What is the difference between coaching and therapy?Apr 17, 2023
One view is that coaching reflects a synthesis of three movements:
the growth of talking therapies; consulting and organizational development
and industrial psychology; and the proliferation of personal development trainings.
~ Julia Bueno, Coaching: one of the fastest growing industries in the world
Therapy Today, September 2010
Coaching is an unregulated industry but it is here to stay. A 2018 market study reports there are 53,300 professionals coaching worldwide. About 33% of them are in the US and it appears that demand is growing. In fact, some say it is one of the fastest-growing industries in the world.
At one time, a brewing conflict between therapy and coaching provoked an almost fear-like argument about crossing the boundary between coaching and therapy. Crafting threat-based messages that amplify fear and envy causes misunderstandings and misinterpretations of where the boundaries are between coaching and therapy. Today, trauma-informed coaching is being embraced by therapists as a way to take pressure off the demand for therapy that is causing burnout.
Coaches cannot do therapy but therapists may use coaching techniques within the therapeutic relationship if they have the training. This is different than having two different contracts (dual relationship) with the same client to do therapy and coaching at the same time.
Let’s begin with the core competencies from the International Coaching Federation (ICF). They make it clear that the distinctions between therapy and coaching need to be maintained with referrals.
- Maintains the distinctions between coaching, consulting, psychotherapy, and other support professions
- Refers clients to other support professionals, as appropriate
The California Association for Marriage and Family Therapists (CAMFT) addressed the issue in the article Coaching vs Therapy that acknowledges some of the challenges of defining coaching; however, they state that regardless of whether a coach has received education and training similar to a psychotherapist, they may not practice psychotherapy without a license. Psychotherapy is a government-regulated profession whereas coaching is a self-regulated career. Anyone can call themselves a coach; however, organizations such as the International Coaching Federation and the National Board for Heath and Wellness Coaches bring an industry-recognized layer of professional acumen and credibility with credentialing that requires training, adherence to ethical standards, and core competencies.
These guidelines are helpful but coaches can find themselves facing complex situations with clients. Coaching and therapy share common ground studying behavior, cognition, and emotions. Some clarity may be found when considering if a diagnosis is needed. Coaches do not diagnose their clients nor do they treat mental illness.
Therapists diagnose and resolve problematic beliefs, behaviors, relationship issues, and feelings. Focused on the analysis of maladaptive behavior and thinking, therapy can be wandering and open-ended with the intent to heal and restore healthy functioning. Because it is an insurance-driven profession, when clients' symptoms resolve, therapy often comes to an end. This does not mean the client is motivated and engaged in home, workplace, and community.
Coaching is a client-driven approach defined by a clear coaching structure with a coach-client agreement, goal setting, planning, and accountability. Within the coaching structure coaches build rapport with their clients, use Socratic questioning to evoke awareness, and draw out the client’s potential. They may also address obstacle thinking and behaviors that block performance and goal achievement.
Can coaches work with clients who have experienced trauma?
Most people experience trauma sometime in their life accompanied by painful emotions that are tied to difficult circumstances. According to Sidran Institute for Traumatic Stress Education & Advocacy, an estimated seventy percent of adults in the US have experienced a traumatic event at least once in their lives but only twenty percent of these people go on to develop PTSD.
The lingering feelings may influence behaviors that affect their work and home life. Surely this deserves a referral to a trained professional experienced in a trauma-informed approach. Psychology Today defines trauma this way:
Trauma is the experience of severe psychological distress following any terrible or life-threatening event. Sufferers may develop emotional disturbances such as extreme anxiety, anger, sadness, survivor’s guilt, or PTSD. They may experience ongoing problems with sleep or physical pain, encounter turbulence in their personal and professional relationships, and feel a diminished sense of self-worth due to the overwhelming amount of stress.
Research suggests that more than seventy percent of people with mental illness receive no treatment from healthcare professionals globally. Coaches need to do their part to make the recommendations and present the referral in a way that alleviates feelings of prejudice and discrimination against people with mental health; however, coaches regard clients as responsible for their own decisions.
Because clients have experienced trauma does not mean that they need therapy. Traumatizing events such as the loss of someone you love, a life-altering accident, or a serious illness affect people differently with a flood of thoughts, strong emotions, and how they cope with uncertainty.
Eighty percent of people who experience a traumatic event do not go on to have PTSD. In general, people adapt well over time to life-changing situations because resilience is not extraordinary. Clients may certainly be dealing with painful circumstances but that event doesn’t have to define the outcome. Consider what Psychology Today states about dealing with trauma.
Although the instigating event may overpower coping resources available at the time, it is nevertheless possible to develop healthy ways of coping with the experience and diminishing its effects. Research on trauma identifies several healthy ways of coping, such as avoiding alcohol and drugs, seeing loved ones regularly, exercising, sleeping, and paying attention to self-care.
Resilience is ordinary behaviors, thoughts, and actions that can be developed and learned. The core components of resilience — connection, wellness, healthy thinking, and meaning-making — empowers clients to withstand and learn from difficult experiences, even if they stem from extraordinary experience. These core components work well within the coaching structure.
- Prioritize supportive relationships
- Take care of your body with sleep, nutritious foods, and exercise
- Stress management practices like meditation and mindfulness
- Avoid negative outlets (drugs, alcohol)
- Finding purpose through helping others or being proactive
- Move towards goals
- Look for opportunities for self-discovery
- Maintain a hopeful outlook
- Learn from the past
Because therapists are trained to be experts, they often lean towards informing or intervening whereas coaches are more likely to use an evocative inquiry to evoke awareness. This is an essential quality of coaching. Facilitating healthy ways of coping, seeing loved ones, and paying attention to self-care.
