The ethics of working with clients who are mentally unwell is a hot topic in the world of positive psychology and coaching. It can seem a grey space, especially as clients aren’t always aware of the differences between counselling, psychology, therapy or coaching or the range of modalities used, from talking to hypnotherapy, EFT to somatic bodywork. It can be difficult for clients to sift through the options and find what is right for them.

So how do we support clients to understand what we do? And if we feel we are not the right person to help, where is our responsibility in that?

Coaching might attract clients with a variety of needs, and because it is often a shorter term investment with less stigma attached, it might be seen as a more accessible option. Where too does positive psychology sit in this? What role does it have to play in ill-health when its initial remit was, as Peterson (2008) tells us, to build on the good in life, rather than repair the bad.


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Ethical Considerations

Navigating this uncertainty is our responsibility as practitioners. We need to understand and acknowledge where we are comfortable to go with our clients, and when we are moving into territory that is out of our remit, maybe taking on a role better filled by another professional. This shouldn’t be seen as a failure, the client simply needs a different set of skills.

These discussions with clients must take place prior to the work starting and again at the contracting stage but should also be an ongoing review as the relationship progresses. Clear contracting is essential; if we agree at the start where we are heading then it is easier to spot when things are veering in a different direction.

But does this mean that positive psychology and coaching don’t have a place in mental illness?

Untangling The Confusion

It helps to view mental health and mental illness as two separate constructs. Keyes Dual-continuum model (2005) depicts this as two intersecting lines, from high to low mental health and from high to low mental illness. Positive psychology’s aim was to support those who were mentally well but at the same time ‘languishing’ in low mentally health.

Of course people with a chronic condition are not constantly in a state of crisis and might be managing their symptoms effectively so can be in a position of high mental illness but good mental health. Our bodies follow cycles; daily, monthly, seasonal and longer and we can cycle in and out of illness. Learning to not resist these rhythms can be part of navigating periods of mental ill-health with less fall out.

Positive psychology is first and foremost about self-awareness and self-knowledge. It helps build skills and learn strategies that can support us. To paraphrase St Francis, change what we can, accept what we can’t and recognise the difference.

Mental Recovery

This kind of positive self-management supports those living with chronic conditions. When time and energy are at a premium, knowing what strengthens and what erodes your resilience is key. Self-determination theory (2000) is all about becoming your own expert, building confidence and trust in yourself and these are all areas that positive psychology and coaching can support.

So personally, I believe there is a place for building mental health alongside treatment and recovery of mental illness. This work reduces the recurrence of illness and helps re-store us to pre illness levels of mental health or beyond through developing new techniques and ways of being that sustain us.

Re-Stocking Our Mental Assets

Positive psychology helps us identify and build mental assets to boost mental wellbeing. Assets like hope, optimism, self-compassion, mindset and self-belief. My go-to analogy is the necessity for physical rehab after the cast coming off a broken bone. In the same way our mental health benefits from a programme of strengthening in areas like confidence (could it happen again?), identity (I didn’t think this would happen to me) or Shame (does this make me different?).

People who do better in post-traumatic growth do so when they can find a purpose to their suffering. Positive Psychology can support coming to terms with an experience and building a useful, positive narrative about what has happened and even help people to come back stronger.

So Where Is The Boundary?

For me, the boundary between therapy and positive psychology coaching is not the person’s mental health but the professional’s understanding of their remit and what they are comfortable with. Reflection, supervision and training can support this awareness. In our contracting we need to make clear the purpose of the sessions, then the areas we dive into with a client can be varied and wide, but much less grey.

There is room for the two areas to be worked on simultaneously, separately or consecutively. Perhaps it doesn’t raise much conflict in me because of my work in social housing, supporting people who were five, ten or even twenty years post-crisis but still unable to move on. People should not be left in this no man’s land with no access to practices that can sustain and promote healthy minds.

If positive psychology is ‘the scientific study of what makes life most worth living’ (Peterson, 2008), then we must remember that reasons to live are most important to someone struggling with their mental well-being. Keeping that in mind is the compass I use to navigate my decisions of who I feel it is appropriate to work with.


The ethics of working with mentally unwell clients in positive psychology and coaching is complex. Practitioners must navigate boundaries, communicate clearly with clients, and understand when to refer to other professionals. Positive psychology can support mental health alongside illness recovery, building resilience and promoting well-being.

Read more about Tracy Bevan and her other articles HERE


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Keyes, C. L. (2002). The mental health continuum: From languishing to flourishing in life. Journal of health and social behavior, 207-222.

Peterson, C. (2008). What is positive psychology, and what is it not. Psychology Today16. Peterson, C. (2008). What is positive psychology, and what is it not. Psychology Today16.

Ryan, R., & Deci, E. (2000). Self-determination theory and the facilitation of intrinsic motivation,

social development, and well-being. American Psychologist, 55(1), 68–78.

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