We could all use a little help sometimes, all of us. What do I need? Coaching or
therapy? We'll get into that today at Live On Purpose TV.
So doing the therapy? Maybe some coaching?
Which one? What's the difference? Coaching or therapy?
Okay, there are differences and I think it's important to understand those
differences as you make a choice about that. Probably, it's helpful to start with
a basic philosophy of where we're starting from in the first place. Okay so
if you think of your mental health on a continuum or a spectrum, there's two ends
to this spectrum. So over here on the left end is the sick end, so that's where
we have diagnosis, pathology, treatment, all of those fun things are over here on
this end of the spectrum. What's on the other end? To understand that and let's
go to the middle first, so the middle right here in the center of the spectrum
is what I call health. Health meaning not sick, that's all we're going to use to
define health at this point, so not sick. You could be sick in bed with a fever
throwing up, there comes a time when you can get out of bed and you're not sick
but that doesn't mean that you're truly fit, thriving, prospering, that's this end
of the spectrum. So if we look at the entire spectrum, that's going to help us to
understand where therapy and coaching might fit in. Taking this end of the
spectrum first. Now I practiced in this end of the spectrum for about 13 years
in my career, I had a traditional psychotherapy practice, this is where I
brought in my clients, I would give them a diagnosis and I give them a diagnosis
I mean, I would identify a diagnosis, what condition do they have, what illness or
mental illness is going on over here on this end of the spectrum, is it
depression, is it bipolar, is it schizophrenia, what's going on over here.
That was the diagnosis part and then for that diagnosis,
we come up with a treatment plan. The treatment plan is to address the
symptoms and the problems and the difficulties that are being caused in a
person's life as they're on this end of the spectrum, that might include
medication therapy which is what we're talking about here today, other kinds of
interventions that might assist that person to move this direction.
The insurance companies would pay the bill for that typically as long as the
diagnosis was appropriate and billable and as long as there was a good
treatment plan in place that had been evidence-based and shown to be effective
in moving people across the spectrum to this middle area. Now when you hit the
middle area which I defined as health, meaning not sick, that means there is no
longer a medical necessity for therapy because there's no longer a diagnosable
condition. So a lot of this is driven by the history of where psychotherapy has
come from and this came from basically a medical model so think about in the in
the field of medicine and I've compared it also to physical health, you
know you could be sick in bed, fever and that you can get out of bed, well in a
similar way in the medical field, it's based around diagnosis and treatment
plans so that's what we're talking about in the therapy dimension. To practice in
this field, in this side of the spectrum requires education and licensure and all
kinds of hoops that people have to jump through because the license, not only
shows that they are credentialed and trained to work in that area
but also, that it's set up as a protection to the consumer because
people who are receiving these services are deemed or defined to be vulnerable
so, and that's maybe more information than you wanted, but therapy is a
licensed activity that is performed by professionals
who are both trained and credentialed to act in that part of the spectrum. So now,
what about coaching? I'm going to put coaching over here on this end because a
coach or a consultant or a life personal development professional is not
necessarily licensed to diagnose and treat illness for example. In fact, they
are not licensed, typically. I am, I'm a licensed psychologist, I can work in this
end of the spectrum and I did for about 13 years, I have moved my practice over
to here where I do personal development and life coaching even though I am still
a licensed psychologist who could practice on this end of the spectrum,
I've moved it over here for a lot of reasons that are personal to me but
let's talk about what this end of the spectrum means, what it is. On this end of
the spectrum, notice we're not so worried about pathology and treatment, we are
more concerned on this end of the spectrum with skills, development and
enhancement of life and productivity and happiness, that's all on this end of
the spectrum and it's not medically necessary because we crossed the border
from sick into not sick. So when you ask the question "Do I need therapy or do I
need coaching?" I think the word need is part of the the revealing factor here.
If you need it, it might be therapy, if you want it or desire it, it might be
coaching that you're looking for. Now there's some upsides and downsides on
both ends. Obviously on this end, we're going to be dealing with diagnosis and
and treatment plans and the insurance company is more likely to pay for what's
going on on this end of the spectrum, they will not pay for this end of the
spectrum typically because it is not medically necessary. I haven't seen
insurance plans that cover personal development coaching, I just don't think
it's a very common thing at all. So on this end of the spectrum, you're going to
be paying out of pocket typically. Now there's another thing that we run
into with coaching and I'm sharing this with you both is a warning and is just
information because it is not a licensed activity, you don't have the same
protection that you have on this side of the spectrum because these people
haven't necessarily gone through any particular training or credentialing or
licensure that says that they're qualified or at least meets certain
criteria to address the issues that you might bring to them, that can be an
upside or a down side depending on how you're looking at it, I just want you to
be aware of that because anyone can set up a shingle that says "Hey, I'm a coach.
I'm a life coach." Okay, awesome. What's their credentials, their training, their
experience? You don't know. You need to be able to answer that question if you hire
them. Over here you've got some assurances that that person has probably
been to school, they've at least taken a test and paid a fee with the state to be
licensed to do what they say that they can do. So hopefully that clears up some
of the difference between therapy and coaching so that you can make a
determination of which side maybe is more appropriate for you and there's a
lot of overlap in the middle. Can I just thought you acknowledge that as well?
There is a lot of overlap right here in the middle of the spectrum. I have found
for example, that most human beings are experiencing things that I would
consider to be right here in the middle of the spectrum. I'm talking about some
common things like depression, anxiety, relationship conflicts, life
purpose questions, those kinds of things are very very common here in the middle
of the spectrum, it doesn't necessarily mean that you're sick, it might mean that
you're human, welcome to earth, that's how we roll here.
So in either category, in the therapy world, a lot of people who are kind of on
the milder end of diagnosis or aren't on the severe ends of mental illness will
still benefit from therapy because those principles can apply to them, in a
similar way, people in this middle of the spectrum could benefit very greatly from
coaching where there are principles that are applied
that can help them move through some of these kind of middle of the spectrum
difficult things that they're experiencing on to something much
greater and much better than whatever they had before. Either way, if you choose
the therapy route, if you choose the coaching route, I think it is extremely
important for you to be discerning and to hire carefully.
Remember, your therapist or your coach is working for you, not the other way around.
I understand that traditionally, the therapy end of things deals with a more
vulnerable population and a lot of times that creates some dependency between the
therapist and the person who's being counseled, we want to watch out for that
okay, because you are still in charge either way, this person is working for
you not the other way around and you may fire them at will. I tell all my clients
this in our first session, you can fire me at will because if I am not helping
you to move toward that end of the spectrum,
then I don't think I have any right to be involved on your team, that is my
personal commitment to all of my clients. I think you can expect that, you can
demand that from anyone who is on your team, a therapist or a coach,
be discerning, make sure that that person is working for you because you're the
important factor here. Be discerning, make sure that you've got good reasons to
hire the person that you're hiring that you resonate with their approach or with
their philosophy, that their values are consistent with what it is that you're
looking for in your own life and in your own family. Either way you can get a huge
benefit if you're humble enough to open yourself up to the services of
professionals who can provide either therapy or coaching for you and there
are so many possibilities.
There's a whole spectrum. We all could use some
help, right? Coaching, therapy, hopefully that helps to clarify the issue for you.
I'm Dr. Paul, this is Live On Purpose TV.