Recently I met an older lady who got a bit upset when she heard I am a psychologist. She told me a story which was similar to others I have heard before: being unhappy with her role towards her grown up children and their communication style, she had recently gone to a psychotherapist. After eight weeks she ‘had enough‘ and stopped the intervention. She complained the therapy didn’t help her at all as it was ‘only talking about the past‘ while she still didn’t have any tools or ideas on how to change the situation. She was disappointed that she had invested her time and resources into seeing an expert who did not move her forward.
What is the problem here?
Not having been there, I can of course not be sure. What I can say though, is that many people seem to be confused when it comes to the question what Psychotherapy is and can do, and also what it isn’t suitable for. This confusion has even grown since the popularization of another, younger discipline which is still widely unknown and even more misunderstood: the practice of Coaching.
If you consider working with a professional to achieve personal growth, this article can help you to make the right choices.
1. What is Psychotherapy?
One of the main attributes of Psychotherapy is that it begins with the diagnosis of a psychological disorder or problem. The objective is to reduce the suffering caused by the disorder or to cure it completely. Some of the most common psychological problems being treated through Psychotherapy are anxiety disorders, depression, obsessive-compulsive disorder, personality or eating disorders, stress-related disorders, psychosomatic troubles, life crises or trauma.
There are many different forms of therapy and some are more suitable for specific disorders and personality types than others. Most of the time, Psychotherapy happens through conversation with the psychotherapist, while specific kinds of therapy also use methods like role playing, behavioral and mental exercises or relaxation techniques. Psychoanalytic based forms of therapy place more emphasis on the exploration of how problems in the past may have caused troubles in the present. Other forms like Behaviour Therapy focus more on the current situation, exploring thoughts and actions the patient must change in order to overcome his troubles.
Most patients find it essential to connect on a personal level with a therapist before they engage in the process. However, most psychotherapists are specialized in a specific therapy system, making it just as crucial to get informed about about the advantages and limitations of the method being used.
2. What is Coaching?
“Coaching” is a term first used and commonly known from professional sports. It implies training, motivation, accountability and partnering with an athlete for his or her best performance. It later became obvious that the coaching methodology could also be a vital tool in the corporate world. This movement was partly created by a book called “The Inner Game of Tennis” (Gallwey, 1974). The core idea is that there will always be a gap between a person’s potential and their actual performance. The reason for this is often an interference based on fear and doubt: fear of losing or embarrassment, lack of self-confidence, trying too hard or to be perfect, trying to impress, a busy mind, anger or frustration. To illustrate it in the paradigm of tennis, it could be the little voice in our heads saying ‘Im an idiot, I should have played this ball backhand!‘ Gallwey concluded that if we are able to reduce this interference we will increase our performance.
This is where the coach comes in, by empowering a person to reach their full potential. However, performance coaching does not rely on the experience, wisdom, advice or insight of the coach even though we traditionally think of a coach transferring knowledge to the player(s). Coaching is mainly non-directive and instead builds on people’s capacity to learn and think for themselves.
The coach’s primary responsibility is therefore not to teach, but to facilitate learning through skills that raise awareness and help clients to understand themselves better in order to achieve goals they identified themselves. This in turn means that the coach is forced to give up on the idea that he has the right answers and respects the client doing things in his own way. This makes the learning process intrinsic, releasing more energy, creativity and imagination. Moreover, the reward is bigger when goals are being met and achievements will most likely be sustainable because they are not dependent on the presence of a “great teacher”.
Some people limit coaching to performance coaching in the workplace. However, the field grew vastly in the last years and encompasses other categories such as Life Coaching and Career Coaching.
3. Summary of the main differences between Coaching and Psychotherapy1
|Therapist and patient||Coach and coachee/client|
|Medical/clinical model, based on diagnosis and pathology.||Learning/developmental model, focusing on attainable goals.|
|Therapy patient usually has difficulty functioning and/or feels emotional pain.||Coaching client feels stable and desires to move to a better level of functioning.|
|Relieving pain and symptoms.||Reaching of self-defined goals.|
|Doctor-patient relationship (the therapist has answers)||Co-creative partnership (the client discovers his/her own answers)|
|Emotional Clarification and Improvement||Action and Practical Outcomes|
|The therapist diagnoses, then provides professional expertise and guidelines to provide a path to healing.||The Coach helps the client to identify goals and challenges, facilitates learning while holding the client accountable to reach desired goals.|
|Progress||Takes time as process goes deeper.||Can be rapid as process stays more superficial.|
|Responsibility||Therapist is being perceived as responsible for process and outcome||Coach is responsible for process; Client is responsible for results|
|Costs||Can be covered by health insurance||Not covered by health insurance.|
|Qualification||Therapist has standardized qualification and many years of training, different regulations from country to country.||Coaches have varying levels of expertise and different backgrounds, not standardised. International Coaching Federation (ICF) seeks to provide accreditation.|
|History||First schools established in the early 20th century. Psychological theories and scientific framework given.||Established as an independent discipline in the mid 1990’s. Developed out of practical developments and needs, influenced by psychological theories.|
4. What you need to know
The truth is, Coaching and Psychotherapy do often look and sound similar, and depending on the school of thought, the boundaries can blur. Both approaches aim to bring about behavioural change and help people to understand how their thoughts and actions can interfere with their performance and well-being. Nevertheless, that does not make coaching the same as psychotherapy and many health professionals are rightly concerned that the unstandardised state of coaching will result in people taking over tasks that they are not sufficiently trained for.
Therefore, two points appear essential:
It is crucial to know the differences between the two disciplines. Psychological disorders require psychotherapeutic or psychiatric treatment while goal-orientated endeavours might be best met within a coaching paradigm. The right choice depends on the topic being brought to the sessions. Thinking back to the old lady, this distinction could provide an answer to her disappointment.
Traditionally, learning happened through someone instructing others as a function of expertise, knowledge or status. This is what happens in most classrooms, offices and medical practices all over the world up to today. Many people don’t know any other approach and consequently expect a doctor or psychotherapist to provide them with the ‘right’ instructions and solutions. Coaching evolved out of a paradigm shift that challenges this tradition and therefore contains a lot of potential to help us realise that the responsibility for sustainable health and well-being lies in our own hands; in all settings.
1 Table adapted from Bluckert (2005). The boundaries between Coaching and Psychotherapy are not always clear and vary according to the framework and theories used in both approaches.
Bluckert, P. (2005). The similarities and differences between coaching and therapy. Industrial and Commercial Training, 37 (2), 91-96.
Downey, M. (2003) Effective Coaching. Lesson’s from the coach’s coach. Cengage Learning: United States.
Gallwey, W. T. (1974) The Inner Game of Tennis. New York, Random House.
Williams, P. (2003). The Potential Perils of Personal Issues in Coaching – The Continuing Debate: Therapy or Coaching? What Every Coach Must Know! International Journal of Coaching in Organizations, 2, 2, 21-30.