because people suffering with EDs are attracted to our profession.
Setting up a referral network takes two steps:
finding mental health practitioners in your area via http://locator.apa.org
All you have to do is copy and paste this into the form at http://locator.apa.org:
Hello Dr. [name], > > > > I'm a [whatever you are] and I work with clients to achieve their health and fitness goals. I am interested in putting together a referral network for clients who need help outside of my skill set and scope of practice, and I was wondering if you have time to talk about your practice and how we can work together to help more people live healthier lives. > > > > Thanks for your time, [your name] > >
This is all you have to do. Two things, and I’ve already given you the link and the words. Just click, copy and paste.
But I know a lot of you reading are still hesitating, because Josh Hillis did.
“Ok, real talk, I’m on http://locator.apa.org/ and I’m a little nervous. Sure it’s kinda fun to ‘shop’ for a referral network, but all these concerns come up! I’m like — now what if I don’t have anyone to refer to them for a while? Will they think I suck? What about talking to them? They have like Phd’s and stuff! This is all super silly I know. But maybe I’m not the only person who’s feeling like this, so I thought I’d say something.”
One of our members encouraged him:
“As a clinical psychologist and someone who treats EDs, most of the time there isn’t a clear, quick, standardized way of screening for eating or exercise disturbances for non-clinicians. However, if you think about behaviors existing on a continuum, problems are typically coming up at the extremes–too much or too little. If a trainer and/or coach wrote me a message asking if I would consider being part of their consultation/referral network I would be THRILLED. I think we need more partnerships like this.”
“Ok, just emailed one. I feel so much better now!”
Because referral networks are not just your safety net. They’re your clients’ safety net and a way that we can help the people we can’t help.
Click. Copy. Paste.