Episode 29: What’s the Difference Between Therapy and Coaching?

This week we address the differences between therapy and coaching - not only will we define and review the application of each profession, but we will also discuss the limitations of each. As a former therapist turned coach, I provide some insight into how client conversations and goal setting should differ in the two settings.
Coach with Clarity Podcast Lee Chaix McDonough

29: What's the Difference Between Therapy and Coaching?

One of the most common questions I'm asked is about the difference between therapy and coaching. As a coach, it's important to understand the differences between the two professions, the overlap between them, and how to know which approach will best serve your client.

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Show Notes

One of the most common questions I'm asked is about the difference between therapy and coaching. As a coach, it's important to understand the differences between the two professions, the overlap between them, and how to know which approach will best serve your client.

Today we're zooming in on therapy versus coaching and I hope that whether you are a therapist, a licensed mental health professional, a coach or simply exploring the profession of coaching, you will find today's deep dive to be helpful.

I'm looking forward to hearing your comments and feedback about it.

Topics covered

  • Why there's no one, simple definition of therapy
  • Some examples of how different states and professions define psychotherapy
  • The types of scenarios that suggest that it may be appropriate to refer a client for therapy
  • My favorite definition of coaching
  • Why the partnership aspect of coaching is a major differentiator in comparison to therapy
  • How our questioning differs in coaching versus therapy
  • Why coaches are usually in a better position than therapists to help clients maximize their potential
  • The benefits of observing coaching in action
  • When coaching and therapy overlap

Resources mentioned

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Well, hi there, friend. Welcome to the Coach with Clarity podcast, my name is Lee Chaix McDonough, and I want to thank you for joining me today as I answer one of, if not the most common question I get asked, which is, what is the difference between therapy and coaching?

Now, I think this is a very important topic for us to go into whether you are a therapist or not. And in fact, if you are a coach, I think it's also important that you understand the differences between the two professions, the overlap between the two professions, and how to know which approach will best serve your client, if not both of them. 

So we're going to spend some time today really diving into this topic, and I hope that whether you are a therapist or a licensed mental health professional, whether you're a coach or whether you are exploring the profession of coaching, you find today's deep dive into therapy versus coaching to be helpful, and I really do mean this to be a deep dive. I want this to be a nuanced conversation because I think when we try to reduce this question to a simple pat answer, it becomes reductive, and we don't actually appreciate the nuanced approach to both professions.

So I'm excited to talk about this with you today. I am sure there's going to be a lot of comments and feedback about it. So if you want to share your thoughts with me, the best place to do so is over at Instagram. You can follow me @CoachwithClarity, and I would love to know your thoughts about today's episode, you can post them on the episode post that will be out there, or you can slide right into my DMs and let me know what you think @CoachwithClarity

So now let's dive into what is the difference between therapy and coaching? And first, to answer that question, we need to be really clear on how we define therapy and how we define coaching. And that's an issue because there are many different ways we can define therapy. The definitions can vary state to state, and they also vary from profession to profession. So the way social work may define therapy, or psychotherapy, is different than how counseling does, which is different than how psychology does. So I want to be clear that I will not be putting forth one simple definition of psychotherapy today, because it does vary based on the specific profession and on the state or province where the provider is licensed but I will give you a few examples that I think highlights some main points about what therapy is and what it's not. And I want to start with my own state of North Carolina, where I am licensed as a clinical social worker. And when I go to the North Carolina statutes for clinical social work, there's a definition in there of clinical social work practice, and it's defined as, “the professional application of social work theory and methods to the biopsychosocial diagnosis, treatment, or prevention of emotional and mental disorders”. So right there, in the legal definition, we are talking about mental disorders or emotional disorders, which suggests that there's going to be some sort of psychopathology, or symptoms associated with a mental health disorder, and we are looking at diagnosis, treatment, and prevention. So we are still very much in this kind of biopsychosocial medical model. And as a clinical social worker, that's what would guide my practice as a therapist, I would be working with clients who are experiencing some sort of emotional or mental disorder, likely one that would meet criteria for a diagnosis, and I am involved in the diagnosing and treatment of that disorder. So that is how we define clinical social work practice or psychotherapy as social workers in North Carolina but as I mentioned, there are different disciplines that we need to look at as well. And I know many of you are counselors, or are clinical counselors, and I wanted to make sure you were represented as well. I went to the state of California because I know they have a lot of laws and regulations very particular to their state around the provision of psychotherapy services. And when I went to their statutes and I looked at their definition of clinical counseling, I found that they define professional clinical counseling as, “the application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental and emotional issues”. So again, we are looking at remediation, we are looking at improving, we are looking at getting people back to baseline. So again, these interventions and techniques that we're using in psychotherapy are meant to relieve issues or problems surrounding emotional health or mental health. Interestingly, in the California statutes, they're also very clear that this is not intended to capture other non-clinical forms of counseling for the purposes of licensure. So when they talk about non-clinical, they mean non-mental health, and that is spelled out right in their statutes. So I think that's important to remember that they are defining clinical work as being for the purpose of improving mental health. So they are drawing very strict boundaries around that, and that's going to be important later when we talk about coaching. 

