In my work, one of the hardest things I face is letting a client know that it’s time move on. There are many reasons for ending therapy, and I’m going to explain some of them so you can see how complex the decision can be. I’ll start with a couple of reasons why clients end therapy.
If you go into a bookstore, or on a e-commerce site that sells books, you'll notice that the self-help section is huge. Really HUGE. It seems like we want to improve so many areas of our lives - our size and appearance, our love life, our business and work lives, our mental health, and so many others. There are self-improvement programs you can buy online, and the books are full of ideas that you can use and apply to help improve your life. However, when we buy these programs or try these techniques, many times they don't seem to work - why is that?
There are a few reasons that might explain this. One factor is that our time and energy is limited. We get caught up in work and work issues, daily hassles like cooking and paying bills, family responsibilities... If you think about it, you'll find there are many, many reasons that we don't accomplish all the self-help and self-enhancement programs we purchase. All of these activities take time, and they take energy. When we do have a few minutes for leisure, many times we want to do something else. It's understandable - if something feels like too much work, we tend to avoid doing it.
Another factor might be lack of support. We know that when people have support, they're more likely to make changes and they're more likely to stick to them. Beginning an exercise program is a great example: You're way more likely to keep moving and exercising when you have someone there with you. They support you, and to some extent, keep you accountable. Your coach is there to mentor you and to cheer you along as you creat the life you want to have.
Accountability is the third factor I want to mention. I'm not thinking about accountability in a pressurized "have to" sense. Rather, I am suggesting that having another person to work with who knows your goals, your struggles, and your strengths can be an amazing support for you as you work to reach those goals and change your life!
I love the word "coach" - it has such a positive connotation. Coaches share their knowledge with you, support you as you challenge yourself to reach goals (and challenge you themselves by nudging you toward your goals), and celebrate progress and life changes as they happen. It's a life-affirming, positive, and healthy profession.
Unfortunately, there is a lot of confusion about coaching and what it is, especially in regard to how it's different from counseling or therapy. One common - and wrong - distinction I hear a lot is that counselors work with people who are struggling with problems or mental illness, and coaches work with people are healthy. I need to say this clearly - this is NOT true! Even trained mental health professionals buy into this false distinction. Another thing I hear a lot is that coaches set measurable goals and counselors' goals are less well-defined. Again, simply not true. There are many, many other misconceptions, and I hope to clear up these and a few others in this post.
Let's talk about the first misconception. It's half true - coaches do work with people who are not experiencing emotional difficulties or mental illness. They are not trained to do so, and are not licensed or supervised in doing so. However, the other half - that counselors don't work with those who are healthy - is simply not true. The reality is that counselor's and psychologist's training makes them very qualified and trained to do coaching. Dr. Michael Bader, a licensed psychologist, points out that:
The biggest difference between coaching and therapy, in my view, is that the theory that guides my work as a therapist can explain how coaching does or does not work, while theories that guide coaches can't do the same about therapy. (http://www.psychologytoday.com/blog/what-is-he-thinking/200904/the-difference-between-coaching-and-therapy-is-greatly-overstated)
Another, similar distinction is that therapists and counselors work with the past, and coaches work with the future. Again, this simplistic division simply isn't true. Let me give you an example. In the therapy I do, Dialectical Behavior Therapy (DBT), we focus specifically on how to manage situations that are likely to happen in the future. While I do sometimes explore the past in terms of how it affects my client's current level of functioning when it's relevant, the work I do specifically involves working toward making a better future. Cogntive behavioral therapy in general has this orientation. It''s simply untrue that counselors don't focus on the future.
The second misconception - that coaches set measurable, time-limited goals and therapists don't - again, simply is not true. Therapy works best if client and therapist work together to set exactly these kind of goals. That's how we measure progress. Many therapists I know will assess their client's sense of whether or not they are achieving their goals every session or every few sessions. Tied into this misconception is the idea that therapy is long-term and coaching is not. Again - many good systems of therapy (solution-focused therapy for example) work best with a time-limited model.
Many coaches like to point to specialized training they have worked on. As a psychologist, I very much appreciate the effort these coaches have made to educate themselves and work in an ethical manner. Professionals like these are a credit to their profession. However, coaching as a whole has not licensure, certification or even educational requirements. There is no professionally agreed upon code of ethics. Because of this lack of centralized standards and ethical principles, engaging a coach is a risk.
Please don't get me wrong - there are many, many wonderful, trained and ethical coaches out there. There are also some great training programs out there. The International Coaching Federation has made an effort to create a code of ethics and implement standardized training. I think this is a wonderful start. However: The ICF has no authority to implement these standards to the field as a whole. There are no licensing requirements. I hope that will change in the future, and believe that it will. Until then, however, there is a wide range of traininig programs ranging from in-depth programs requiring supervision to simple online classes with no practice component. At this point in time, they can all claim to be "coach training programs" with equal legal standing.
The fact of the matter is that counselors and psychologists are highly trained. They have engaged in in-depth coursework, practicum and internship experiences during which they get real-life experience, and supervision. They are licensed, and regulated by licensing boards and codes of ethics. Because of these safeguards, there is more consistency and safety for you, the consumer.
So, let's get at the issue of how this works. Coaching is focused on helping you identify and make movement toward reaching your goals. So is therapy. Coaches are trained (ideally, but not necessarily) in helping you set and achieve these goals, through specific techniques including targeted and open questions, activities, and developing insight. Counselors and psychologists can do this too. The truth of the matter is that a trained and licensed counselor can do anything and everything that a coach can do. Coaches, however, are not able to do everything a counselor or psychologist can do. Coach trainer Barbara Silva said:
As a coach trainer this is an issue I discuss quite a bit with my students. The biggest difference as I see it is that a therapist may address both coaching and therapeutic issues whereas the coach must remain within the coaching realm, staying away from clinical issues. From the client's point of view, it's more about their perspective on the kind of assistance they need.
The last misconception I want to address is one that I have to admit bugs me because it strikes at the heart of my work. I read a lot that coaching is a wellness model, while therapy is a treatment. Reality: Many, many therapists (myself included) adopt a wellness model. Focusing only on the negative and on how to fix what is wrong does not help over the long term. Focusing on wellness, and healing, and health is an important aspect of therapy.
So, the bottom line is that really is not much of a difference except training. (I know that there may be coaches that take issue with this, but the evidence is pretty clear.) Therapists and psychologists can do anything and everything a coach can do, because they are trained, they work with wellness as well as problems, and they use many of the same techniques, methods, and models.
If you are interested in working with a coach, check out the International Coaching Federation for their training and ethical guidelines: http://www.coachfederation.org. They are an excellent resource, and can refer you to well-trained and ethical coaches. If you are interested in working with a psychologist or counselor, ask them if they do coaching - many do!
Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.
If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: firstname.lastname@example.org
© 2014 Dr. Laura Burlingame-Lee, Ph.D.
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