Therapy vs. Coaching Services: Who Should You Work With?

This blog post is for all the people, like me, who have ever wondered what the hell it matters whether you work with a therapist or a coach these days.

Education

First and foremost, the pretty obvious difference to address is from the standpoint of education, certification, licensure, etc. While we know that therapy license requirements vary state by state, it is still a safe assumption to believe that your licensed therapists have (at bare minimum) a 4 year college degree in a related field, a master's degree from an accredited college, and X amount of internship and clinical hours tied to that. Therapists have been licensed by a governing body to provide services to you by the state in which they practice.

As for coaching... well, as some may know, it is no where near as strictly monitored as therapy. Someone may call themself a coach with little to no training or formal education. A coach does not need to be licensed or certified to practice. Because of this, in 2012, the National Board of Health and Wellness Coaching (NBHWC) was created. In 2016, they collaborated with the National Board of Medical Examiners (NBME) to establish a set of standards and give the profession some credentials - essentially, to give coaching services a platform to be taken seriously. Today, a National Board Exam exists for coaches to become a National Board Certified Health and Wellness Coach (NBC - HWC). Today there are 113 programs that are approved by the National Board for Health and Wellness Coaching. These programs all meet the NBHWC required standards for instructional hours, practical skill development and assessments, and are instructed by faculty who meet the qualifications and competencies established by the NBHWC. Those who wish to sit for the National Board Exam must complete one of these approved programs, and have recorded 50 live client sessions post-completion.

Without the NBHWC, there are no distinguishing factors that would tell you a coach is one because they say they are, or they are one because they have the formal training and education for it - the same sense in which your therapist cannot provide services to you without being licensed by the state.

Scope of Practice

Short, sweet, and simple: a therapist has the ability to diagnose and treat their clients. A coach does not. Unless your coach has additional certifications, licenses, education, tied to their name (as in they are also a doctor, a nurse, a therapist, etc.), they cannot diagnose or treat you. Someone like me, for example, would not be able to diagnose or treat a client in any way.

Often times, a therapist is called upon as the "expert." Your coach should never be regarded as the "expert." In a coach and client relationship, the client is the expert in their own life, and the coach is the accountability partner. It is within a coach's scope of practice to use evidence-based and client-centered processes to develop and assist clients in achieving their own goals.

Check out the following link for more information on a coach's scope of practice: https://nbhwc.org/scope-of-practice/

Summary

Not sure if you should work with a coach or a therapist? Here are the main differences:

During a therapy session you will discuss past events, going as far back as your childhood. You will talk trauma, neurobiology and brain development. You may be diagnosed and treated for mental illness by your therapist. You will learn to process and cope with past events as it pertains to your mental health in present day. Your therapy sessions are long-term, focused on processing the past and how it appears in your present.

During a coaching session, very simply put, we are focused on the here and now. Coaching services are meant to be short-term (3-6 months), where we discuss your current state and focus on your future. Coaches meet you as you are. They are there to assist you with reaching pre-existing goals, or motivate you to develop and meet new goals - all aligned with your holistic health and overall well-being. It is outside the scope of practice for a coach to dive into your past, diagnose, and/or treat you (unless they have the additional credentials to do so).

There are times when coaching can walk a fine line, because coaches may need to ask questions about your past in order to understand where you are at present day. However, these questions are solely meant to gain clarity. Your therapist can practice coaching skills with you, but your coach should never be your therapist. However, coaches can often times work in conjunction with therapists, as well as different physician offices, and should refer out when they need to.

Example: You may work with a therapist to process why you reach for alcohol as a coping mechanism - diving into your past. You may work with a coach to change this behavior going forward. ***Your therapist may double as your coach because it is within their scope of practice to do so - but working with a coach is likely significantly cheaper if you solely want to focus on your present and future.***

Bottom Line

Take advantage of your free consultation sessions with a therapist and coach. You will not have much success with someone in either field if you cannot mesh with them on a personal level. Remember that coaches do not need certification to practice. If it is important to you to work with a coach who is certified, do not be afraid to ask for their credentials.