So my clinical social workers, my counselors, we've given some examples of what you might be defining psychotherapy as. For my psychologists out there, I don't want to leave you out. And so for your example, I went to the Colorado statutes, and they define psychotherapy or psychotherapy services as, “the treatment, diagnosis, testing, assessment or counseling in a professional relationship to assist individuals or groups to alleviate behavioral or mental health disorders”. So again, those are for my psychologists, that's from the Colorado statutes. And again, we're looking at treatment, diagnosis, testing, assessment of behavioral and mental health disorders. So this is still in keeping with those two earlier definitions we saw from California and North Carolina, we are looking at a client or a client population that is experiencing some level of distress or dysfunction around mental health. That is very much the territory of therapy, and so I think this is important for coaches to hear as well. When we are engaging with a potential client or with an existing client, and they indicate that they are experiencing symptoms or issues that would suggest that perhaps there's a deeper mental health issue at play, this may not just be worrying, perhaps this is an anxiety disorder, or this may not be a temporary sad feeling, we may be looking at depression. This is where we start moving outside of the realm of coaching, and into the realm of therapy, and this is when referral will be increasingly important. So that's why I think it's really important for all coaches to understand what therapy is and how we define it, because that will help coaches know when it's appropriate to refer a potential or existing client for therapy. So to sum all of this up, I will share the American Psychological Associations working definition of psychotherapy, or at least an excerpt from it because it's pretty long, but they define psychotherapy as, “the informed and intentional application of clinical methods and interpersonal stances to modify behavior, cognitions, emotions, or other personal characteristics”. So again, we're looking at clinical methods, and inherent in this idea of clinical is that it relates to a patient, to the course of a disease, or the observation and treatment of patients. So that's kind of a dictionary definition of clinical, but I think it's important to consider that and remember that we are really talking about mental health disorders, mental health diagnoses, and these are the things that belong in the realm of therapy. 

So now that we understand what therapy is, let's switch gears and talk about what coaching is, and I want to share with you my favorite definition of coaching, which comes from the International Coaching Federation or ICF. ICF defines coaching as, “partnering with clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential”. So there are a few reasons why I love this definition so much. First is the idea that coaching is a partnership. So what that suggests is that both parties in this relationship are on equal footing, there's no power differential, it's not that the coach knows more than the client or vice versa, we are coming at it from an equal level. And that approach, that partnership approach, is not one that we've always seen in healthcare or in mental health. Now I recognize especially within the last decade or so that there has been a renewed focus on patient centered care where the needs of the patient or the client are paramount, they're centered, and they are involved in their own treatment planning and care plan. But the fact of the matter is, traditionally within a medical model, and even within a mental health care system, there has been a power differential between the therapist and the client, the therapist is considered the expert at the diagnosis and treatment. And even though I know many, many therapists who do take a partnership approach with their clients, the fact is, when a client is seeking mental health care, they're often coming into the relationship with the expectation that the therapist is the expert, that they know what's going on, they understand this diagnosis, they understand the best course of treatment. That traditionally is not an assumption that is made when someone enters a coaching relationship, at least if they're working with an ICF credentialed coach, because truly the very first word in that definition of coaching is partnership, and that partnership is what anchors the coaching relationship. 

