This is the first in a two-part series. Part 2 will include a 7 step guide to finding a therapist for those on the lookout for mental health support. Sign up for the newsletter at the bottom to be alerted when part 2 is published!

Coaching and therapy are two powerful tools for improving health and well-being. Both coaches and therapists provide clients with strategies and frameworks to reach their goals, but the approaches and qualifications of each can vary greatly. In this blog post, we'll explore the differences between coaching and therapy, including topics and tools, scope of practice, training and qualifications, insurance and payment, as well as ethics and legal considerations. We'll also discuss who might benefit from working with a coach or therapist, and how to find the right practitioner for you.

Note that these are all generalities and not always the case for all coaches or therapists. Take each section as a good rule of thumb, and chat with your prospective coach or therapist to learn more about their specific practice and approach.

Time-frame: Past, Present, Future

When it comes to coaching, the focus is on helping people achieve specific goals and make progress in their personal or professional lives. Coaches work with clients to devise practical, actionable steps and strategies that clients can use to reach their goals and make positive changes in their lives. Typically, coaching will be more present and future-oriented. Therapy tends to focus more on understanding and working through past traumas or experiences underlying present emotional and behavioral concerns in order to make positive changes.

Topics and tools

Coaching topics can address physical, emotional, financial, spiritual, environmental, and social health and can overlap with goals that clients may have in therapy. Coaches may use a number of strategies and theories to guide their work including: motivational interviewing, positive psychology, transtheoretical model of change, and interpersonal neurobiology among others.

Therapy, while similar to coaching in some aspects, takes a different approach. Instead of focusing on designing goals and strategies to achieve holistic goals, therapists focus on helping people work through mental health issues, emotional problems, and behavioral concerns. Therapists may use a variety of approaches, such as cognitive-behavioral therapy, psychoanalytic therapy, or interpersonal therapy among many others, depending on the needs of the client. 

Effective coaches and therapists will both provide clients and patients with a number of tools, strategies, and frameworks for addressing their concerns during and outside of sessions.

Training and Qualifications

The level of experience and training among practitioners can vary greatly. Therapists are required to undergo years of training and hundreds of hours of clinical supervision as part of their licensure. Ongoing education is necessary to maintain their license to practice therapy.

Coaches can range from self-taught to those with master's degrees and national board certifications that require years of training as well as  supervision. National Board Certified Health and Wellness Coaches (NBC-HWC) must complete ongoing education to maintain their certification. It is advised that clients always do their research to understand a potential practitioner's qualifications.

Scope of practice

Coaches cannot diagnose or treat mental health issues, and while some are qualified to recommend supplements for mental or emotional support, they cannot recommend or prescribe any type of medication without the oversight of a medical professional. Therapists are qualified and trained to diagnose and treat mental health issues, and some are able to recommend and prescribe medication. 

Ethics & Legal

All therapists are bound by the Health Insurance Portability and Accountability Act (HIPAA), which is a federal law that sets standards for protecting the privacy of personal health information. Under HIPAA, therapists are required to protect the confidentiality of their clients' personal health information, including any information that is shared during therapy sessions. This means that therapists are not allowed to disclose any information about their clients' mental health or treatment without the client's written consent. There are some exceptions to this rule, such as when the therapist is required by law to report abuse or when there is a risk of imminent harm to the client or others.

Private health coaches are not legally bound by HIPAA and may have their own privacy and confidentiality policies that are not as extensive or comprehensive as those of a therapist. Additionally, non-certified coaches are not subject to any particular code of ethics. However, all NBC-HWC are required to follow HIPAA regulations and guidelines as well as adhere to a strict code of ethics to maintain certification.

Insurance and payment

Due to the relative newness of professional certified coaching, the American Medical Association (AMA) is still in the process of approving the general use of CPT codes for insurance reimbursement. As a result, coaches in private practice are currently unable to accept insurance or payments from HSA/FSA accounts. Although some therapists do take insurance, the low reimbursement rates have caused many to no longer accept this form of payment, although many still accept HSA/FSA funds.

Who should I work with?

In many cases, it can be very beneficial for an individual to partner with both a coach and a therapist to reach their holistic well-being goals, particularly when dealing with a mix of mental, emotional, behavioral, and other health goals. Coaches can help you to develop the tools and strategies to manage current challenges and improve outcomes in both the short and long term. However, if you have unresolved trauma, it could be triggering difficult situations that require you to rely on your coaching tools and strategies to prevent negative outcomes and experience well-being. If this is the case, it may be beneficial to work with a therapist to heal these old wounds to prevent them from creating ongoing challenges that you must continually work to overcome.

In addition, if you experience untreated anxiety, depression, or other mental health concerns that are negatively impacting your day-to-day or could interfere with your ability to achieve your coaching goals, it is important to seek out the assistance of a licensed therapist.

A good coach will recognize and offer referrals out to clients who would benefit from working with a mental health practitioner in addition to or instead of coaching. If you work with a coach in-person, they may be able to offer recommendations for therapists in your local area. For those working with coaches in an online setting, they should be able to offer you guidance on how to find a therapist that will meet your needs wherever you may be located. 

If you think you could benefit from working with a therapist, but don’t know where to start, check out part 2 in this series and get your free how-to-guide. Sign up below for more useful newsletter content and to be alerted with new posts and resources become available!