Coaching vs therapy: what I do, and what I don't

There’s a real difference between therapy and coaching, and a lot of people in my position blur it, which I think is a mistake. Here it is plainly: therapy is licensed health care that can diagnose and treat mental health conditions. Coaching is focused, practical work on patterns, and it isn’t licensed and treats no conditions. I trained as a therapist, and with my clients I work as a coach. That’s a real choice, made for real reasons, and I’d rather explain those reasons out loud than let the difference stay fuzzy, because when a field isn’t regulated, being straight with you is what I owe you instead of a license.

What’s the actual difference?

It comes down to what each one is for. Therapy is for conditions, things that need treatment: depression that’s flattened someone, trauma that keeps intruding, an addiction, an anxiety disorder, thoughts of suicide. Therapists are licensed by a state, they can diagnose, they keep medical records, they carry legal duties, and their work is often covered by insurance, because it’s health care in the literal sense. Coaching is for patterns: two people basically doing okay who are stuck in a fight that survived the books and the counseling, a couple rebuilding after an affair, a person deciding whether to stay. Coaching teaches you how your own pattern works, it stays in the present, it follows a defined plan with a set number of sessions, and it makes no medical claims at all. The clean test: if the problem is an illness that needs treating, that’s therapy. If it’s a pattern between two people that needs changing, that can be coaching.

Why would someone trained as a therapist choose to coach?

The honest answer is simpler than people expect: coaching is the work I wanted. My training is clinical, and it shapes everything on this site. But the job I love is the active one, relationship-building with couples, catching the live pattern between two people and working on it in the present, practical and with a plan. That is coaching, exactly. Treating illness is a different job that belongs to licensed care, that line stays bright, and when treatment is what someone needs, I say so and help them find it. The work sits naturally on the coaching side, and that is where I set up shop, under its own name.

Isn’t “coaching” just a way to dodge the rules?

For some people, honestly, yes, and that’s exactly why you should choose carefully, because coaching is barely regulated and anyone can use the word. So the fair question isn’t “is this coaching or therapy,” it’s “does this person know what they’re doing, and are they honest about the limits.” My answer to that isn’t a license number, because I’m not claiming to be a licensed therapist. It’s transparency: the entire approach is written out on this site, in full, for you to read and judge before you spend a dollar. The training is laid out. The method is laid out. The limits are stated plainly and repeatedly. When a field doesn’t regulate itself, complete openness is what a practitioner offers you instead, and you get to weigh it yourself. That’s the whole reason this page exists rather than a reassuring line of fine print.

When should I choose therapy instead?

Whenever the situation involves a condition rather than a pattern, and I’ll be the one to tell you if I think that’s what’s going on. Choose therapy if anyone’s having thoughts of suicide or self-harm, if there’s violence or fear in the relationship, if addiction is active and untreated, if trauma symptoms are running the show, or if a possible mental health condition has never been properly looked at. In those cases the right choice is licensed care, full stop, and I’ll say so early and help you find it rather than coach around something that needs treatment. Sometimes the answer is both, a therapist for the clinical part and this work for the pattern, in the right order. The full version of all of this is on the coaching vs therapy page, and the approach itself is in The Unforgiven Self.