Things just aren’t going as you had planned for your life, you’re struggling with some big decisions, or you are facing down the barrel of a big life change. Or maybe you’ve felt down for a while and aren’t sure what to do about it. Maybe you feel directionless, apathetic, bored. Whatever it is, you have made the very brave and important decision to reach out for help.
There are many reasons that we might decide to take this step. I myself have had several different therapists over the years for couples therapy, family therapy, to recover from an abusive relationship, and because I just felt like I needed some support.
Seeing someone for mental health support should be neither scary nor difficult. But the many options can be overwhelming. Not only are there a ton of different kinds of therapists out there, but there are also coaches. And not just life coaches, but job coaches, wellness coaches and just about every other type of coach you can think of.
Well, I have a Ph.D. in psychology, and I am a certified wellness coach. Hopefully, I can break it down for you in simple terms and help shed some light on this confusing topic.
But first, a caveat. Therapists and coaches are real people. Which means they have flaws and shortcomings, just like everyone else. I won’t necessarily say there are good ones and bad ones, but there are professionals that will be a good fit for you and ones that won’t.
The important thing when choosing any kind of healthcare provider is to trust your gut instincts. If you don’t feel a connection with the person, if you feel judged by them, or uncomfortable for any reason — move on. There’s plenty of people out there that want to help you and finding the right one can take some trial and error. A lot of providers will offer a free short telephone consultation too, so you don’t necessarily have to waste your money, either.
So with that aside, what are the three big differences between a coach and a therapist, and how do you know which one you need?
When you decide to go looking for a therapist, one thing you may notice is the variety of letters after their names. In order to become a licensed therapist, (LMFT, LPC, LCSW etc…) one must have completed a master’s degree. This means at the very least, they’ve had six years of psychological education, have worked with clients under supervision as interns, and have passed a licensing process. That’s just the baseline. There’s some variability in the requirements of these licenses and it varies from state-to-state but again, the most important thing is that you feel comfortable with them and trust them.
When faced with more complicated mental health issues, such as an OCD or bipolar diagnosis, any type of psychosis, or severe trauma, you may want to seek more specialized professionals. These folks are usually doctors, either with a Ph.D. (psychologist), or an MD (Psychiatrist). They’ve had extensive training for at minimum eight years, although generally longer. They often specialize in a certain type of illness and in the case of Psychiatrists (and in some states, psychologists) they can prescribe medication.
Now, what sort of education does one need to become a coach? This can vary quite a bit depending on the coaching program, but in general, a bachelor’s degree is sufficient, and it doesn’t necessarily matter what the degree was in (although, again that depends heavily on the program). A coaching program can last anywhere from a few months to a couple of years. Coaches are also encouraged to specialize in a particular issue, like health and wellness, addiction recovery, business, etc.
Currently, coaching is a pretty unregulated industry, meaning certification isn’t necessary in order to market yourself as a coach. Unlike a therapist, who must be licensed in order to practice, and has to continue to update that license to stay in business, pretty much anyone can say they are a coach. This has created some bad stereotypes in the public eye and some warranted skepticism, but there are truly great coaches and great programs out there. There is an International Coaching Federation that is currently giving accreditation to programs and is moving to better regulate the industry, but it’s still very wild-west at the moment, so buyer beware.
Keep in mind, there are many reasons a person would choose to become a coach or get training in a coaching program. Many certified coaches also have a lot of other training in addition. The program I completed consisted almost entirely of healthcare professionals. Nurses, PTs, nutritionists, and more, and they all wanted better tools in order to work with their clients. For example, as a nurse, you’re taught what a patient needs as far as care, but you are not necessarily taught how to make a reluctant patient actually do what you are recommending. Motivated interviewing and goal-setting are big parts of coach training. A coach will spend a lot of time learning why people might struggle with actually achieving their goals, and learn ways to help them follow through.
Difference in philosophy
Aside from education, the second biggest difference between a coach and a therapist is the philosophy that their work rests upon. By and large, the psychological world is based on an illness model, while coaching is based on a wellness model.
