Therapy or Coaching? – What Does a Client need?

How do I decide between  Therapy or Coaching?

There has been many ponderings on the essential differences between therapy and coaching. Writers have pointed out that if you have problems and are anxious you need therapy. If you are fine but want to make improvements to your life – opt for a series of coaching sessions.

They go on to say therapy involves various interventions to change an unhelpful outlook. And coaching aims to help the client find answers and insights to issues through questions. Both facilitate change but in different ways.

In essence that is a helpful guideline but the lines are blurred particularly when a therapist like myself uses solution focused brief therapy. However I have found that being aware of either side of that line is really helpful when setting goals with my clients.

A time for therapy
Gerry was suicidal. Two years prior to seeing me he had been mugged, he had also nursed his father though the latter stages of terminal cancer. After returning to work he was distressed to discover that the company he had devoted many years to, had severe financial difficulties. His job was on the line and this became the straw that broke the camels back. The threat of redundancy and cutbacks caused Gerry high anxiety and sleepless nights. Exhausted and worried he slipped into depression.

When he first came to see me I found that Gerry had developed post-traumatic stress disorder (PTSD) from the mugging and the trauma of nursing his father. Not knowing if he would be made redundant or not had increased the pressure and thrown him into a highly emotional state. The constant rumination and worry locked him into a negative train of thoughts.

The goal was clear – Calm down the emotions first
So what did I do? In the presence of high anxiety there is only one route and that is to break the grip of the PTSD and anxiety. The brain does not know the difference between what is real and imagined. Worrying about loosing your job or it really happening causes the body to respond in the same way. When fear is present the conscious logical mind is made to play second fiddle to the highly aroused emotional brain.

PTSD and anxiety acts like a magnet to attention
No matter how brilliant your talking approach is, unless you are able to calm a stressed out ruminating mind, the person sat in front of you will not be available for change. Fear will cause attention to constantly be drawn to the stimulus and feelings around those fears.

High emotion stops coaching questions being processed
Any amount of inspired questions from an attentive coach will be like water off a ducks back as the brain struggles to process words and their meaning. Creative thinking is bypassed as worry imprisons the imagination, curtailing positive problem solving or the development of new ideas.

Thinking out of the box requires the person being coached to be ‘present’
A coach once said to me that having the person in front of them really present is crucial to a beneficial coaching outcome. Because searching for solutions can take time and can become an arduous process if the brain keeps getting pulled off track by anxiety issues.

Have you had the experience of being asked a question that you find difficult and your brain feels as if it is doing loops? Time disappears as your mind goes on an inner search to find an answer. This is a very creative process and requires logic and imagination to drip-feed each other. This can only happen in a brain that isn’t preoccupied with high stress.

Coaching after therapy
Once Gerry was feeling much better he decided he wanted some help in making decisions about his working life. The past few years had made him ‘ see life in a different way’ and he now questioned many of the things he had valued in the past. Here was where the main change of therapeutic direction came in.

Drop the techniques and reframes
No longer was I focused on helping Gerry to see the world in a more beneficial light but was asking questions to help him discover who he was now. No suggestions, no obvious reframes, no techniques or advice – just focused questions and practical exercises that would help Gerry find out what made him feel good. Stirring Gerry’s imagination enabled him to discover what was important to him, what made him feel good and how he could start to build his life from this authentic platform.

A radical shift occurs when relevant non leading questions are asked
Gerry was surprised to find himself articulating how happy he could be if he lived nearer his brother and family. How it brought a huge sense of relief to think of stepping out of the corporate world and going into business with his brothers catering company. And after a couple more sessions he had formulated a way to do this. He is now living that life he envisioned, happy and empowered.

So coaching or therapy?
Essentially different but after the presenting problem has been overcome you can use a less directive form of communication and help your client become clearer about what they want for the future, the direction they are going, be more energized and motivated. And because that person can know themselves better than any other – asking clean, solution focused, thought provoking questions is the way to achieving that.

Jill Wootton (47 Posts)