When and how to refer a client to a therapist?

Apr 5, 2021

Coaching is a powerful process, but it’s not the answer to all problems. Sometimes, a coaching client should be referred to a different specialist, such as a therapist or counselor. In fact, failing to do so is a clear ethical violation for a coach.

Thankfully, ICF has developed a helpful guide for when a referral to a therapist or other professional is recommended or required. Below is the quick overview, and you can download the full text of a white paper on this topic here.

Coach Client Therapist Referral



  • Coach’s ethical responsibility
  • Psychotherapy is outside  coaching scope of work
  • Intervention is important  to recovery
  • Intervention may save a life


  • Issue is outside your competency  and experience level
  • Issue interferes with daily  functioning
  • Issue is a barrier to making  progress in coaching
  • Issue is psychological in  nature and deals with deep seated emotions


  • Be direct and calm
  • Express concern and care
  • Point out specific behaviors
  • Listen closely
  • Encourage client to seek help
  • Normalize therapy
  • Make referral


  • Marked changes in mood such as irritability, anger, anxiety, or sadness
  • Decline in performance at work or school
  • Withdrawal from social relationships and activities
  • Changes in weight and appearance, including  negligence of personal hygiene
  • Disturbances in sleep (either oversleeping or  difficulty falling or staying asleep)
  • Expresses hopelessness or suicidal thoughts

Common issues that warrant a referral to therapy include anxiety, depression, eating disorders, post traumatic stress, substance abuse, suicidal ideation, and thought disorders.


If you believe someone may be in imminent danger  of self-harm or hurting another person:

  • Call your local emergency number
  • Stay with person until help arrives
  • Ask what means they have that may cause harm
  • Listen, but do not judge, argue, threaten, or yell

If you think someone is considering suicide, get help  from a crisis or suicide prevention hotline.

Contact information for crisis centers:

Befrienders Worldwide – https://www.befrienders.org/

International Association for Suicide Prevention – https://www.iasp.info/resources/Crisis_Centres

International Suicide Prevention Wiki – http://suicideprevention.wikia.com/wiki/International_

* Other helping professionals include a support group, a mentor, a specialist coach, or a spiritual representative.  See “Referring a Client to Therapy: A Set of Guidelines” for more details on indicators and the referral process. 

** Keep in mind that mental health is on a spectrum, so watch for duration, frequency, and intensity of symptoms. Consider consulting a supervisor or a mental health professional when you are uncertain. 

Sources: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Arlington, VA: American Psychiatric Association. American Psychological Association. (2017). Retrieved from www.apa.org. Qualitative research conducted by ICF. 

Cite as: Hullinger, A. M. and DiGirolamo, J. A. (2018). Referring a client to therapy: A set of guidelines. Retrieved from Internation al Coaching Federation website: https://coachingfederation.org/app/uploads/2018/05/Whitepaper-Client-Referral.pdf.

Smita Raghum
Smita Raghum


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