What this means is that when you go to see a therapist, the bottom line is that they want to find out what is wrong and fix it. A therapist may be a very sympathetic ear, and a kind-hearted person but, the entire design of therapy is finding the thought patterns and behaviors that are holding the client back, and helping them to see these for themselves. And ultimately the goal is to change these negative or self-defeating patterns.
When you go to see a coach, they want to find out what is going right in your life and help you create more of that. Coaches are taught to find their clients' strengths and help them put these to use. They are taught ways to maintain positivity and optimism throughout the entire process. Coaches believe that their clients know deep-down what they need, and they do not need to be told. A big part of coaching is empowering your client. A coach may make suggestions, but in general, they are allowing the client to shape the goals, the program, and ultimately set the pace for their own progress.
A third difference is the relationship between the client and the professional. A therapist is trained to maintain very strict boundaries with their clients. They are told not to disclose personal information or opinions, and to simply be a mirror for whatever the client is feeling. They will generally not take on friends as clients because of possible conflicts of interest, and they will generally not friend clients on social media or spend time with them outside of therapy.
For coaches, these boundaries are much looser. Often coaches will work with friends and create relationships with their clients. There are no hard and fast rules about disclosing personal information during a session, although a good coach will not bring their opinions into it too much since the belief is that the client already knows what they need. But the tenor of the coaching session is definitely more like working with a friend, and an equal.
More recently, a lot of therapists are also getting training as coaches, in order to even better help their clients.
Among my friends who have crossed over from being a therapist to being a coach, or who have started to integrate more coaching into their therapy sessions, the big draws were the positivity aspect, and the closeness it allowed. Many therapists I know have felt a little limited by talk therapy alone, wanting to incorporate more holistic practices, and even bringing spiritual content into their work. They have found that a lot of clients aren’t just looking for a blank sounding board, but a deeper, more human connection.
Illness vs wellness
As we are discovering more and more about mental health, we are realizing that treating atypical behaviors and thought patterns as an illness isn’t always the best route. The illness model is based on western medicine and the underlying assumption is that there is a baseline of health. Illness as any anomaly and it is viewed as something that needs to be “cured,” often with medication. The brain is treated the same as would any other organ that is not behaving properly.
But, in the vast majority of cases, there are very good, very real, external reasons why someone may be struggling. They may have gone through a particularly difficult divorce or experienced a loss, they may be experiencing ambivalence about their career path or their environment. Most causes of depression or anxiety are not chemical, they are environmental. This is not to say that therapy doesn’t treat the biological, psychological and social aspects of a person, it is just to say that it is still ultimately operating from a manual that is based on a medical model: cataloging symptoms in order to create a diagnosis, which will determine the path to treatment.
Coach or therapist? Which is right for you?
If you are wondering whether you need a coach or a therapist, here’s a good place to start.
If you have any suspicion or knowledge that you have a diagnosable mental illness, like PTSD, OCD or any sort of delusional or even psychotic thoughts or behaviors, then a therapist is the right choice for you. But, many people find that working with a coach as well as a therapist can be really beneficial. A therapist is better trained to help with trauma and irrational thought patterns, but a coach can help you stay on track with wellness or work goals, and make you feel like you’ve got a friend in your corner.
If you are not suffering from deep trauma, suicidal thoughts or self-harm, then ask yourself these questions:
Do you feel that deep down you know what changes you need to make, but are either just scared or feel like you need some accountability? If that is the case, a coach may be a good choice.
Are you embarking on a new stage of life, such as starting a new career path, or a big move? You are excited but feel like you could use some support? A coach is perfect for this kind of life change.
Do you feel hopeless, helpless and/or unsure as to what is wrong? Do things feel too overwhelming to cope with? Does your life feel unmanageable? If any of these are true, a therapist may be a better choice. Remember, coaches are trained to help you see what is working in your life and create more of that. If you are feeling like nothing is working, it may be frustrating to start there.