Therapy vs. life coaching: What’s the difference?

It’s not unusual for people to assume that therapy and life coaching are similar, or even the same. Many conflate the two practices and don’t understand that there are major distinctions that separate these modalities. Today we’ll break down what makes therapy different from life coaching.

Training and education. First, mental health practitioners (i.e., therapists, counselors, social workers) undergo extensive training in order to become licensed to practice in the field. These providers must graduate with at least a master’s degree from an accredited program, along with completing a practicum and internship. After graduation, these providers begin what is commonly-known as a “residency,” where they practice therapy while receiving supervision. Anyone can call themselves a life coach, regardless of their background or training. Life coaches aren’t trained in areas that have the potential to cause problems in relationships where a power dynamic exists, and are often poorly equipped in handling transference and countertransference. Their work isn’t governed by a code of ethics, so blurred boundaries and dual relationships are much more likely.

Mental health providers are also required to take and pass lengthy licensure exams, which requires months of study and preparation. This leads us into the next major difference when it comes to therapists versus life coaches…

Diagnosis. Second, mental health providers can diagnose clients with a mental health disorder. Actually - going back to the licensure exam piece - providers must thoroughly understand mental health disorders in order to pass licensure exams. Studying the nearly 300 mental health conditions in the DSM-5 is one of the most demanding aspects of test preparation. The DSM-5 (the Diagnostic and Statistical Manual of Mental Health Disorders) is a taxonomic and diagnostic tool used by a wide range of healthcare professionals in diagnosing and treating mental health conditions. In addition to thoroughly understanding the different types of mental health diagnoses, therapists are also trained in knowing what therapies and treatments are best suited for each of those diagnoses. To put it simply, therapists can recognize if you meet the criteria for a mental health disorder, they can diagnose you with a mental health disorder, and they know how to treat that disorder. You do not need to have a mental health condition in order to see a therapist, however. Almost anyone can benefit from therapy.

With diagnosis comes the third major difference between mental health providers and life coaches…

Insurance. Third, because mental health providers can diagnose clients, they can also bill insurance. Health insurance will only reimburse for counseling sessions if the provider can make a case for why therapy is needed. In the eyes of an insurance company, if there’s no diagnosis, there’s no issue; it’s not a medical necessity. Even when providers don’t directly bill insurance (like at this practice), clients can still submit their own superbills for partial or full reimbursement. Superbills contain billing codes and diagnostic codes, which give insurance companies the information they need in order to pay for services. Further, insurance companies know that therapy providers have specialized training in evidence-based methods that yield real results. They know and trust that the support of a trained therapist will lead to an actual decrease in distressing symptoms. Which leads us to the next difference…

Focus of sessions. Life coaches typically work with clients on tangible and specific goals. They might help someone work towards a specific career goal such as starting a small business; a personal goal such as finding fulfillment through new hobbies; or a health goal like adapting to a new dietary or fitness regime. Interestingly, mental health providers can also help clients work towards these types of goals, while also supporting anyone struggling with mental health symptoms such as anxiety, depression, insomnia, low self-esteem, or anhedonia. Life coaches might claim to help in these areas, but they lack the proper training to truly be able to support someone struggling with mental health.

When thinking broadly about the focus of sessions, life coaches and therapists also differ in that life coaches place more emphasis on accountability, whereas therapists emphasize healing and wholeness. In therapy, if a client struggles with low motivation, accountability, and goal setting, a therapist may facilitate growth in these area by exploring related thoughts and feelings, along with looking at past experiences. A therapist can support you in accomplishing many of the same goals that might bring you to a life coach, with the added benefit of working towards healing and lasting change.

Ultimately, while there are qualified life coaches, choosing someone who is a licensed therapist (or working towards licensure) is the best choice. Therapists can support clients in a more holistic and informed way, are much more qualified in offering strategies, guidance, and expertise, and work within a healthcare field where safeguards exist in order to protect clients.

If you have more questions about the differences between life coaches and therapists, email me at dannica@meridianvistapsychotherapy.com

How to start therapy

Choosing to begin therapy is a brave and vulnerable step, though it often comes with a lot of unanswered questions. How do I find a therapist? How do I schedule an appointment? Do I need to prepare? What do I talk about? What can I expect?

