What’s the difference between coaching and psychotherapy?
What’s the difference between coaching and psychotherapy?
This question comes up frequently. Sometimes people are simply wondering what I do. Other times, clients tell me they feel like they’ve been to “therapy” after they’ve just processed some emotionally challenging situations at work. So where do I draw the line?
Differentiating coaching from psychotherapy is important because they can seem so similar. After all, both coaching and psychotherapy are focused on helping people grow and change, and both can be places where people are doing hard, reflective work. And when they’re done well, both can be deeply transformative.
But coaching and therapy are different professions with different scopes of practice. I’m always happy when clients tell me they have a therapist, because it tells me that they have a place to work through issues that come to light during a coaching session.
I’ve also encouraged clients to enter into counseling when the situation requires. In fact, sometimes finding a therapist—and getting over the obstacles in the way of getting the care they need—are part of our coaching agenda.
When doing so, however, I see the process referring clients to counseling as one of broadening the conversation. I believe pairing coaching with psychotherapy can be a tremendously powerful combination, in which people can create a team of supportive presences around themselves.
For this team to work well, though, everyone needs to be clear about their roles and scope, and clients in particular need to know who is best suited to help them with what.
In a whitepaper written for the International Coaching Federation (ICF), Alicia M. Hullinger, Vice President of ICF’s Thought Leadership Institute, and Joel A. DiGirolamo, ICF’s Vice President of Research and Data Science, offer some important guidelines.
Hullinger and DiGirolamo suggest that coaches and psychotherapists are on the same continuum of practice, much in the same way that athletic trainers, physical therapists, sports medicine physicians, and orthopedic surgeons are. Just like a person would consult a different person to improve their overall fitness than they would to rehab a torn muscle, they argue, coaches and psychotherapists occupy different scopes of practice defined by differences in focus, purpose, and population:
Coaching focuses on visioning, success, the present, and moving into the future. Therapy emphasizes psychopathology, emotions, and the past in order to understand the present. The purpose of coaching is frequently about performance improvement, learning, or development in some area of life while therapy often dives into deep-seated emotional issues to work on personal healing or trauma recovery. Coaching tends to work with well-functioning individuals whereas therapy work tends to be for individuals with some level of dysfunction or disorder. Therapy works more with developing skills for managing emotions or past issues than coaching.
The distinctions they draw are important and also show how clients can benefit differently from both practices.
I often work with leaders who are coming to terms with significant challenges. They may also be carrying things from their past that’s influencing how they’re responding to those challenges. And so when we meet, I’m always assessing what’s inside my scope and what’s outside.
I do this by asking three questions that mirror Hullinger and DiGirolamo’s work.
Focus: Where does our attention lie?
As Hullinger and DiGirolamo note, coaching is ultimately about how a client is responding to the present, with an eye toward the future. To be sure, the past is obviously important in understanding the present. After all, knowing how we got here, why someone might tend to respond in one way or another, and what the stakes are is key if we’re going to be making progress.
The difference from therapy, though, is how much time we’re spending in the past. In coaching, we’re not digging up old wounds or trying to process deep-seated anxieties or traumas. We dip our toes into the past, but we don’t dive in. So if clients feel a need for a deeper excavation and reconstruction of what’s happened to them, therapy is a better fit than coaching.
Purpose: What are we doing here?
Hullinger and DiGirolamo see coaching and therapy as having different models of care. Therapy, as an outgrowth of the medical professions, tends to view mental health through the lens of disease. As a result, the purpose of therapy and counseling lies first in diagnosing and categorizing the causes of particular symptoms people may be experiencing and then prescribing a treatment for those symptoms in the hopes of promoting healing.
In contrast, coaches don’t diagnose or treat. As Hullinger and DiGirolamo suggest, coaches start with the assumption that people already have the strengths, capabilities, and wisdom they need to respond to the challenges they’re facing—understanding, of course, that they may at some point need deeper support. From that starting point, coaches are less interested in diagnosing symptoms and instead helping people understand, learn, and grow.
Or to put it differently: Therapy is ultimately about healing, in which we can learn very important things about ourselves. Coaching is about learning, with the knowledge that what we learn can, at times, be quite healing.
Whenever the need for healing begins to take precedence over learning, we need to add another partner to our conversation.
Client: How well is my client doing?
Hullinger and DiGirolamo remind us that mental health is on a continuum. We move along that continuum throughout our lives. Sometimes, we may need more help than others. Although coaches may be working with people facing challenging problems, those problems are not interfering with clients’ everyday lives. Therapists, on the other hand, work with deeper, systemic problems that are limiting clients’ ability to live and relate to others.
Although clients’ issues can vary, Hullinger and DiGirolamo suggest that clients may benefit from therapy if:
They are or are thinking about harming themselves or others.
They seem permanently stuck in life and are unable to make progress.
They feel excessively angry about their lives or toward others.
They have withdrawn from relationships or activities that have given them joy.
They are struggling with self-care, including personal hygiene and sleep.
They frequently find themselves feeling excessively worried or nervous.
They are experiencing persistent feelings of sadness or hopelessness.
Their behaviors around food—such as overeating or undereating—and their weight are impairing their health.
They are experiencing persistent difficulties healing from an emotionally overwhelming event, including acts of violence, sexual assaults, or natural disasters.
They exhibit signs of substance use disorder.
Their thinking seems paranoid, delusional, or incoherent.
While coaches can refer a client to therapy, going to therapy is ultimately the client’s choice. And some clients do decline the offer.
But if they take the offer, they have an opportunity to restore a deeper sense of balance and health to their lives that will enrich their relationships with themselves and others—and make their work in coaching all the more fruitful.
Interested? Want to learn more about the work I do? Contact me here.