So the second part of this definition talks about coaching as being a thought provoking and creative process. So, “thought provoking” suggests that there's going to be a level of inquiry and questioning to encourage the client to go deeper. Now, this definitely is one area where there is overlap with therapy, because I know a lot of therapists who are particularly adept at asking questions that are meant to invite the client to go deeper and to explore, and so maybe here what we need to do is differentiate between the purpose for the questions. Many times in therapy, when I was practicing, the questions I was asking my clients were meant for reflection. They were meant to encourage the client to look at past behaviors or past relationships, and then consider them in context of their present moment. So how did what they were experiencing or what they went through in the past, create habits, or create assumptions, or create thought patterns, that lead to their current behavior. We may do a little bit of this questioning in coaching if only to help the client establish their thought patterns or their habits, but most times the questions were asking them are more about, “Okay, let's talk about where you are now, what's working for you, what's not”, and “what needs to stay the same or what needs to be modified as you move forward”. So we are not spending a whole lot of time making connections between past experiences and present day life. Instead, we are grounding in the moment. We're looking at where we are today and asking the client what needs to happen for them to move forward to achieve their goals tomorrow. 

So that's the thought provoking piece, and the creative piece is important too, because as coaches, we can use a variety of approaches and skill sets and techniques, in order to inspire the client to come up with innovative out of the box solutions or next steps. Coaching has the potential to be a rather eclectic approach to client work, because we can pull in from so many disciplines. Yes, certainly coaching is influenced by psychology, but it's also influenced by organizational development, by human resource management, by education, by spirituality and spiritual practices. So we can really take a comprehensive and holistic approach to working creatively with our clients and I think that's reflected in the ICF definition of coaching. 

And then finally, that third part of the definition is career important, because that's where we are talking about maximizing personal and professional potential. So in order to help our clients maximize their potential, we're really talking about helping them live at an optimal level. So they are getting to their ideal state. That's what coaching helps them do. In order to get to the ideal state, generally speaking, our clients need to already be at what I call their “baseline fine state”. That's where things in life are fine. You know, they could keep going the way they are now, and they wouldn't have any significant distress, they would be perfectly okay. And yet, on some level, they would know they're not achieving everything they're capable of. So being at that “fine state” suggests that they're coping, they're doing well, you know, they can get by, and it also suggests that there's no significant underlying mental health symptomology or disorder as well. Or if there is, they are actively working with a therapist or appropriate mental health care provider in order to address that, because the work we're doing is to help them get from a good state, to a great state, to an optimal state. Now, a lot of my therapist colleagues are saying, “You know what, Lee, but that's what I do, too. I help my clients live better lives through therapy”, and yes, you do. And as a therapist, you are capable of helping your clients maximize their potential, I don't mean to suggest that you're not, but oftentimes within a traditional therapeutic approach or within the structures that we've been given whether because of the medical model, or the insurance based system, or what have you. We're not always able to do that as therapists. We are often, not always, but often limited to diagnosis and to treatment versus maximizing potential, and this is particularly literally true for therapists who are paneled with insurance companies and have an insurance based practice. 