This post outlines how starting therapy works, along with what you can expect at the beginning of the therapy process. While this post is specific to Meridian Vista Psychotherapy, most private practices operate in a similar way. If you have additional questions, don’t hesitate to reach out!

STEP ONE - Finding a therapist: One of the most common questions that comes up is how to find a therapist. There are so many places on the internet to view therapist listings, it can be overwhelming to know where to start. Psychology Today is one of the more reputable online directories, and has tools that allow you to filter results by specialty, therapy modality, insurance, and more. If cost is an issue, Open Path Collective is an online directory of therapists who offer sliding scale pricing (i.e., reduced cost). You can also conduct a simple Google search, using terms such as “therapists near me,” “online therapy,” or “therapy for anxiety disorders.” At the end of the day, there is no wrong way to find a provider.

Remember: Make sure your therapist is licensed in the state you live in. Seeing a licensed clinician ensures that you receive high-quality, evidence-based care by someone with a graduate-level education and extensive training. In Virginia, licensed providers might use titles such as “Resident in Counseling,” “Licensed Professional Counselor,” or “Licensed Clinical Social Worker.” (Residents in Counseling are licensed by the state, but are in the process of completing the required hours for fully independent licensure and are under supervision.)

STEP TWO - Making contact: Once you’ve found a couple of therapists that seem like a potential good fit, go ahead and reach out! If you’re using Psychology Today or another online directory, you can message the therapist directly through the site. You can also visit a therapist’s website and reach out using the online contact form. If a therapist has published their email or phone number, you can contact them directly. If you’re unsure of what to say, you don’t have to say much. A simple email with something like, “I’m interested in beginning therapy,” is all you need to get started.

STEP THREE - The initial consultation: After reaching out, hopefully you’ve heard back within a day or two. You can always follow up if you haven’t heard anything, though moving on to a different therapist may be a better option (i.e., someone who is more responsive). When you’ve gotten a response, most therapists will offer a free consult. What’s this? It’s an opportunity for you and the therapist to talk before scheduling a full appointment. You might share more about what brings you to therapy, along with asking any questions you’re curious about (i.e., scheduling, cost, frequency of sessions). These calls - which are conversations and not talk therapy - are usually about 15 minutes and are free of charge.

STEP FOUR - Scheduling an appointment: During the consult, if all goes well, the therapist will typically ask if you’d like to schedule an initial therapy session. Once you’ve decided on a day and time, you will receive an email link to fill out paperwork. This paperwork must be completed before your appointment. If you have any questions about the paperwork, you can discuss these with your therapist at the beginning of your session. All appointments are online at Meridian Vista Psychotherapy, making them convenient (no commuting, traffic jams, or paying for parking), more affordable (no office rent!), and more accessible (open to anyone in Virginia). Appointments take place through Simple Practice, which is a reliable and HIPAA-compliant online healthcare platform.

STEP FIVE - Your first therapy appointment: Make sure to check your internet connection before the time of your appointment. You’ll want to be somewhere quiet, private, and free of distractions. Please avoid activities such as driving or walking during your session. Write down any questions you might have. Take a deep breath; there is nothing to be nervous about. Your therapist is ready to meet you right where you’re at, and will help to guide the conversation. Often therapists have a long list of questions that they ask during an initial session (which sometimes goes into the second session). If you struggle to feel comfortable, talk about it. Give yourself a handful of sessions with one therapist before deciding to move on to someone else. With that, any good therapist will welcome feedback. As uncomfortable as it might feel, don’t hold back if something isn’t working or doesn’t feel right; these are your sessions and how you feel matters.

STEP SIX - Finding your way in therapy: As you continue to meet with your therapist, you’ll find that you feel more comfortable and stable as you get to know your provider and establish therapy goals. It can be helpful to keep notes during your week of what you’d like to talk about in therapy. You can do this in a journal or on your phone. If you don’t know what to talk about in a therapy session, your therapist will be able to guide you in finding something meaningful to explore during your session. Sometimes sessions where you come with the least end up yielding the biggest insights.

If you have additional questions about getting started or the therapy process in general, please drop me an email at dannica@meridianvistapsychotherapy.com