Coaching compared with Psychotherapy

A common question that I get is how coaching differs from psychotherapy. The two have much in common since both are helping professions with the goal of supporting clients to make positive change in their lives. In fact, the overlap between the two professions is evidenced by the fact that many psychotherapists are also coaches, with some having switched over their practices completely to coaching.  Moreover, certain schools of psychology, notably humanistic and cognitive behavioral therapy, have had a strong influence on coaching.

When we refer to psychotherapy we must recognize that there are many different approaches and theoretical frameworks, over 1,000 according to Wikipedia. Obviously, an analysis of these various schools and sub-schools is far beyond the scope of this discussion. This article will focus on the medical model for mental health since this approach has dominated the field of psychotherapy.

Let’s now take a look at some of the key differences between coaching and psychotherapy in terms of area of focus, type of conversation, nature of relationship, level of challenge and accountability, format and timeframe, regulation and cost.

Area of focus

Psychotherapy primarily helps people deal with emotional problems that are interfering with the quality of their lives. Examples are grief, trauma, relationship concerns and mental health issues such as depression, anxiety, substance abuse and personality disorders. Coaching, on the other hand, does not deal with pathology. A coach starts with the assumption that the client is emotionally sound. If this turns out not to be the case, the coach will refer the client to a qualified psychotherapist or counselor since coaches are neither trained nor licensed to deal with mental health issues. A good coach, however, will have the ability to spot these and refer the client accordingly.

In psychotherapy, the focus is usually on supporting the client to resolve a problem, although this is not always the case – for example, Positive Psychology is a notable exception. Moreover, psychotherapy often looks closely at the past in order to identify and process unconscious issues and deal with past wounds and traumas. Again, this is true for some schools of psychology; for example, Psychoanalysis and Psychodynamic therapy, but not so for others, such as Gestalt Therapy and Acceptance and Commitment Therapy.

Coaching, on the other hand, is always goal oriented and solution-focused. While it recognizes the importance of the past, it focuses primarily on the future.  Whereas people go to a psychotherapist for help in overcoming a problem or for relief from emotional distress, they go to a coach in order to build a more desirable future. Coaching supports clients to define and reach concrete goals and to make tangible changes in their professional and/or personal life. Like psychotherapy, coaching also builds self-awareness, but it is oriented toward “action” as opposed to “understanding.” In a nutshell, coaching is about helping clients to realize their untapped potential.

Type of Conversation

In psychotherapy, the conversation is often open-ended without definition of a specific outcome. The topic is what arises in the moment, what is coming to the surface. While coaching is also flexible and person-centered, it tends to be more structured. Each session works towards achieving a specific desired professional or personal objective. This in turn fits into the larger framework of goals, strategies and actions that defines the overall coaching relationship.

In psychotherapy, conversations frequently involve the exploration and expression of feelings and emotions and the processing of deep-seated personal issues. Coaching conversations deal with more practical and tangible goals that the client wants to achieve in his professional or personal life; for example, improving performance at work, building leadership skills or planning and executing an important project. The coach helps the client to identify what she wants to achieve, plan a strategy to achieve it, and execute that strategy step-by-step.

Both professions use open and powerful questions in order to facilitate insight and self-awareness within the client. However, whereas psychotherapy often focuses on “why”, coaching is more interested in “what”, “how” and “when”. While psychotherapy is often oriented towards introspection, coaching is more oriented toward doing and becoming. For a coach, the main purpose of an insight is to move the client into action.

Relationship

While there are obvious similarities, including support, trust, safety and confidentiality, the relationship between and coach and a client is quite different from that between a therapist and a client. In psychotherapy, there is more of a clinical relationship, in which the therapist assumes the role of the healer or the expert in the client’s problem or dysfunction. The fact that therapy is often covered by health insurance – at least in the US –  underscores its alignment with a medical model.

The coaching relationship can be characterized as a partnership of equals. The coach views the client as an expert in his own life with all the resources necessary to reach his goals. The role of the coach is to help the client to find his own answers. There also tend to be less boundaries in a coaching relationship. Whereas a therapist is unlikely to share details of her personal life – unless absolutely necessary –  a coach is more likely to reveal aspects of herself as an aid to the client’s learning. For example, some coaches do a focusing exercise with clients at the start of each session to “clear the space.” In this exercise, both the coach and the client briefly identify any background thoughts and feelings that could interfere with their being fully present in the coaching conversation.  Of course, the coach will only share what is appropriate, but there is, nevertheless, more self-revelation than occurs in therapy. In working with an executive or a leader, a coach recognizes the client as an expert in her field. Rather than giving advice or transmitting expertise, the coach’s role is to facilitate positive change and growth within the client. In fact, the International Coach Federation (ICF) defines coaching as “partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.”

