Couch vs Coach?

When I began my training as a Coach, a large portion of time was spent exploring the matter of whether coaching was a form of 'Therapy through the Back Door'. Some clients have even asked me, do I need to lie on a couch? The answer is definitely not - unless you're feeling faint or tired, of course and you want to :)

Counselling and therapy retains a certain amount of stigma and people are generally quite averse to admitting to having a 'mental health' concern; historical images of 'the men in white coats' coming to restrain you in a straight jacket as portrayed in movies such as 'One Flew Over the Cuckoo's Nest' with Jack Nicholson spring to mind. Thankfully, unless you've attempted to self-harm, harm another person or commit a crime, you can't be forced into a mental ward these days. But the stigma very much remains and with this is mind, people may want to talk to someone about their concerns whilst avoiding the label of having therapy or counselling. After all, some would argue that having a Coach sounds much cooler than having a Therapist!

Psychological illness or disorders can affect anyone, in varying forms and it's nothing to be ashamed of. In England, 1 in 6 people report experiencing a common mental health problem (such as anxiety and depression) in any given week (source: NHS Digital). The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association is readily accessible on the internet and anyone who has attempted the 'Dr. Google' method' of self diagnosis may have had led to diagnosing themselves with Depression, Anxiety, OCD or even Psychopathy to name a few! But I advise a serious word of caution with this just as Medical Doctors do with self diagnosing physical illnesses; most of us will display 'symptoms' of mental illness in some form at any point in our lives. We all have the capacity to experience sadness, anxiety, anger, paranoia, fear, grief and loss of control for example and it is perfectly normal to experience such feelings throughout the course of our lives. It is the number, frequency, intensity, longevity and co-morbidity of symptoms, coupled with a consideration of contextual and environmental factors that determine an illness, not simply the presence of some of these symptoms at any given point in your life. Just as you cannot diagnose medical issues using google, you cannot diagnose mental health concerns without the appropriate training and background. In summary, there is a reason why Psychologists and Psychiatrists have to spend years training! It's also important to note that not all Psychologists are equal and depending on specialisation, some will be able to diagnose and support you with your issue whilst some won't. Part of the Code of Ethics that most Psychologists operate by includes only practicing within their area of expertise.

So when it comes to coaching, it's not a straightforward answer if you ask the question "Should I see a coach or therapist?" It might be helpful to consider the similarities and differences between the two. Coaches and therapists generally share a similar set of skills; listening, empathy, support, unconditional positive regard. These skills not only help to establish an effective working relationship but relate to the act of 'counselling'. Indeed, a coach may sometimes play the role of a counsellor. As you address your needs and goals, it is very difficult to coach without addressing you; the person as a whole and what you bring into the room. Coaches and therapists may even share a similar set of techniques and models for working with clients, for example, cognitive behavioural techniques, motivational interviewing, reflection and paraphrasing, appreciative inquiry. What they don't share is a similar bank of knowledge on psychological disorders and illnesses and this is where you can draw a clear line. The coach, unless they also have qualifications and training in Clinical Psychology, is very unlikely to be able to diagnose mental health issues nor to treat them whereas this is the therapist's area of expertise. The coach may be able to work with the 'every day' symptoms of disappointment, fear, anxiety or sadness but not the disorder. If you are seeking to get results, then it's best to go to the right 'expert' for example, you wouldn't go and see a dentist about back pain, even though both a Dentist and Medical Doctor may have qualifications in the field of Human Physiology and Anatomy. Finding the right professional can be confusing (click on this link to understand the difference between counsellors, psychotherapists, psychologists and psychiatrists, for example) and if you are unsure, then a good starting point is a chat with your GP.

So in the context of coaching, how do we know whether the issue being addressed is relevant for coaching or therapy? A good friend of mine who is a qualified therapist gave me this piece of advice; if the issue has been ongoing for a period of time and, is significantly impairing the quality of your life, then this might indicate a need for therapy. Ultimately the therapist is best placed to diagnose and treat. It's as simple as if you suspect there is an issue, then seek an expert opinion. Think of it this way; if your car was making a noise every time you pull out of the driveway, you would take it to a mechanic to diagnose what the issue is.

You may well ask ; can you have coaching at the same time as therapy? This is another matter for debate and in my professional opinion the answer is, it depends. If the therapy relates to a specific issue in your life, for example, bereavement but otherwise, you are seeking to focus on goals in other parts of your life and you have the emotional and physical resources to do so, then there's no reason why you couldn't see a coach to help you perform better in these areas whilst receiving counselling for the bereavement matter at the same time. It's always a good idea to let your therapist and coach know if this is taking place. In another scenario (and this is just one example); if you were seeing a therapist for clinical depression and had severe difficulty getting motivated about things, this may well conflict with the coaching process as coaching does require you to take action and ownership for achieving outcomes. Whatever the case, no two situations will be the same and there may be a blurred line between coaching and therapy. In practice, all good coaches and therapists would have supervisors to consult with on a case by case basis and would have your wellbeing and safety at the forefront of their mind. At the very least, if you're unsure, then raise the matter and explore it together with your coach, therapist or doctor.

*If you have a serious issue to discuss or need to talk to someone immediately in an emergency, please contact The Samaritans who are available day or night to offer a supporting ear; 116 123.

About the Author:

Tia Moin is a Positive Psychology Coach and Business Psychologist. She has expertise in the field of Business Psychology, Coaching Psychology and Positive Psychology. Tia treats each of her clients on a case by case basis and strives to act responsibly and ethically. She makes regular use of supervision and has qualified therapists in her network. Her training and background in the field of psychology means that she remains alert to and aware of potential mental health concerns and while she is unable to diagnose or treat, she is committed to supporting individuals in the transition to therapeutic services where needed.