Understaffing has undermined the behavioral health industry for years.

Only slightly more than a quarter of the nation’s need for mental health services is being met, according to KFF. Mental health coaching has emerged as a crucial way for the industry to provide care for lower-acuity patients who need a helping hand meeting goals, rather than a diagnosis and symptom management. 

Many coaches hold high-level degrees and may be qualified to work towards a therapist license, but opt to coach instead because of the flexibility, benefits and rewarding nature of working with clients to set and achieve goals.

Still, behavioral health coaches make less than therapists at digital health companies on average. According to a report by Therapists in Tech, the average salary of a behavioral health coach is $70,000, and that of a licensed therapist is $90,000. 

“Mental health coaching is very empowering,” Amy Schamberg, an independent nationally board-certified health and wellness coach and certified functional medicine coach, told Behavioral Health Business. “It breaks down barriers.”

Schamberg offers one-on-one and group coaching as well as employee wellness workshops. She spent over a decade working as a school psychologist before getting certified as a functional medicine health coach. After suffering a severe case of burnout in her school psychology career, Schamberg took a significant pay cut and switched careers to work as a full-time Headspace coach.

Santa Monica, California-based Headspace provides mindfulness and mental health tools through an app and enterprise-level offerings including therapy and psychiatry services. In April, the provider expanded its coaching services to be available directly to consumers. 

Schamberg left Headspace after about a year and a half to create her own practice and acquire more freedom and flexibility. Headspace provided Schamberg with “a ton of” support and training, and she describes management as doing “a really good job.”

“The workload was super high,” Schamberg said. “We provided coaching through chats. I would sometimes have multiple conversations going on at once, which could be a little tricky. But overall, I really value that experience.”

Schamberg holds a master’s degree in school psychology, which is on par with Headspace requirements.

To become a therapist in Colorado, where Schamberg is located, clinicians must obtain an additional degree to work with people over the age of 21 outside of a school setting. She considered getting an additional master’s in counseling instead of becoming a coach. Still, she said that it would have required multiple years of classes and a year or two of supervised work experience.

Master’s level degrees are common among Headspace coaches, according to Shula Melamed, senior behavioral health coach at Headspace and a national board-certified health and wellness coach.

“A lot of the coaches that work on the team are extremely intelligent [and] educated,” Melamed told BHB. “Some have counseling degrees and have decided not to do counseling.”

All of Headspace’s coaches must be nationally board certified by an accredited institution or have earned a Master’s-level degree in a psychology-related field along with over two years of relevant experience. They must also have more than 200 hours of supervised training. Melamed herself holds two master’s degrees, one in psychology and one in public health.

Headspace also operates an in-house training program approved by the National Board for Health and Wellness Coaching (NBHWC).

Many of the coaches at digital mental health provider Lyra also hold master’s level degrees, according to the clinical director of Lyra’s mental health coaching program, Shane O’Neil-Hart. But even more important than hiring coaches with graduate-level degrees is hiring people with the potential and skill set to help people, and then training them in Lyra’s evidence-based model, O’Neil-Hart said.

“I wouldn’t necessarily substitute somebody who has a master’s degree in some form of psychology [for an ICF accredited coach], because there’s so many different types of psychology,” O’Neil-Hart said.

Burlingame, California-based Lyra partners with employers to provide mental health benefits to more than 17 million people globally. The provider offers AI-powered clinician matching, a library of digital resources and short-term support from a mental health coach via video or live messaging.

Lyra also moved into the world of severe mental health issues earlier this year with the launch of Lyra Complex Care.

The provider hires coaches who have attended coaching programs accredited by the International Coach Federation (ICF). In addition, Lyra operates an “extensive” four-to six-month onboarding process that includes multiple days of live training workshops during the first few weeks, asynchronous preparation and personalized feedback before coaches start seeing clients. Coaches then consult with peers to strategize the most effective ways to help clients.

At Lyra, many coaches are people in their second career, O’Neil-Hart said, and the average age of a Lyra coach is older than that of a Lyra therapist.

“This ability to bring to their life experience [is] just one of the things that clients find to be really valuable about coaching,” O’Neil-Hart said.

Benefits and downsides of coaching

Mental health coaching offers benefits that make it an attractive career path, even for some people who could receive their therapist licenses if they choose to.

Melamed chose to become a coach, in part, because of the lower patient acuity level. Therapists usually see patients at a higher level of need, right before “the rubber hits the road,” she said.

“There’s something about setting goals, helping people come with small, achievable steps to get there, seeing them hit the goals, being there, reframing when they’re not able to get to where they want to go, and showing them that there’s another way to get to where they want to be,” she said.

People who seek coaching are not “totally flailing,” Schamberg said, and are actively motivated to make changes in their lives.

“You get to see transformations that you wouldn’t otherwise see because coaching is all about behavior change,” Schamberg said. “Most people know what that [change needs to be], or they kind of have a hunch, but if they could do it themselves, they would have done it.”

O’Neil-Hart commonly sees that Lyra’s coaches want a career in mental health but enjoy working with more mild mental health challenges, similar to Melamed and Schamberg. He also sees the remote nature of the job and flexibility as some of the most commonly enjoyed benefits.

While remote working offers flexibility, it can also lead to a certain isolation level. Melamed says that while she would not want to commute to work every day, she does miss seeing her community.

Headspace also offers an educational stipend for coaches which creates growth opportunities, according to Melamed. Crucially, working for Headspace also guarantees her a level of stability through benefits.

“I don’t know why anyone would work for the company that didn’t give them health insurance,” Melamed said.

Just because mental health coaching involves lower acuity patients does not mean that the career does not involve paperwork.

The amount of notes Melamed makes about her clients is comparable to that of a therapist, she said, though the text-based nature of the coaching conversations means it’s easy to scroll back through a previous conversation with a client.

Schamberg says one of the hardest parts of her job is the follow-up work required of her in between coaching sessions. She analyzes her clients’ responses to preliminary questionnaires, takes notes, sends email recaps after sessions and checks in throughout the week.

For every four hours a week she directly meets with clients, Schamberg says she spends 12 hours of work behind the scenes.