What is the difference between psychotherapy, counseling, and coaching?

Psychotherapy or therapy is a professional process, which may have a medical slant to it. Therapists must make a psychiatric diagnosis and certify that the sessions are “medically necessary” in order to bill medical insurance carriers. Therapists tend to follow a treatment plan to help patients accomplish their goals. It is considered a healing process. Therapy continues as long as the therapist and patient feel they are making progress. But as long as therapists bill an insurance company, they are implying, and willing to certify, that the therapy is medically necessary for treatment of the diagnosis.

Typical diagnosis categories that therapists bill for include, but are not limited to: depression, anxiety, bipolar mood disorder, attention deficit hyperactivity disorder (ADHD), adjustment disorders, post traumatic stress disorder (PTSD), addictions, impulse control disorders, obsessive-compulsive disorder (OCD), and many disorders of childhood and adolescence not listed above. Clinical assessment instruments may help a therapist make a diagnosis and create a treatment plan.

Please note that relationship problems like marital or family relationship problems are not listed above because they are not medical diagnoses covered by health insurance plans. But they are commonly covered by Employee Assistance Plans (EAPs) for a limited amount of sessions. If your therapist is willing to make a psychiatric diagnosis and claim that relationship therapy is what is medically indicated to relieve that condition, (s)he can often bill third party payers, including health insurance carriers, for the treatment.

Counseling

Counseling is a more general and inclusive term that often reflects, but is not limited to the psychotherapy process. Counseling of a non-medical nature, which cannot be considered as psychotherapy, may be provided by professional therapists other types of counselors. One example of non-professional counseling is Pastoral Counseling from a religious minister.

The manner in which a counselor goes about encouraging client growth and development varies based on the needs of the client. This may range from psychological “first aid” and/or assistance coping with grief and loss at one end of the spectrum to establishing life or career goals at the other end of the spectrum.

The term “Counselor” implies “One who gives counsel.” But professional counselors avoid giving advice or direction to clients, who are seen as needing to process through various alternatives to find the best one for themselves. Advice giving transfers responsibility from the client to the counselor and fosters an unhealthy dependence on the counselor. Counselors may or may not use clinical assessments or treatment plans. Many clients see counseling as a way to get “tools” for challenging situations.

Coaching

Where therapy is the practice of helping people deal with dysfunctional patterns and/or relationships, coaching can be seen as helping relatively healthy people optimize their lives. Coaching services presume the client is healthy, whole and prepared to achieve his or her own goals and objectives. Therapy tends to focus on resolving past and current issues to free up a person to lead a healthier life. Coaching tends to be forward looking. It is also more action oriented and less about assessment – more about progress.

Coaching is primarily a positive experience that should be revitalizing and enjoyable, and leave the client feeling clear-headed and capable. It tends to help people view themselves and others differently and deal with stress and time pressures better.

According to the International Coach Federation (ICF), “Coaching is an ongoing relationship which focuses on clients taking action toward the realization of their vision, goals or desires. Coaching uses a process of inquiry and personal discovery to build the client’s level of awareness and responsibility and provides the client with structure, support and feedback. The coaching process helps clients both define and achieve professional and personal goals faster and with more ease than would be possible otherwise.”

Certification boards like ICF exist to certify coaches, something that is more important to businesses and corporations than to individuals. Individuals seeking life coaching would do well to seek a referral from someone they trust or to look for a coach, who has passed a certification process. Licensed therapists, who are then trained and qualified in coaching are some of the best prepared to provide coaching services.