Coaching VS. Psychotherapy: What’s The Difference?

With the emerging global community and an internet presence even in remote jungles and mountain villages, we all live in an age of exponential changes. It is no surprise that there has been a corresponding pressure on the psyches and equilibriums of just about every living human being.

In response to that pressure, the field of psychotherapy has grown itself up, from the seemingly narrow minded Victorian context of Freudian analysis to more recent scientific advances in mapping brain function. Techniques have ranged from passive and remote interpretation to more active interventions such as EMDR and DBT.

Baby boomers have played a large role in turning psychotherapy into a household word; a term reserved not just for the mentally ill, but also for the “worried well”. And managed care has capitalized further by applying the medical, disease-based model onto the practice, requiring any and all users of health insurance to declare a diagnosis worthy of treatment. That is to say, it is a model of treatment provided by licensed and credentialed practitioners who must authorize and frequently request sessions through a complicated and laborious set of rules in order to be reimbursed–and only then, at a discounted rate.

Because of this co-opting by the managed care industry, psychotherapy has become a practice relegated to those clinicians who oftentimes do not charge “full fare” and only see clients within the insurance industry.

This climate of medically based, devalued care has therefore spawned a whole new breed of helping professionals– executive coaches, life coaches, or personal coaches.

So what are they really? And how are they different from psychotherapists? What do they offer and who can they help?

Perhaps the easiest way to explain this is by way of example. Let’s consider a typical presenting problem, but taken from the two different perspectives.

Amy is a 50 year old mother of 3, one of whom is in college and the other two in high school. Married 25 years and a part time executive assistant at a local widgets factory, she has begun to feel bored, antsy, sometimes irritable and a bit lost.

It’s not that she is unhappily married really, or that she doesn’t like her job really, or that she is fed up with the adolescent attitudes of her 3 kids. She doesn’t feel depressed, in the sense that her appetite is off, or her concentration impaired. It’s true that she has put on a few pounds lately, and she tends to forget things more often, and her moods are not exactly happy.

She just doesn’t feel good; she literally doesn’t know what to do with herself anymore, and so she asks friends and her minister for referrals.

If Amy made an appointment with a psychotherapist, she would have presented her insurance card, called for an authorization herself, and paid a copay of $10 to $25. Upon intake, she would have been directed through a series of questions aimed at uncovering the source of her unhappiness, delving into early childhood memories of outstanding events, achievements, losses, and traumas. She would also recount the details and qualities of her relationships with her parents and her siblings, significant caretakers and significant others.

Over the ensuing weeks, she would have begun dwelling on the pain of her past and the possible ways that such pain, if repressed all these years, might be affecting her now. Through awareness and abreaction, a breakthrough of raw and intense emotion, she would begin to integrate previously split off aspects of herself and her memories.

Amy also discovered that her therapist had applied a diagnosis of adjustment reaction with mixed emotional features, which, after six months became dysthymic disorder, a milder form of clinical depression.

In many ways there is overlap in the different approaches to this client, especially when a therapist, like myself makes the transition to life coaching.

As a coach, I also would want to know the details of her upbringing, but with more of a focus on what has “worked” rather than on what hasn’t. Rather than charting her life in terms of a genogram (a graphic tool used by therapists to illustrate the relationships and dynamics among nuclear and extended family members), I would help Amy create a life balance wheel or mandala (a graphic tool used by coaches to illustrate core values and beliefs, and the ways they are manifested in various relationships to one’s environment). We would focus on her future goals as related to being an empty nester, and in terms of her career, her spirituality, her marriage and her friends. As a therapist these things would also be discussed, but with more of an eye to the past, and the ways that previously unresolved psychological conflicts might be blocking her from feeling happy.

Instead of meeting weekly for 50 minutes with the onus of responsibility on the client to produce “material” for the therapist to listen to, and respond when indicated, the coach would give assignments based on a careful listening to the client’s stated goals. The work with a coach could be done in person or over the phone, with between-session email and brief phone contact. With a coach the power is more equalized and the relationship a partnership. In therapy, it still carries the mantle of one up, one down, expert and client, doctor and patient.

Overcoming blocks would be a major focus of both approaches. With psychotherapy it is more emotion based, however; “working through” or peeling away layers of the onion, so to speak. In coaching it could be accomplished by finding a way to make the block useful, or at least recognized as a weak link (like in a team) that needs to be tamed and supported in order to act effectively.

Obviously many therapists already employ many of these coaching techniques in their practices. Indeed, Internal Family Systems Therapy, is one school which actively engages the client to embrace and integrate various aspects of self, as opposed to letting go, or working through and leaving them behind.

No matter what, being coached by a professional already trained in psychotherapeutic techniques, can add a richness and depth to the work, and an outcome that allows for true happiness and success outside of the managed care industry, and relevant to the emerging global community.

DBT Therapy Orange County DBT-trained clinicians help you and your child find a balance between acceptance and change.