Coaching vs Psychotherapy: The Definitive Guide

Coaching vs. therapy is a debate that has been going strong for many years and has been covered extensively in various texts. However, the difference between these two fields is still one that traditional therapists and those in the coaching world love to discuss. 

Coaching and therapy are two very unique fields, so why does this question sometimes feel so confusion? Well, lines between therapists and coaches (including Nurse Coaches) are seemingly getting more blurred by the day. In fact, many therapists are now incorporating coaching modalities into their sessions with clients or have switched almost entirely over to being coaches. And coaching is, by nature, a therapeutic modality which stems from positive psychology. So there is a fair amount of overlap.

But more importantly , there are some very important distinctions between the two practices. These delineations can help clarify the differences between coaching and psychotherapy for the public and our fellow coaches. This article is designed to help Nurse Coaches know how to practice within your scope, while also leveraging the skills of our interdisciplicatry team.  

Just as nursing and psychology experienced growing pains during their inception, coaching is currently going through many of those shifts. Let’s help ease those growing pains by creating some clarity in this coaching vs. therapy discussion.

Shared Roots in Psychology

To many people, coaching may seem like a brand new field. While it’s true that coaching has exploded in popularity and public recognition in recent years, its roots actually lie in much older fields of study: psychology and philosophy. 

Socrates is quoted as saying, “The unexamined life is not worth living.” Once the basic human needs of food, shelter, and clothing are fulfilled, humans can shift their attention toward actualizing their potential, fulfillment, and spiritual connectedness through psychotherapy or coaching.

There have been many great psychological theorists and philosophers who have contributed greatly to their fields. Many of their theories and ideas also helped shape the field of coaching, from solution-based therapy to reflection and ontological approaches. (If you are interested in learning more, read the intro to “Becoming a Professional Life Coach” by Williams and Melendez).

One of the most marked shifts in modern psychology — a shift that helped connect coaching and psychotherapy — occurred in 1998. That’s when Martin E. P. Seligman, President of the American Psychological Association, famously coined the term “Positive Psychology.”

Seligman stated, “Psychology has moved too far away from its original roots, which were to make the lives of all people more fulfilling and productive, and too much toward the important, but not all-important, area of curing mental illness.” He went on to reiterate that psychologists should strive to help clients build optimism, happiness, and satisfaction — things that are also a chief priority for coaches.

coaching vs psychotherapy

Coaching vs Psychotherapy

According to the Handbook of Positive Psychology, “We must bring the building of strength to the forefront in the treatment and prevention of mental illness.” (p.3). This, along with Seligman’s words on positive psychology, proves that coaching and psychotherapy are more similar than some might think, like cousins.

But of course, cousins still have some key differences between one another, and so do these two fields. So, let’s get down to why we are here: the differences between coaching and psychotherapy.


Coaching focuses on goal setting and actualizing potential. Coaches teach their clients how to set realistic goals and take appropriate action, allowing clients to improve their performance (in work, their relationships, their health) and enhance their quality of life. Ultimately, coaches aim to help their clients function at their highest capacity.

Coaching also tends to live in the present moment. While we often create visions of an ideal future, we bring those visions into the present moment and use them as a place to come from, not a place to get to.

In contrast, therapy aims to solve past pain and tends to be retrospective. It is based on the premise that there is a problem to be fixed and focuses on past wounds and interpreting the way someone is showing up in the world based upon something that happened in their past.

Client and Provider Characteristics

A good coach needs to recognize when a client should be referred to a therapist. This is particularly important when the client is demonstrating symptoms of deep depression, suicide, alcohol or drug addiction, or other serious mental health conditions. Let’s discuss what makes a client the right candidate for coaching vs. therapy.

Coaching is built on the premise that the client is fully whole and totally alive. Coaching clients tend to be higher functioning, action-oriented, and ready to change their lives for the better. 

As providers, coaches aren’t expected to be an “expert” in mental health. Instead, they should be a wise and compassionate support system, a partner who co-creates the relationship and helps clients reach their goals. A coach does not give advice or try to ‘fix’ their clients but merely guides them toward making the best choice for themselves.

On the other hand, therapy clients typically need to deal with past issues in order to be able to function in the world. This means that they may struggle with their mood or with accomplishing daily tasks. Clients who exhibit heavy amounts of emotional baggage tend to get greater benefits from working with a trained therapist.

Therapists do take on the expert role, by providing diagnoses and prescribing interventions based upon them. This results in a much more formal relationship than the coach-client relationship.

The Process

Coaching tends to be less formal and structured than traditional therapy. The coach is able to share intuitions, feelings, and observations. They are also able to challenge the client and speak their truth at all times.

Therapy is less of a give-and-take between the client and the expert. In most cases, the client is encouraged to share their own insights (or “ramble”), with the expectation that the therapist will spot connections between present problems and past difficulties as they speak.

coaching vs psychotherapy

Putting It All Together

The differences we’ve discussed above are far from the totality of the coaching vs. therapy debate. These distinctions simply give us coaches a way to stay within our framework so that we can powerfully serve our clients without crossing ethical or professional boundaries.

A good coach can help their clients achieve unprecedented levels of happiness, fulfillment, success, strength,  and resilience. They can help their clients create those tiny shifts that will radically change their world so that they may become the architect of their dreams. They remind their clients that they are in charge of their life and the process.

A great therapist can bring their clients up from the depths of despair and confusion into a world of higher functioning and far less overwhelm. Their diagnoses can give their patients much-needed understanding of their current reality, and their advice and treatments can help their clients learn to be in charge of their lives.

These two fields are surely complementary. A client can work with a therapist to resolve past wounds while working with a coach to be actionable and take the small steps required to build the future they desire. Therapy teaches coaches to be patient; change doesn’t happen overnight. It reminds us that there are physiological roots to some problems.

Coaching keeps us privy to the power of human potential, our limitless capacity for insight, and our profound ability to change, grow, and challenge our limiting beliefs.

In the end, both fields are about empowering our clients to grow and become stronger. And helping our clients grow stronger is exactly what the Transformative Nurse Coach Certificate Program is all about! In this course, you can learn the power that Nurse Coaching can bring to your life — both as a coach and as a client. 

You’ll discover the value of lifestyle medicine and coaching modalities, and you’ll gain the skills (not to mention 120 contact hours) required to sit for the AHNCC’s Nurse Coach Board Certification exam.

If you’re ready to use coaching to help your clients reach a higher state of health and wellness, check out our free training to learn more about Nurse Coaching. And, if you want to hear more about our program from nurses just like you, visit our Facebook group today!



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