Psychotherapy or Coaching?

Coaching and psychotherapy, what’s the difference? Why choose one over the other? What is it that I need or could most benefit from now?

All good questions for those who’ve come to notice a personal need for help. And as a psychologist who provides both kinds of service I do have an opinion. I believe it’s a question of depth, that is, how deeply the needs concern our fundamental sense of identity, well-being, and confidence.

When the Answer is Coaching

Coaching is responsive to the normal needs we encounter to learn, grow, and adapt in the course of our role-taking at work and outside of work. These needs arise in the form of problems that concern our efficacy and readiness as an agent and actor, perhaps accompanied by signs of struggle. Usually its not only we, but also others - our supervisor, spouse, and co-workers - who recognize our needs for help. They might be characterized as needs for perspective, insight, and feedback, something that helps us clarify the true nature of the problem at hand.

Coaching is an intervention that promotes adaptive development in times of change and challenge. A coach, particularly a psychologically trained coach, provides the reflective pause and assessment (of self and situation) we need to figure things out and develop new ways of thinking, acting, and interacting. Others (e.g., mentors) may also be involved to promote skill building and help us hone our judgment. It’s an example of organizational capacity building, which aims to bolster the productive capacity to perform and generate results.

In some cases, coaching is used to support development of high-potential employees who are being deployed in “stretch assignments.” It’s also used to help managers or executives who are struggling. In the latter case, the aim is to avert failure and get talented persons back on track. Depending upon how long these struggles persist, a person may experience declines in their capacities to meet expectations and reverse the trajectory of performance. Growing levels of stress, strain, and fatigue can undermine confidence. In some cases, this creates a deeper kind of need for help.

When Psychotherapeutic Help is Indicated

The same person who is a candidate for coaching - typically a high-potential professional or executive - can also be a candidate for psychotherapy. The problems that call for psychotherapy may originate at work or outside the workplace. But they run deeper and tend to impact all aspects of a person’s life and relationships. It’s what happens when chronic patterns of stress and strain persist, and when our efforts to adapt and “get a handle on things” fail. It wreaks havoc on our confidence and leaves us feeling discouraged, even hopeless.

These problems transcend the usual role-based challenges addressed by coaching. That’s not to say that there is no connection between these problems and the role-based challenges that can stimulate growth. But, as the Challenge-Development Curve below suggests, beyond a certain point (the “inflection point”) we can be overwhelmed by challenges, our coping resources (cognitive, emotional, social, and practical) can be depleted. At that point we can experience the downward spiral of “decompensation.” We become more intensely distressed, confused, and our sense of self-efficacy is shaken.

12-18 Challenge-Development Curve with Ref Pause.jpg

At this point, we may be entering mood disorder territory (persistent feelings of depression or anxiety). At the root of these conditions is fear and the avoidance of that which we fear. This is when any “chinks in our armor” will be revealed. These kind of fears and insecurities usually operate outside our conscious awareness, which grants them unchecked power to close off whole domains of experience, insight, and adaptive action. This kind of fear steals our joy and make us brittle. But as remote and confusing as these fears may feel, they are discoverable and amenable to resolution in psychotherapy. 

Implications for Action

Now, let’s set this discussion in context. How might persons in your organization or your family be struggling with role-based challenges to perform? Are they able to freely and openly process their feelings and needs for support with others who can help? Do they know how to access and use the resources available to them? Are their struggles beginning to show? Are they seeming less able, more frustrated or confused? Have you broached the discussion of coaching? Or do you believe that they may need something more, perhaps they are a candidate for psychotherapy?

Because of the way coaching has grown, there are many kinds of coaches. Some offer specialized advice based on industry-specific or function-specific experience and expertise. Although they may use 360 feedback tools or other style-based assessments, their primary qualifications center on practical problem solving. Others are trained as psychologists or at least have advanced training in psychologically relevant approaches to adult learning and development in an organizational context. But even these may not be the right professional to help someone whose needs run a bit deeper and call for psychotherapeutic help.

It was estimated over 30 years ago that 10-15% of people presenting for coaching may be experiencing “clinical” issues - the severity and/or chronicity of their distress qualifies them for clinical care. If anything, that estimate is probably low given changes in the workplace in the intervening time. So, I’d recommend that that HR leaders, managers, and spouses and partners normalize the practice of addressing these deeper needs at critical moments in our lifetime. In most major cities you’ll find psychologists or other mental health professionals who do this work, who understand this population and their environment. It should be a normal part of our approach to wellness and self care!