Scope of Practice for the Fitness Professional: Counseling Clients and Mental Health

Fitness clients aren’t just clients; they are individuals who are juggling many responsibilities and fulfilling multiple roles in their lives. It’s not unusual for a client to enter a workout session feeling overwhelmed, stressed, and energetically spent, prompting you to want to offer impromptu counseling or mental health advice.

If you’ve successfully built rapport and trust with your fitness clients, they know you serve as a significant source of support and as an individual who can offer guidance and advice outside of the physical fitness dimension. As a result, your clients will often confide in you about their personal and professional struggles.

You have a duty to respond professionally and tactfully without crossing the boundaries of your defined scope of practice. What does this scope of practice look like as it relates to a client’s mental health needs? What can you do as a professional to respect those boundaries and still acknowledge the real struggles clients regularly face?

Counseling the  “Venting” Client

Clients, like all of us, need to blow off steam and “vent” in order to clear their minds or regain focus on a specific task or goal. It’s not inappropriate for a trainer to listen empathetically and respond with comments such as, “I can appreciate how stressful that situation is for you” or, “That must have made your day incredibly challenging.” Such reflective listening might be a counseling technique, but it’s not outside of your scope to perform it.

It’s ok to let your clients vent about a stressful event or an irritating set of circumstances, and in fact, may make up a significant percentage of your regular conversation. These types of situations don’t necessarily challenge the boundaries of a personal trainer’s scope. Listen to your clients, allow them the opportunity to process their day with you, and offer general and supportive statements like those above.

When It’s Something More

A defined rule of the fitness professional’s scope of practice is: don’t counsel. Personal trainers and health coaches are not trained mental health professionals and, therefore, cannot and should not offer counseling services. While it can be tempting to provide recommendations that may seem obvious to you, or attempt to remedy mental health conditions (depression, anxiety, etc.), fitness professionals must resist.

For example, if a client tells you he or she is depressed, your role is to, again, listen empathetically and maintain client confidentiality. Even if your client asks you for recommendations for how to treat a given situation or condition, you must understand that doing so places you and your client at risk.

Offering services that fall within the defined scope of another health professional is a violation of ethics and scope. Doing so can result in a revocation of certified status and possible disciplinary procedures, or worse, a lawsuit brought forth by the client.

In these situations, the actions you can effectively and safely take include coaching clients through behavior change as it relates to lifestyle and health, provide general health, fitness, and nutritional information from reputable sources, and refer to the appropriate healthcare professional to address and manage conditions outside your scope.

Types of Mental Health Professionals For Referral

In order to refer clients for counseling to other healthcare professionals, you must build connections and enhance your professional network. If you don’t already have a mental health professional within your circle of trusted referral sources, consider making connections with a licensed psychologist, a clinical social worker (MSW), a licensed professional counselor (LPC), licensed mental health counselor (LMHC), or another therapist.

If you don’t know a mental health professional, use your other professional connections (i.e. other personal trainers, a manager, etc) to support your efforts to make contact with someone licensed and trained to treat mental health issues.

Once you have established a professional connection with a therapist, you can gently and tactfully offer to refer your clients to him/her. This will allow you to remain within your scope and connect your clients with additional resources of support.