Introduction

Since recently opening my private practice for 1:1 therapy and coaching – I’ve been getting a lot of questions from potential clients and other clinicians about these two offerings.

The question often arises: What the heck’s the actual difference between therapy and coaching, and which is for me? 🤔

Both approaches offer unique benefits and can significantly impact your journey toward health, well being and balance. Part of the challenge with this issue arises due to wide differences in how coaching is defined.

I’ll offer how I differentiate my businesses so you can at least understand one view on this as you decide what you think about it. So, let’s dive in!

Therapy: Tailored Treatment for Significant Challenges 🩺

Modern, evidence-based therapy provides a structured treatment plan focused on specific goals and challenges based on symptoms that cause a major impact on a patient’s life.

This approach is based on something called the “medical model” which started dictating treatment in the 1940-1950s. By the ’70s the field included highly structured or “manualized” treatments like CBT, Randomized Controlled Trials (RCTs) previously used by the medical industry for physical illnesses, and even insurance paying for some treatments.

Here’s a closer look at how therapy is defined now and what the medical model of therapy offers:

1. Diagnosis & Medical Necessity:

In the 1980s, the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) included objective checklists of symtoms for clinicians and insurance companies to use in establishing clear diagnoses and authorizing treatment. This forms the basis of ‘medical necessity’ and is the gateway for insurance-based treatment.  Prior to this, therapy was based on subjective impressions of the clinician. Currently, insurance companies can request data on progress, and medical records to determine if a patient “meets medical necessity” or not. Treatment will be authorized if a client meets this set of medical necessity criteria, and denied if the insurance company believes the client does not meet medical necessity criteria.

2. “Mental Disease” & Treatment Plan Approach:

By the 1970-1980s, this medical model marked the formal adoption of a “mental disease” framework using a diagnostic, insurance-driven approach to therapy including requiring a symptom-specific treatment plan with measurable goals, objectives, interventions, and progress assessment.

3. Evidence-Based Tools:

In addition to the peer reviewed studies/trials creating modalities, “best practices” recommend that determinations are made and therapeutic progress is tracked using standardized assessments and surveys tracking measureable symptoms.

4. State Licensing Boards and Professional Standards:

State licensing boards became the norm by the 1970s to protect the public. These require professionals meet certain educational, continuing education, ethical and legal standards. Each state dictates their own professional licensing process and requires clinicians to license again in a new state. Most therapeutic modalities encourage little (or none in some cases) personal sharing from therapist to client. Instead, clinicians are trained to assume a “neutral, professional” stance of authority.

Prior to the medical model dictating how therapy is defined and delivered, modalities like psychodynamic therapy, family systems therapy, Gestalt, Jungian, and Rogerian therapy, etc. were largely based on subjective processes.

Coaching: Inspiring Growth and Creating Lasting Change  🌱

Coaching, on the other hand, is a less structured but highly empowering approach. It’s not about diagnosing medically-based problems or designing a structured, measurable treatment plan.

Coaching focuses on helping you tap into your inner wisdom & strengths, build resilience, and increase self-awareness to create meaningful change in your life.

Here’s a closer look at how coaching is defined generally and what it offers:

1. No Diagnosis or Treatment Plans:

Unlike therapy, coaching isn’t based on a client meeting medical necessity, creating a diagnosis, nor a “disease model” of symptoms. This makes it more flexible and accessible if a client is looking for growth without medical diagnoses and the biases that “something is wrong” if they feel depressed or anxious.

2. Certification v. Licensing:

Coaches are not licensed by states, they are often certified through various topical training organizations. Coaching certification programs exist at the state, national, and international level.

3. Authentic Relationship:

Coaching differs greatly from therapy here as well, emphasizing relationship-building through authentic sharing and relatable personal experience. This approach offers hope and encouragement by demonstrating that transformation and lasting change is possible.

4. Holistic and Innovative Tools:

While therapy most often relies on evidence-based tools, coaching can blend common evidence-based tools with holistic and ancient practices. This unique mix allows for creativity and intuition building, letting the client choose what resonates best with them.

5. Unrestricted by Location:

Because coaching isn’t regulated by a state board, it’s not tied down to a specific place or state. Clients can work with their coach across the country, on vacation, or even internationally.

Tension Between the Two

Many therapists respond with heightened disdain and defensiveness to the coaching surge due to the exploitative & laborious process required in licensing. I often hear comments like “therapy deals with the past, coaching is just about goal setting,” “therapy heals you, coaching supports you,” “therapy identifies dysfunction, coaching identifies inspiration,” and even the condescending, “coaches are just wanna-be therapists.”

The fact of the matter is that almost all therapists are, unknowingly, also coaches. Not every session is based around symtpom reducing, often therapy sessions are inspirational and support-based, and often therapists share their personal experiences.

The tension escalates when coaches who have no authoritative training or expertise start delving into therapeutic modalities. This hearkens back to why licensing boards were created in the first place – to protect the public.

Which Path To Choose? 🤷

So, from my seat there ya have it…but which one is right for you?

It’s vital to acknowledge and understand that both therapists and coaches can be terrible, and both coaches and therapists can be amazing. Doing your due diligence in interviewing, discussing what you need, and researching your options are all key for making a healthy choice. 

Being fully transparent in my practice, the issue boils down to medical necessity: My therapy clients meet medical necessity. I create treatment plans based on diagnoses for them. My coaching clients do NOT meet medical necessity. We work on broad topics without a structured treatment plan.

When To Consider Therapy

If you’re experiencing significant distress that’s interfering with your ability to function in your daily life and meet your responsibilities, or if you suspect that you may have a diagnosable condition that requires expert intervention. Therapy offers the structural oversight to address such issues.

When To Consider Coaching

If you’re already functioning well, and want to make meaningful life changes healing childhood wounds, break generational cycles, or uncover new strengths. Coaching is ideal if you’re looking for encouragement and inspiration to help you feel more whole and connected to yourself, in your personal or professional life.

Conclusion: Let’s Connect! 

There’s a place for both therapy and coaching in the world of personal growth and healing. I’ve been a therapist for over 30 years and value it, and I’ve also seen the power of healing through coaching.

Whichever path you choose, make sure it’s the one that aligns with your current values, needs, and goals.

If you’re interested in working with me 1:1 and would like to discuss if therapy or coaching is the right fit for you, click here to schedule a free consultation.

❤️In Health & Wholeness,

Shannan