Challenge and Accountability

In therapy, a client tends to work at a comfortable pace, session-by-session. A coach is more likely to challenge and stretch the client by encouraging him to take actions that are slightly out of his comfort zone. Please refer to my article on the comfort zone and peak performance.  Since coaching does not deal with “pathology”, the coach tends to play less of a protective role. Whereas a therapist is very attuned to a client’s emotional fragility, a coach will tend to expect more from a client and hold them accountable for their actions and outcomes. In fact, each coaching session ends with specific action items to be completed by the client before the next session. In my experience, it is unusual for a therapist to hold a client accountable for completing an agreed set of actions. Of course, this is a non-judgmental process, where the coach frames every situation and outcome as a learning opportunity.  At the same time, the partnership between equals of a coaching relationship often results in less dependency on the part of clients than in a therapy relationship.

Format and Timeframe

Coaching is quite flexible in its delivery. For example, it is not unusual for a coach to meet a client in a coffee shop, park or other public place to conduct a coaching session. This is not typical in therapy, perhaps because of the stigma that unfortunately still often accompanies it. Coaching sessions are often conducted over the phone or over the internet, a trend that continues to expand driven by the rapid evolution of digital communication and collaboration platforms. Therapy relies predominately on face-to-face sessions in the therapist’s office, with phone sessions used only in exceptional circumstances. Once again, this reflects therapy’s medical orientation and the fact that health insurance will often not cover telesessions.

Coaching is also generally more flexible with regard to the duration and timing of sessions. Coaching sessions often range between 30 to 90 minutes and are conducted weekly, bi-weekly or monthly. Often coaches make themselves available to clients between sessions for brief conversations or text messages. A coach is more likely to check up on a client between sessions. Many coaches also provide their clients with written notes of each session as well as helpful tools and resources. This is in contrast to therapy, which typically consists of a 50-minute hour with no shared notes or follow up.

Contracting tends to be more formalized in coaching than in therapy. Many coaches require their clients to sign a written agreement stipulating the terms and conditions of the coaching engagement. In coaching there is an agreed outcome and fixed number of coaching sessions; for example, a coaching engagement of 12 sessions. Thus the timeframe of coaching is defined up front and typically much shorter than that of therapy, which can often stretch on for several years.

Coaching is generally more structured than therapy. As mentioned before, therapy tends to be more open ended. In coaching, there is a clear framework not only for the overall coaching series, but also for each coaching conversation.

Regulation

While psychotherapy is a regulated field, coaching is not. In most countries and jurisdictions, psychotherapists must be licensed by the national or regional government. There are no state-mandated licensing or governing boards for coaching; however, perhaps because of its business origins, coaching is often self-regulated through professional bodies. These bodies, the largest of which is the ICF, maintain ethical and professional guidelines to which all member coaches must adhere. Both therapists and coaches require continuing professional education to maintain their credentials.

As mentioned above, a coach will refer a client who manifests emotional distress to a qualified therapist. However, these does not mean that the therapy and coaching are mutually exclusive. A client could work with a therapist on emotional issues while at the same time working with a coach on professional and personal goals. Furthermore, some therapists are trained in coaching and can incorporate coaching techniques in their practice. On the other hand, coaches are not qualified to conduct psychotherapy.

Cost

Although on a per-session basis, coaching, especially executive coaching, is generally more expensive than therapy, a typical coaching engagement is usually much shorter in duration than most types of therapy. On the other hand, since therapy focuses on treating a diagnosable pathology – at least in the view of insurance companies – it is often reimbursable under medical insurance. Coaching is obviously not covered by medical insurance since it is not focused on healing or curing, but on helping the person to grow professionally and personally.

Conclusion

At first glance, coaching and therapy often seem very similar to the uninitiated eye. In reality, as we have seen in this article, they are two quite distinct approaches that differ in area of focus, type of conversation, nature of relationship, level of challenge and accountability, format and timeframe, cost and regulation. Both are invaluable resources to anyone who desires to improve the quality of their life.

References

Hart, V., & Blattner, J., & Leipsic, S. (2001). Coaching Versus Therapy, a Perspective. Consulting Psychology Journal: Practice and Research, 53, 229-237.  https://www.apa.org/pubs/journals/features/cpb-1061-4087-53-4-229.pdf

Hullinger, A. M. and DiGirolamo, J. A. (2018). Referring a client to therapy: A set of guidelines. Retrieved from International Coach Federation website: https://coachfederation.org/app/uploads/2018/06/Whitepaper-Client-Referral-June-2018.pdf

“Life Coach vs. Therapist.” Tony Robbins, Robbins Research International, Inc.  https://www.tonyrobbins.com/coaching/life-coach-vs-therapist/

Williams, P. Coaching vs. Psychotherapy, The Great Debate https://www.cce-global.org/Assets/BCC/Resources/CoachingvsPsychologyTheGreatDebate.pdf


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s