Coaching vs Therapy: Do I Need Therapy, or a Coach

We could all use a little help sometimes,
all of us. What do I need? Coaching or therapy? We’ll get into that today at Live
On Purpose TV. So doing the therapy? Maybe some coaching? Which one? What’s the
difference? Coaching or therapy? Okay, there are differences and I think it’s
important to understand those differences as you make a choice about
that. Probably, it’s helpful to start with a basic philosophy of where we’re
starting from in the first place. Okay so if you think of your mental health on a
continuum or a spectrum, there’s two ends to this spectrum. So over here on the
left end is the sick end, so that’s where we have diagnosis, pathology, treatment,
all of those fun things are over here on this end of the spectrum. What’s on the
other end? To understand that and let’s go to the middle first, so the middle
right here in the center of the spectrum is what I call health. Health meaning not
sick, that’s all we’re going to use to define health at this point, so not sick.
You could be sick in bed with a fever throwing up, there comes a time when you
can get out of bed and you’re not sick but that doesn’t mean that you’re truly
fit, thriving, prospering, that’s this end of the spectrum. So if we look at the
entire spectrum, that’s going to help us to understand where therapy and coaching
might fit in. Taking this end of the spectrum first. Now I practiced in this
end of the spectrum for about 13 years in my career, I had a traditional
psychotherapy practice, this is where I brought in my clients, I would give them
a diagnosis and I give them a diagnosis I mean, I would identify a diagnosis, what
condition do they have, what illness or mental illness is going on over here on
this end of the spectrum, is it depression, is it bipolar, is it
schizophrenia, what’s going on over here. That was the diagnosis part and then for that diagnosis, we come up with a treatment plan. The
treatment plan is to address the symptoms and the problems and the
difficulties that are being caused in a person’s life as they’re on this end of
the spectrum, that might include medication therapy which is what we’re
talking about here today, other kinds of interventions that might assist that
person to move this direction. The insurance companies would pay the bill
for that typically as long as the diagnosis was appropriate and billable
and as long as there was a good treatment plan in place that had been
evidence-based and shown to be effective in moving people across the spectrum to
this middle area. Now when you hit the middle area which I defined as health,
meaning not sick, that means there is no longer a medical necessity for therapy
because there’s no longer a diagnosable condition. So a lot of this is driven by
the history of where psychotherapy has come from and this came from basically a
medical model so think about in the in the field of medicine and I’ve
compared it also to physical health, you know you could be sick in bed, fever and
that you can get out of bed, well in a similar way in the medical field, it’s
based around diagnosis and treatment plans so that’s what we’re talking about
in the therapy dimension. To practice in this field, in this side of the spectrum
requires education and licensure and all kinds of hoops that people have to jump
through because the license, not only shows that they are credentialed and
trained to work in that area but also, that it’s set up as a
protection to the consumer because people who are receiving these services
are deemed or defined to be vulnerable so, and that’s maybe more information
than you wanted, but therapy is a licensed activity
that is performed by professionals who are both trained and credentialed to
act in that part of the spectrum. So now, what about coaching? I’m going to put
coaching over here on this end because a coach or a consultant or a life personal
development professional is not necessarily licensed to diagnose and
treat illness for example. In fact, they are not licensed, typically. I am, I’m a
licensed psychologist, I can work in this end of the spectrum and I did for about
13 years, I have moved my practice over to here where I do personal development
and life coaching even though I am still a licensed psychologist who could
practice on this end of the spectrum, I’ve moved it over here for a lot of
reasons that are personal to me but let’s talk about what this end of the
spectrum means, what it is. On this end of the spectrum, notice we’re not so worried
about pathology and treatment, we are more concerned on this end of the
spectrum with skills, development and enhancement of life and productivity
and happiness, that’s all on this end of the spectrum and it’s not medically
necessary because we crossed the border from sick into not sick. So when you ask
the question “Do I need therapy or do I need coaching?” I think the word need is
part of the the revealing factor here. If you need it, it might be therapy, if you
want it or desire it, it might be coaching that you’re looking for. Now
there’s some upsides and downsides on both ends. Obviously on this end, we’re
going to be dealing with diagnosis and and treatment plans and the insurance
company is more likely to pay for what’s going on on this end of the spectrum,
they will not pay for this end of the spectrum typically because it is not
medically necessary. I haven’t seen insurance plans that cover personal
development coaching, I just don’t think it’s a very common thing at all. So on
this end of the spectrum, you’re going to be paying out of pocket typically.
Now there’s another thing that we run into with coaching and I’m sharing this
with you both is a warning and is just information because it is not a licensed
activity, you don’t have the same protection that you have on this side of
the spectrum because these people haven’t necessarily gone through any
particular training or credentialing or licensure that says that they’re
qualified or at least meets certain criteria to address the issues that you
might bring to them, that can be an upside or a down side depending on how
you’re looking at it, I just want you to be aware of that because anyone can set
up a shingle that says “Hey, I’m a coach. I’m a life coach.” Okay, awesome. What’s
their credentials, their training, their experience? You don’t know. You need to be
able to answer that question if you hire them. Over here you’ve got some
assurances that that person has probably been to school, they’ve at least taken a
test and paid a fee with the state to be licensed to do what they say that they
can do. So hopefully that clears up some of the difference between therapy and
coaching so that you can make a determination of which side maybe is
more appropriate for you and there’s a lot of overlap in the middle. Can I just
thought you acknowledge that as well? There is a lot of overlap right here in
the middle of the spectrum. I have found for example, that most human beings are
experiencing things that I would consider to be right here in the middle
of the spectrum. I’m talking about some common things like depression,
anxiety, relationship conflicts, life purpose questions, those kinds of things
are very very common here in the middle of the spectrum, it doesn’t necessarily
mean that you’re sick, it might mean that you’re human,
welcome to earth, that’s how we roll here. So in either category, in the therapy
world, a lot of people who are kind of on the milder end of diagnosis or aren’t on
the severe ends of mental illness will still benefit from therapy because those
principles can apply to them, in a similar way, people in this middle of the
spectrum could benefit very greatly from coaching where there are principles that
are applied that can help them move through some of
these kind of middle of the spectrum difficult things that they’re
experiencing on to something much greater and much better than whatever
they had before. Either way, if you choose the therapy route, if you choose the
coaching route, I think it is extremely important for you to be discerning and
to hire carefully. Remember, your therapist or your coach is
working for you, not the other way around. I understand that traditionally, the
therapy end of things deals with a more vulnerable population and a lot of times
that creates some dependency between the therapist and the person who’s being
counseled, we want to watch out for that okay, because you are still in charge
either way, this person is working for you not the other way around and you may
fire them at will. I tell all my clients this in our first session, you can fire
me at will because if I am not helping you to move toward that end of the
spectrum, then I don’t think I have any right to
be involved on your team, that is my personal commitment to all of my clients.
I think you can expect that, you can demand that from anyone who is on your
team, a therapist or a coach, be discerning, make sure that that person is
working for you because you’re the important factor here. Be discerning, make
sure that you’ve got good reasons to hire the person that you’re hiring that
you resonate with their approach or with their philosophy, that their values are
consistent with what it is that you’re looking for in your own life and in your
own family. Either way you can get a huge benefit if you’re humble enough to open
yourself up to the services of professionals who can provide either
therapy or coaching for you and there are so many possibilities. There’s a whole spectrum. We all could use some help, right? Coaching, therapy, hopefully
that helps to clarify the issue for you. I’m Dr. Paul, this is Live On Purpose TV.


  1. Hello! Great video! I am going to school to be a therapist, but interested in life coaching as well. Are you able to still do both? Thank you!

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