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What is the difference between coaching and therapy?

As coaching becomes increasingly popular, and as more psychologists and psychotherapists are offering coaching services, this question is frequently being asked. And rightfully so. There is certainly overlap between the fields of coaching and therapy, but knowing the distinctions is important, especially if you are considering which one might serve you best!


As a licensed psychologist and a positive psychology coach, I have training and competencies in both psychotherapy and coaching. It is of utmost importance that I ensure my clients clearly understand which service I am providing to them. My private coaching practice is completely separate from my work for a large healthcare system as a neuropsychologist, but I still go to great lengths to make sure my coaching clients understand what coaching is, and what it is not.


First, it’s important to note the major overlap among coaching and therapy:


Both coaching and psychotherapy apply knowledge of human behavior, motivation and behavioral change.

Both coaching and psychotherapy utilize interactive counseling techniques.

The key differences between coaching and psychotherapy lie in the focus, goals, and client-professional relationship in each activity. The table below provides an overview of these differences. A more thorough description follows.


Focus


In psychotherapy, the focus is on a psychological problem or psychiatric illness.

Psychotherapy is based on the medical model. Psychotherapists are trained to identify, diagnose and treat psychological problems and psychiatric illnesses through evidence-based counseling techniques and programs.


Psychotherapy is a health care service and is usually reimbursable through health insurance policies. In order to receive psychotherapy services which are deemed medically necessary, a client/patient must meet diagnostic criteria for a psychiatric/psychological disorder (e.g., major depressive disorder, bipolar disorder, posttraumatic stress disorder, ADHD, substance abuse/dependence).


In coaching, the focus is on enhancing life satisfaction, optimizing performance, and achieving personal or professional goals. The focus is on cultivating human potential.

Coaching may address specific personal projects, job performance and satisfaction, or general conditions in the client’s life, business or profession.


Coaching is not a health care service, and while some psychotherapists integrate it into their treatment methods, coaching services provided to coaching clients are not reimbursable through health insurance policies.



Goals


The goal of psychotherapy is to alleviate symptoms of an illness and/or change dysfunctional behaviors related to a psychological disorder. The goal is also to take people from dysfunctional or non-functional living to healthy or stable functioning.


In coaching, the goal is client-identified. A client may want to explore a career change that would allow them to do more meaningful work. A client may want help managing their time better so that they have more time and energy to put into their family relationships or a passion project. A client may want to lose weight or improve their follow-through on fitness goals in their life.


The coach helps the client make changes that will assist the client in getting the result they want in their life. The coach works with the client to create and maintain motivation for change, explore obstacles to change, and create plans and facilitate follow-through on plans for change.


The goal is to take a person from “fine” (stable, healthy functioning) to “flourishing” (highest level of performance and life satisfaction). Coaching embodies the idea that we can all keep getting better, and we don’t ever have to stop growing, improving or setting and achieving new goals.



Client-Professional Relationship


In psychotherapy, the professional (psychotherapist) tends to take a more passive, reflective approach. Though there are some more directive forms of psychotherapy, therapists are, in general, trained not to give clients specific advice, and instead to help their clients arrive at their own answers to problems.


Because psychotherapy clients have emotional or psychological disorders, they are often emotionally vulnerable. This vulnerability is increased in therapy, where the expectation is that clients will discuss very intimate personal information and feelings about which they are understandably sensitive. Their past life experiences may have made trust more difficult for them to achieve. Thus, therapists are often considered to be in a place of disproportionate power and must tread very carefully, being sure to protect the safety of their clients and to “above all else, do no harm”.


Coaches tend to implement an active, energetic approach. It is more common for coaches to give specific advice and ideas, as coaching clients are in a relatively healthy place mentally and emotionally and thus are ready to receive guidance and teaching on how to make changes that will assist them in reaching their goals.



Why having a psychologist as a coach is ideal


The coaching field is currently an unregulated field, meaning anyone can call themselves a coach. There are certification programs available from various organizations, and these programs vary in terms of their educational and experiential requirements, but a certification is not required in order for an individual to offer coaching services.


Meanwhile, a psychologist has completed a doctoral degree in psychology and has expertise and extensive knowledge in human behavior and behavioral change. Psychologists are trained to apply social science research to therapeutic practices, and have completed hundreds of hours practicing under the supervision of a licensed professional. In my case, as a neuropsychologist, I also have additional education and training in neuroscience, cognitive functioning, and how the brain influences behavior.


Psychologists also must adhere to strict ethical and legal standards. Confidentiality, boundaries, and protecting the safety and wellbeing of clients are taken very seriously. (There is no licensing board for coaches and thus no legal or ethical requirements in place, as of this writing, specifically for coaches.)


Now, all of this is not to say that coaches who are not psychologists are incompetent. In fact, several of the coaches I respect and admire the most do not have a graduate degree in psychology. However, it is my opinion that a psychologist who has completed additional training in coaching has a distinct edge and can provide a gold standard of coaching.


Additionally, because of their expertise in identification of psychological disorders, a psychologist is able to recognize when a person seeking coaching services is more appropriate for psychotherapy instead, and can refer them to a licensed therapist. A coach without this training/background in psychology is less able to identify whether a client needs therapy versus coaching, and thus a client may spend tremendous time and effort on the coaching process with little effectiveness because therapy was needed first.


I think an analogy is helpful here. Consider a yoga instructor who is a trained physical therapist. The PT-yoga instructor is not only very knowledgeable about human anatomy and biomechanics, but he or she can also easily recognize when a person is at risk for injury, or already has an injury, and adjust the yoga practice as necessary or make other recommendations. Similarly, the psychologist-coach is not only very knowledgeable about human behavior and psychology, but he or she can also easily recognize when a person is suffering from a psychological disorder and should be referred to a mental health professional for appropriate treatment outside of coaching.


 

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