The distinctions between traditional therapy and coaching continued:
Let’s take a deeper look at the second of these distinctions.
- Fix versus Create
Why clients come to see you
In most clinical practices, clients come with a presenting problem that they either want the therapist to solve or because someone else has sent them to get ‘fixed.’ Psychotherapists see many of the latter in marital therapy and child therapy.
Applying the traditional medical model of therapy, the therapist would likely undertake the following strategies:
- Talk with the client about her personal and medical histories and previous mental health treatment.
- Explore the history and duration of the problem.
- Discuss why the client believes she might have this problem at this time in her life and continue to gather pertinent current and historical information.
- Consult the most recent DSM (Diagnostic and Statistical Manual of Mental Disorders) or the ICD (International Classifications of Diseases), give the client a diagnosis, and develop a treatment plan. If the client has insurance, the diagnosis hopefully is one that the insurance company will accept.
If not, the therapist faces the common dilemma of deciding whether to assign a DSM diagnosis that will enable the client to get insurance reimbursement. Many therapists will do this simply to enable the client to get reimbursement — not because the diagnosis is in any way helpful (with the exception of training in a clinical program setting). This situation is the sad reality of managed care and the rigid application of the medical model to the helping professions, which is mostly the case in the United States.
Beyond this dilemma, the therapist must consider the client’s perspective throughout this relationship. Clients assume that they will be fixed and will achieve emotional healing as a result of their relationship with a therapist; that is why they sought therapy in the first place.
Coaching clients, on the other hand, seek a coach for a myriad of reasons, most of which relate to their future. New clients usually do not come because they have a major problem — certainly not a major psychological one. They are not coming with a dysfunction and typically are not coming in pain. They might have a little general malaise because they want more out of life and don’t know how to get it. Economists call this category of people the worried well. They don’t need, or usually even desire, a diagnostic label. They don’t have something broken that needs an expert to fix. They just want more out of some aspect of their life and assume that by working with a coach, they will achieve greater success in planning, setting goals, and creating the life of their dreams.
If a client with a major psychological problem comes to see a life coach, the appropriate action is to refer that client to a qualified therapist. Coaches need to be proficient at recognizing appropriate
and inappropriate coaching clients, as well as the ethical guidelines of maintaining both a therapy and a
coaching practice. As a general rule, it’s important to keep miles between your coaching and therapy practices if you choose to have both. Additionally, once a person has been your coaching client,
it’s unwise to take him or her into your therapy practice. The reverse is mostly true as well, but a therapist may do coaching with a former therapy client as long as there is a ritual ending of the therapy relationship and the new coaching relationship is begun formally and clearly. Therapists who have added
a coaching niche to their business also maintain a list of qualified therapists for referrals. Likewise, therapists sometimes refer clients to life coaches when they have resolved their therapeutic issues and are ready to move forward with their life design and plans.