• • So Many Options, So Little Clarity |
  • Differences Based on Regulations and Laws |
  • Differences Based on Service Approaches |
  • 5 Discovery Steps to Finding the Right Support |

So Many Options, So Little Clarity

If you need mental/emotional support related to a personal or professional issue and you’re thinking about contacting a therapist or a coach, you’ll want to know the difference between them so you can make the best-informed decision.

Unfortunately, information available on the internet from experts, organizations and mental health institutions is inconsistent, often incomplete, and sometimes just wrong. How do you wade through it all and get some clarity? Hopefully, this information will help you out, at least, in the context of the United States. 

You’ll find plenty of variety among therapists; all with overlapping and often competing services. Many call themselves therapists. You’ll also find psychiatrists, psychologists, psychotherapists, social workers, and counselors who may or may not self-identify as a therapist. However, a person must be licensed in order to use the designation “therapist.”

While there are many types of coaches with varying types and levels of expertise as well (life, fitness, health, leadership, professional, career, spiritual, etc), life coaches generally more closely resemble therapists, provide many of the same services, and can often compete for the therapists’ clients. That’s where to start with coaches. For descriptions of different types of coaches, see my blog post comparing mentors and coaches.

What’s probably immediately obvious here is that service options are numerous and confusing. This only exacerbates the stress you may experience if you’re feeling insufficiently self-resourced and in need of help.
Back to top

Differences In Regulations and Laws:

Licensing:

Therapists:

Of the professionals listed above, ONLY those licensed by the state where they practice can call themselves therapists, psychotherapists, or social workers.

Typically, therapists have an advanced Masters or Doctorate degree,  in psychology or social work. Both are required to complete a supervised case working practicum. Without the fulfillment of the latter requirement, psychologists and psychiatrists cannot counsel clients or patients.

In addition to the above training, social workers receive specialized training in how socio-economic factors contribute to their client’s circumstances and options as well as how to help clients access mental health services and institutions. Therapists are usually concerned with the client’s relationship to self, loved ones, co-workers, friends, and/or society.

By law, only psychiatrists can prescribe medication.

Counselors:

Similarly, counselors, especially health counselors, are licensed in most states. They generally hold the professional title “Counselor,” not “Therapist.” Still, some unlicensed individuals use the title Counselor. You can always ask if a prospective counselor is licensed and what type of license s/he possesses.

Much like coaches, counselors tend to specialize in a service area: health, grief, weight loss, financial, or addiction. Logically, licensing requirements vary greatly across the different areas of specialization. These requirements and even titles will vary from state to state. For example, a priest may not need much additional training to become a licensed counselor to provide spiritual, marital, or other forms of guidance to his parishioners. On the other hand, health counselors and social workers can have very similar education and training and often compete for the same clients. It is not uncommon to find either working for, or in tandem with, a health provider (e.g, hospital, clinic, public agency, or institution). Furthermore, therapists may be trained in a specialization such as grief counseling and provide this service under either professional title provided they have the appropriate license.

Coaches:

Coaches are not regulated by a state or national entity and they have no nationally recognized licensing, registration or certification requirements and process. The International Coach Federation (ICF) does certify individual coaches and some affiliated coaching schools, but it is not a recognized regulatory agent for the US or international field of coaching. Coaches can and often are certified by the institutes that trained them.

Insurance:

Licensed service providers – therapists and counselors – are inclined to be covered by your insurance policy. However, don’t assume this to be true. Look into it. And, make sure to review the fine print concerning under what circumstances you’ll be granted coverage and how much coverage you have. This will give you an idea of how many sessions are permitted.

Convenience:

Licensed therapists and counselors are restricted to work only with clients who are physically located in the state, or sometimes locality (e.g. county), where the license was issued. While some therapists conduct sessions over the phone and the internet, most continue to follow a more traditional in-person approach. Being subject to state laws complicates and, in many cases, even prohibits access to clients outside their immediate jurisdiction.

In contrast, coaches often offer virtual sessions online or via telephone in addition to in-person sessions. In fact, the clientele of some coaches is nearly 100 percent virtual. This gives the coach the option to serve clients all over the world. It also offers an attractive option to those clients who are unable to or are significantly inconvenienced by, the commute to their practitioner’s office. For some clients, the distance or physical separation affords them more anonymity, privacy, safety, independence, and ultimately control.

Therapists are required to keep notes and/or record their sessions. Many counselors and coaches also take notes and make recordings of sessions. By law, therapists and counselors are required to protect their clients written or recorded records. Licensing jurisdictions typically require that such records be under lock and key.

Furthering client confidentiality, national and state laws protect “doctor-client” privileges, which are extended to licensed mental health practitioners. Coaches, on the other hand, are not subject to these regulations; however, they will typically adhere to a very similar code of ethics prescribed by licensing authorities.
Back to top

Differences In Service Approaches:

It’s surprising how many stereotypes and opinions there are about what therapists and coaches do. In fact, and in the interest of full disclosure, what is presented here is actually my opinion based on my practice, experience, and reading. Hopefully, it orients you toward a few good questions to ask when searching for the practitioner who’s right for you.