Coaches can even acknowledge trauma but they can not explore or treat it. If you are working with a client who has Post Traumatic Stress Disorder (PTSD) please make sure to give a referral to a trauma-informed therapist. PTSD is a serious psychiatric disorder that requires treatment that affects approximately 3.5 percent of adults in the US every year. The American Psychiatric Association estimates that one out of eleven people will be diagnosed with PTSD in their lifetime.
Post Traumatic Growth (PTG) is the far more common response to trauma. That does not mean that they do not have painful feelings and difficulty working through the trauma. In fact, working through emotions and thoughts produces Post Traumatic Growth as a result of struggling with a stressful or problematic experience. Clients change their perception of themselves, improve their interpersonal relationships, alter their life philosophy, change their spiritual orientation, increase their compassion and empathy for others, find ways to express their emotions with greater ease, feel greater comfort with their own vulnerability, find ways of experiencing themselves as capable and self-reliant, change their life priorities, and find new directions in their life.
Resilience: “Psychologists define resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress—such as family and relationship problems, serious health problems, or workplace and financial stressors. As much as resilience involves “bouncing back” from these difficult experiences, it can also involve profound personal growth.”
Coaching is often differentiated from therapy as one looks forward and the other looks back. Therapists focus on the why and coaches on the how or coaches stick with the conscious mind and therapists delve into the unconscious realm. These are misleading definitions because coaches do go into the past and therapists do go into the future. If coaches are just addressing how clients reach their goals then how are they managing the subconscious behavioral guidance systems that are continually furnishing us suggestions throughout the day of what to do next? Even marketers are making use of those unconscious processes like pumping out the smell of freshly baked cookies to entice consumers into the bakery. Our brains often act on unconscious impulses before we are consciously aware. Sometimes our goals are in line with our conscious intentions and purposes and sometimes they are not.
It is generally accepted that only a fraction of the mind is conscious. What’s left is outside of conscious awareness. According to an article published in Scientific American, Our Unconscious Mind, Unconscious Impulses, and Desires Impel What We Think and Do In Ways Freud Never Dreamed Of, much of our behavior and thinking are governed by processes beyond our conscious awareness. Embedded attitudes are shadow stories in the unconscious shaping many of our beliefs, thoughts, and actions toward others stored outside our awareness.
Daniel Kahneman, author of Thinking Fast and Slow characterized our automatic thoughts as fast, efficient, and outside the realm of conscious awareness whereas conscious thought is slow and purposeful. These two thought processes are complementary but when they conflict, problems can arise.
Perceptions are subconsciously generating expectations about our behavior and those of others. These can cause problems in performance and achievement. Coaches can’t ignore the subconscious motivations that may be playing havoc with their clients' progress forward.
To address reflective reactions, clients must exert willful, conscious effort to put aside the unexplained and sometimes warranted feelings they may have towards themselves and others. The stronger their subconscious influence, the harder clients have to work to consciously overcome them. For example, health and wellness coaches often work with clients to improve their lifestyle habits that might be disrupting their health or executive coaches may work with clients to change their leadership style. Our ability to regulate our own behavior hinges on our capacity to identify and try to overcome the automatic impulses and emotions that influence every aspect of our waking life. To make that happen, we have to bring the subconscious into conscious awareness. By definition, coaching evokes awareness. To evoke client awareness coaches can’t help but address the subconscious.
Evoking awareness is a coaching core competency. The ICF Core Competency Model’s seventh standard is evoking awareness: “Facilitates client insight and learning by using tools and techniques such as powerful questioning, silence, metaphor or analogy.” This standard has eleven core competencies that further define evoking awareness. Take a look at just some of the eleven core competencies.
- Challenges the client as a way to evoke awareness or insight
- Asks questions about the client, such as their way of thinking, values, needs, wants, and beliefs
- Asks questions that help the client explore beyond current thinking
- Helps the client identify factors that influence current and future patterns of behavior, thinking, or emotion
There are additional core competencies that ask coaches to reach into the subconscious.
- Is sensitive to clients' identity, environment, experiences, values, and beliefs
- Remains aware of and open to the influence of context and culture on self and others
- Seeks to understand the client within their context which may include their identity, environment, experiences, values, and beliefs
- Demonstrates respect for the client’s identity, perceptions, style, and language and adapts one's coaching to the client
- Considers the client’s context, identity, environment, experiences, values, and beliefs to enhance understanding of what the client is communicating
- Recognizes and inquires when there is more to what the client is communicating
- Notices, acknowledges, and explores the client's emotions, energy shifts, non-verbal cues, or other behaviors
- Integrates the client's words, tone of voice, and body language to determine the full meaning of what is being communicated
- Notices trends in the client's behaviors and emotions across sessions to discern themes and patterns
- Acknowledges and respects the client's unique talents, insights, and work in the coaching process
- Is comfortable working in a space of not knowing
- Creates or allows space for silence, pause, or reflection
The past, present, and future are not an effective differentiation between therapy and coaching. Therapists and coaches alike can’t control clients shifting attention between timetables. There is an African untranslatable word Sankofa which means “It is not taboo to fetch what is at risk of being left behind.” Trauma-informed coaches do not linger in the past; however, sometimes they visit past stories to understand their influences on present and future behavior, thinking, and emotions. The key here is that coaches do not wander in the past, diagnose or treat mental illness. Coaches can not treat PTSD but they can coach post-traumatic growth. If the client has PTSD then coaches must work with therapists to assure the symptoms of PTSD do not interfere with the client's ability to benefit from coaching. Therapists and coaches have clear boundaries that make for good allies.
Kahneman, Daniel. Thinking, Fast and Slow. 2011.