But here's the thing, and here's why I am so passionate about therapists entering the profession of coaching. You're right. The skills that you have developed as a therapist are highly transferable into the world of coaching. I want to bring you into the world of coaching because I know what you have to offer, and I believe it can serve coaching clients, and at the same time, coaching is a distinct profession. The way we view the client relationship and the way we engage in that relationship is different. The differences are nuanced, yes, but they are present. And I will be honest with you, I didn't have a full understanding of those nuanced differences until I received coaching myself, and until I engaged in mentor coaching, and my mentor coach flat out told me at our first session, “Wow, Lee, that was a great therapy session you just conducted, in terms of a coach session, not so hot”, and it was having that experience and was breaking down what I did, and why, and where I went the therapy path, and what I could have done differently to make it more of a coaching approach that was so helpful. That's precisely why in the Coach with Clarity membership, we have hot seat coaching calls, because I want my members to have the opportunity to observe what a coaching session looks like, and particularly my members who are therapists have found it so valuable to witness that, because as they're observing the interaction, they're having thoughts – “Okay, I would ask this” or “I would ask that”. And then perhaps I asked a completely different question, and that highlights the difference between a therapeutic approach and a coaching approach. So we can talk about the differences between coaching and therapy in today's episode, and I do hope you're finding that helpful, but ultimately, it's the practice and the observation of coaching that really brings home the difference. So I would recommend, if you are a therapist who's considering coaching, or if you just want to deepen your understanding of the coaching profession, consider working with a coach yourself, or engaging in a program like the Coach with Clarity membership, where you can observe coaching and action, and you can learn more about what makes a coaching approach different from a therapeutic one.

Being able to witness it and experience it in real life is so helpful, because there are areas where therapy and coaching overlap. Both professions are highly client centered. A good therapist, and a good coach, is going to keep the client at the center of their work. So every question that's asked, every action that's suggested, every plan that's created, is based on that client's needs. Now how we define those needs may differ in a therapeutic setting. Those needs may be around symptom reduction, or getting back to a baseline functional behavior. Whereas in coaching, those needs are going to go back to that idea of maximizing potential. So what does the client believe they have the potential to do, and what's standing in their way of accomplishing that desired outcome. But again, both therapy and coaching place the client at the center of the relationship, and good therapists, and good coaches, emphasize client autonomy and their ability to be a part of the decision making process and to co-create the relationship. I would say that both therapists and coaches also rely on goal setting strategies and accountability techniques with their clients, and this is one area where I hear a lot of people say coaching is more about goals and accountability and getting things done, and therapy is more about kind of, the internal inquiry. And again, I think that's kind of reductive because I know many therapists who are very interested in their clients goals and we want to partner with them to help their clients achieve what they want. So I don't think it's fair to say coaches only focus on that but again, we need to look at the desired outcome, we need to look at the results. And generally speaking, in therapy, those results are going to be tied to the client's mental health and wellness. Whereas in coaching, those results are going to be tied to whatever it is the client wants to maximize their potential around. So for a business coach, that might look like a client who wants to improve their business structures, and increase their revenue, or develop stronger work life balance. Again, those results are gonna vary based on your niche as a coach and also what your client wants to accomplish in your work together. 

So while there are areas of overlap between coaching and therapy, especially with some of the skills and tools we use, the application is where we really see the greatest difference. And again, when we're differentiating the two professions, I think It's so important to remember that therapists are the experts in handling mental health concerns, and that when we start talking about dysfunction, disorder diagnosis, this is really where we move outside of the scope of practice for coaches, and we coaches need to be aware of that and consider when it's appropriate to engage our client in a discussion about referring to a therapist. And if you'd like guidance on that, I highly recommend the ICF White Paper all about when and how to refer a client to therapy. It's a great resource, and definitely something that every coach should review. 

I think another thing to consider in terms of the differences between the two professions is where and how we work with our clients. Now we are seeing more and more online therapy happening now, especially with a global pandemic, but traditionally speaking, mental health care happens within a medical setting, whether it's in a clinic, whether it's in an office, or now even when it's at home, you're still engaging with a healthcare provider. With coaching, there's a little more flexibility in that coaches can provide support in a variety of settings for non-diagnostic purposes. So for example, a business coach may actually go into their client's business, observe and do the coaching right there, versus having the client come to them. And certainly, we see this a lot in the corporate and executive world as well, where the coach is going in and serving the client where they are. So I think the best way to conceptualize the differences between therapy and coaching is to think about the who, the what, and the how. And again, for those of you who are longtime listeners, this should sound familiar because these are exactly the questions we're asking ourselves when we are defining our niche, and for more information about that, you can head way back to Episode Four, where we talk about creating clarity in your coaching. But again, when we can be clear about who we are serving, what they need, and how we work with them, then that is where we can create a greater difference between the profession of therapy and the profession of coaching. So we've covered a lot today and I think this is a perfect time for us to transition into this week's Clarity in Action moment. 