Diagnosis:

The clients of coaches are referred to as “normal,” i.e., functioning at their full potential. Those who are temporarily or chronically compromised or dysfunctional will be customarily and appropriately referred to therapists. Coaches don’t diagnose. In fact, they don’t need a diagnosis to initiate their work with clients because their coaching is not seen to be a treatment process. Therapists start with a diagnosis, which some critics say pathologizes their clients.   

Relationship:

Therapists, counselors, and coaches working with clients on mental/emotional issues aim to create a safe, objective, and supportive space. How they do that can differ considerably. Therapists typically establish a hierarchical relationship with their patients/clients: they are the experts, they diagnose the problem and they define the treatment plan.

In contrast, coaches meet their clients as peers and work alongside them encouraging and facilitating the clients’ own discovery of solutions and direction. In fact, clients of coaches typically identify or sometimes receive homework to encourage them to independently take steps in an empowered way. Although less common, some therapists give homework as well.

Focus on the Past or Future:

Coaches work with clients on their outlook, behaviors, goals, and blocks. They aim to support and facilitate change, transformation, and moving forward. The past is relevant only in so much as the client wants to talk about it or explore its connection to the issue they seek to resolve. Some people claim that coaches are strictly future-oriented, but, in actuality, this is not the case.

Although the approaches of therapists vary greatly and many work directly on future goals, it is more often the realm of psychotherapists to dig into a client’s past with an aim to identify the root causes of the diagnosed or stated illness, problem, or dysfunction in order to alleviate or cure it.

Duration of Relationship:

Another common falsehood about coaching is that it is short-term and strictly goal-oriented. While it is true that most coaches offer a package or a variety of packages comprised of a given number of sessions, many relationships extend over a year or more. In addition, coaches typically schedule regular sessions, but they can be intermittent as well. In contrast, therapists will usually establish regular (typically weekly) sessions, and the duration of the relationship is open-ended.

Giving Advice:

Psychotherapists and social workers are trained not to give direct advice. Some will cautiously offer advice in certain circumstances with certain clients, e.g. crisis situations. Social workers often help clients solve practical problems through the identification of resources, options, etc, but decisions are left to the client. A counselor may give advice depending on his/her specialization. Similarly, most coaches do not advise, but it can depend on their specialization as well.

Tools and Techniques:

It’s very difficult to compare and contrast tools and techniques because there is a great deal of overlap. In addition, an increasing number of therapists are adopting techniques more commonly and traditionally associated with coaches, thus blurring the distinctions between the two fields a bit more.

One of the more popular psychotherapy approaches most similar to coaching is cognitive-behavioral therapy (CBT). Put simply, therapists using CBT help their clients change thought patterns, emotional reactions, or reactivity in order to alter undesirable behaviors.

An additional potential distinction is some therapists claim that their work is more internal than that of coaches.

However, many coaches can and do refute these claims. They note they work with emotions and are skilled in techniques that tap into the body and subconscious.

In truth, the fields of practice are so diverse, that generalizations aren’t very helpful or accurate.
Back to top

5 Discovery Steps to Finding the Right Support For You

Step 1: Determine if you need assistance with a  “Diganosible” condition.

First and foremost, decide whether you want a diagnosis or need help with a diagnosis. In either of these cases, consider a therapist.

Step 2: Decide if you want to dig into your history and underlying factors

Second, take a moment to assess whether you want to dig deep into a long-term personal issue and determine the underlying causes. If yes, consider a therapist, and verify that any prospective practitioner offers the type of service (i.e., approach). If not, expand your search to include a counselor or coach.

Step 3: Decide whether you want to focus on resolution and behavior change

Third, take another moment to consider if you focus on problem resolution, behavior change, and moving forward rather than dig into the past. If you do, again consider a counselor or a coach. Still, depending on their approach, some therapists could be appropriate. Look closely at each potential practitioner’s approach and techniques to see if they will support your goals.

Step 4: Consider what type of working relationship works best for you

Fourth, consider what type of relationship will work for you: co-creation with a resourceful and supportive peer (coach), guidance from a well-informed source (counselor), or loosening the reins and embracing an expert’s process (therapist).

Whether you decide to see a therapist or coach, know as much as you can about whoever is on your shortlist. Make sure that their training, specialization, and experience reflect who you are and what you need. Visit the website of the school where your candidates received training. Review how the site describes its approach and program.

Also, visit your prospective practitioner’s website and “about me” page to see if s/he has any additional training. Accumulating skills is a common strategy to better tailor services to specific client needs. Sometimes it’s these extras that will resonate most with you and really make a difference. Do your research!

Step 5: Interview potential practitioners to find the right fit for you

Five, once you’ve done your research, call and talk to each prospective practitioner. State your intentions and ask how they can support you. Ask questions, listen closely and pay attention to how you feel.

What type of approach appeals to you? What is it you want? Which individual practitioner resonates with you? This is really the key!
Back to top

For further assistance, see:

My Spiritual Life Coach and About Me page

Or, Contact Me

Updated July 13, 2022