E16. Differences Between Coaching and Therapy

Welcome to ADHD Crash Course. Today we're going to talk about the differences between coaching and different kinds of therapy. This is a question that comes up all the time. There's a lot of confusion, even amongst people who are working in these industries. What's coaching? What's therapy? What's the same? What's different?

I'm going to give you my opinions. This is based on my work as an occupational therapist, my training as a coach, and some of the differences that I've seen in coaching and psychotherapy, traditional psychotherapy, as well as coaching and occupational therapy.

Coaching vs. psychotherapy

Now, I'm going to start with psychotherapy, because I think that's something that more people have exposure to. One of the fundamental differences that I see is that therapy very often has an orientation that includes the past.

You're looking to the past to impact your present and even to impact your future. Psychotherapists have tools related to trauma, related to complicated family dynamics, and they are often involved in the process of healing.

Coaching is different than that. Our focus is not on the past. Sometimes you might dip into the past when you're looking at things like changing a mindset or changing patterns that aren't really serving someone, but you're not heavily focused, oriented to the past.

Coaching is very much about the present and moving forward. In coaching you're using tools that are helping you get clarity about where you are, where you want to go, what is standing in your way, and what are practical steps you can take to get you there.

This is where I make a point that might be kind of a strange point for a coach to make. But I truly believe that not every season is the right season for coaching. Coaching is about moving forward and despite what our culture pushes, not every season is about moving forward.

Some seasons are about resting, being in the same place, healing, taking a breath. It's nothing to feel bad about, if it's not the right time for coaching. Coaching is there for you when you need it, when you're interested in really moving forward, when you need some clarity and tools in launching yourself to the next step and you're hitting roadblocks. That's a great fit for coaching.

Coaching vs. occupational therapy

I'm going to go on specifically to the differences between occupational therapy and coaching. Occupational therapy, for those of you who don't know, that's my background. I worked for 20 years as an occupational therapist; I love that field. It's a great fit, actually, for people with ADHD, because it's constant change and stimulation, it's great.

What's the difference between OT and coaching? When I was considering this career change, it was really confusing for me, because a lot of people were saying (and they weren't wrong in this) that as occupational therapists, we have a lot of that coaching training. That is something that we already are almost intuitively doing because of our professional training. But there are some pretty fundamental differences in my work as a coach versus the work that I have done as an occupational therapist.

One pretty big difference between coaching occupational therapy is that as an occupational therapist, it's my job to assess where somebody is, design the goals (of course, my clients would weigh in on that) but design the goals, the treatment plan, and determine when we've arrived there.

With occupational therapy, you do a lot of those things by using standardized assessments. You're getting objective numbers and those numbers define where that person is functionally. They also define when they've made progress, and they play a big part of determining when goals have been met.

That's pretty different than coaching, because in coaching, the client is the one saying "Hey, this is where I am, this is where I want to go". Maybe they need some help peeling back layers and getting clear about what they want, but my judgment/ measure/ assessment of where they are isn't really relevant.

When you're coaching, you're trying to not hijack things, not impose your agenda on the work you're doing with your clients. And that can look really different. There's certainly OTs that operate more like coaches. There's probably coaches that operate more like OTs.

Although we share lots of similarities in our approach, in our function based-approach/ our client-centered approach, I do think the difference is pretty dramatic when I'm looking at the work of an occupational therapist versus the work of a coach.

We've talked about the differences between coaching and psychotherapy, coaching and occupational therapy. I also want to mention the difference between ADHD coaching and traditional life coaching, because there are some differences.

ADHD coaching vs. general life coaching

With life coaching, you use questions, the right questions, strategic questions, and really strategic listening to to help people untangle where they are, where they want to go, what's getting in their way, what they want, what they need, all of that... you're using your questioning and your skills in listening to their answers and asking the right questions to help them get clear. Then once you're clear about what's important to them and where they want to go, then you help them break down really practical ways to get there.

So the philosophy is the same, but for a lot of our clients, especially those who are new to managing ADHD or new to even realizing that they can impact things with some strategies, they don't necessarily have all the knowledge they need yet to go forward in managing ADHD.

So, some of ADHD coaching is definitely about education, education on executive functioning skills and how we can support those. That kind of training is not just vocabulary training, it's not just identifying different skills and saying "these are tricky for people with ADHD".

Part of the coaching process is looking at something that's difficult for a client and helping them figure out where this is breaking down for them. It's not the same answer for everyone. You can be someone with ADHD who has executive functioning deficits, and you might really struggle in one area versus another.

There is no "cookie cutter answer" for how to support these skills. This is a big part of what an ADHD coach can help with. (We look at) emotional regulation and other aspects of regulation. For me, some of my work with my clients involves looking at your sensory system and sensory strategies and how you can leverage those for your energy and your attention levels. So, there is a component with ADHD coaching that might look more like a consulting relationship.

Therapy is regulated; coaching is not (yet)

There's one more difference that I wanted to mention between coaching and traditional therapy, occupational therapy, counseling, social work, some of these other fields. There is no regulation of coaching, at least not in the US. I don't know of any country, yet, that has any kind of regulating bodies and that means that, quite honestly, anyone can say they're a coach.

I can't speak to all of these other professions, but I know for occupational therapy, that you are regulated on both a national level and a state level. So being regulated on that level assures that:

a) when somebody enters the field, that they have a certain amount of knowledge and education and b) in order to keep practicing, they have to meet certain continuing ducation requirements.

Every renewal period, every two years, you have to meet that continuing education aspect. Even though I want to make you aware of that difference, I'm not interpreting that difference. I'm not saying that that means without the regulation, that you need to shy away from coaching...

Obviously, I'm a big believer in coaching because I pivoted from a traditional therapy career in order to do this full time! But, I am saying, especially when you factor in ADHD and some of the complexities of coaching when you're specializing in ADHD, that it's important to ask the questions and determine how someone is qualified to be doing this work with you, determine if you are a good fit for their style and their background and what they bring to the table.

There's no shame in not fitting with someone who you've started to explore coaching with. Hopefully, a coach will be the first one to say "Hey, I don't really think that this is going to be a great fit. This is not so much my skill set. Let me refer you to someone else".

That brings us to the end of this episode on the differences between coaching and different kinds of therapies. I hope that I shed some light on the differences and thank you for joining me!

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