So for this week's Clarity in Action moment, I've got three suggestions that should help even further differentiate between therapy and coaches, and provide some direction on next steps, especially if you are a therapist or licensed mental health professional who's interested in entering the world of coaching. 

Suggestion number one is to build your coaching knowledge, and I think this is a great recommendation whether or not you're a therapist. In order to be a powerful coach, we need to constantly be putting the work in and ensuring that we stay up to date on coaching approaches, and that we're also doing our own work as well. So that starts with educating ourselves on coaching philosophy and principles. It may look like seeking out coach specific education or training, it might look like working with a coach or a mentor coach of your own, but the very first thing anyone should do if they're interested in coaching is to build their own knowledge of the profession. And this is absolutely where a company like Coach with Clarity can support you, whether it's through the education that you receive from the Coach with Clarity membership, whether it's through mentor coaching that I provide as an ICF registered mentor coach, or whether it's through the Coach with Clarity certification program. Coach with Clarity is here to help you build your coaching knowledge so that you can go out and support your clients and your community.

So that's suggestion number one. Suggestion number two is to create your own coaching system. You want to make sure that you're using coaching principles as your frame of reference and your anchor points. Now, if you are a therapist, that's not to say that you can't bring in your training and experience, and allow that to inform your coaching work, you absolutely can, and as many of you know, that's what I do. My training was in Acceptance and Commitment Therapy, I certainly use that as my primary modality when I was a therapist, but I've also used it in my coaching work, as well both in my book ACT on Your Business, and in how I coach my members and my private clients. But we do want to make sure that we are really anchoring our work, first and foremost, in strong coaching philosophy. And to do that we want to ground our work in the core competencies and the code of ethics that govern our profession, and for me, that's always going back to the International Coaching Federation. 

And my third suggestion is especially for the therapists and licensed providers out there – please please, please, if you want to enter the coaching profession and provide professional coaching services, do yourself a favor and treat your coaching practice like a separate business. That means creating a separate legal entity for it – separate bank accounts, separate website, separate marketing plan, separate business tools. I know it feels like a lot, but especially if you are holding on to your license and you are still seeing therapy clients, you need to make sure that you are protecting that license and that business by keeping coaching separate. If you try to blend the two, if you try to have therapy and coaching under the same umbrella, it can confuse your clients and they may not understand where they belong, but it could also put you into some jeopardy with your state licensing board. Or if you're working with a coaching client who resides in a different state, their state licensing board could take issue with that as well. But if you are seeing coaching clients under a separate business and a separate legal entity, and you can demonstrate how the who, the what, and the how of your coaching business is different than your therapy business, than I think you are on much firmer ground both legally and ethically. So suggestion number three for my therapist out there, please consider creating a separate business for your coaching practice. 

So to summarize, this week's Clarity in Action moment was three suggestions I have for you to help clearly delineate the boundary between therapy and coaching. Suggestion number one was all about pursuing coach specific education or training. Suggestion number two was about cultivating your own coaching specific approach. And suggestion number three was treating your coaching practice as a separate business. So I hope that you find these suggestions helpful and I hope you are able to put them into action. I would love to hear more about your thoughts about today's episode, and your next steps in your coaching practice. So come find me over on Instagram @CoachwithClarity, drop me a DM or leave a comment on this episode's Instagram post and let me know your thoughts. I can't wait to hear from you. 

I'll be back in your feed next week with another episode of the Coach with Clarity podcast, and actually next week's episode is a coaching call. And I have heard from you all that you love these coaching calls, so I have no doubt next week's episode will be another favorite. And remember, if you would like to be on a future episode of the podcast and receive some powerful coaching, just head over to CoachwithClarity.com, click on Contact, and then you will see a link to an Application where you can apply to receive coaching during a future coaching call. I would love to connect with you and help you build your coaching practice. So my friend, I hope you have a wonderful week and until next time, my name is Lee Chaix McDonough, and I'm reminding you to get out there and show the world what it means to be a Coach with Clarity.

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