Therapy San Diego 101: Should I contact a psychologist or a coach?
I have been working as a licensed clinical psychologist in San Diego for almost 20 years, and throughout those years, I have often interacted and collaborated with other kinds of healing clinicians, such as clinical social workers, and licensed marriage and family therapists. It seems that particularly in the last several years though, life coaches, who provide services that could be perceived as aligned with my profession, have been springing up like mushrooms. According to “IBISWorld,” there has been growth in both the life coaches and mental health professional industries, with the following trends:
“The market size of the Life Coaches industry in the US has grown 3.2% per year on average between 2017 and 2022” (see here).
“The number of businesses in the Psychologists, Social Workers & Marriage Counselors industry in the US has grown 6.1% per year on average over the five years between 2017 - 2022” (see here).
Given the apparent increase in the number of life coaches, it raises the question of whether they are interchangeable with psychologists (and other mental health providers). In other words, when you struggle emotionally or mentally, should you seek out a coach or a psychologist, and what are the differences?
Let’s start with a few definitions
Coaches: The “International Coaching Federation” (ICF), one of the leading organizations for certifying coaches, describes coaching as “partnering in a thought-provoking and creative process that inspires a person to maximize their personal and professional potential. The process of coaching often unlocks previously untapped sources of imagination, productivity and leadership“ (see here). Some coaches help clients address any and all life goals and are referred to as “life coaches.” Others are not so broad in their scope, and focus instead on one area of specialty (e.g., “career coach,” “financial coach,” “writing coach”).
Psychologists: The American Psychological Association (APA), the leading nationwide organization for psychologists in the U.S., offers a detailed description of what a clinical psychologist is, including the following: “...provides continuing and comprehensive mental and behavioral health care for individuals, couples, families, and groups... It is a specialty in breadth — one that addresses a wide range of mental and behavioral health problems— and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper.” (see here).
Similarities between psychologists and coaches:
“Helping professions” - Both psychologists and coaches are “helping professions,” with the goal of improving the lives of people. Both are concerned with helping their clients remove barriers to functioning, which ideally, results in improved sense of effectiveness in life for the person, and thus improved wellness.
Relationship based - Both professions rely on forming an effective relationship between the client and the provider (whether a psychologist or a coach). For their interventions to be effective, this relationship must involve, at a minimum, qualities of honesty, safety, and trust: You must be honest with your provider -- so that they understand what holds you back in the area you are trying to improve. You must feel safe with your provider, so that you can be honest and vulnerable with them. And you must trust that your provider knows what they are doing and can help you – so you can follow their recommendations. A productive working relationship between you and your provider (whether a psychologist or a coach) would significantly depend on there being a good fit between you and your provider. Only after that requirement is met, can their expertise come into play.
Cost - Nowadays, the fee structure for psychologists and coaches bears more similarity than difference. There is some variability in how much individual providers charge per session in both professions. However, overall, psychologists and coaches overlap in the range of fees that they charge more than they differ i.e., the costs are similar.
What are the differences between psychologists and coaches?
Training and Regulation – Many rules and regulation govern the practice of clinical psychology. To practice clinical psychology independently (i.e., without supervision), a psychologist must pass federal and state licensing exams. These include the Examination for Professional Practice in Psychology (EPPP), which is required in the US nationwide. In California, where I practice, psychologists also need to pass the California Psychology Law and Ethics Examination (CPLEE) in order to get licensed. To take these licensing exams, state licensing boards typically require a minimum of a doctoral degree in psychology (PhD or PsyD) from a regionally accredited or government-chartered institution. Additionally, to be eligible to take the exams, psychologists must complete a large number of clinical hours under the supervision of a licensed psychologist so that they can hone their clinical skills. All in all, the path to licensure and independent practice as a clinical psychologist takes many years and is governed by rules and standards that are in place to assure competency.
By contrast, for coaches, there is no centralized governing body that regulates or oversees this profession as a whole. There are a few certifying organizations for coaching, with the International Coaching Federation (ICF) being one of the leading ones (see more here). However, it is not against the law to call yourself a coach and provide services as such even if you were never trained or certified by any of these organizations; certification is an option, not a must. Moreover, even those who get credentialed as coaches, receive significantly shorter training time in their discipline relative to the course of training required of clinical psychologists. Of course, there still might be highly skilled coaches with substantial experience, and not-so-skilled clinical psychologists. Yet, the big picture beyond any given individual suggests that psychologists are more broadly and thoroughly trained than are coaches, before they are allowed to practice independently.
Even after being licensed, clinical psychologists must continuously abide by a strict and formal code of ethics (see “Ethical Principles of Psychologists and Code of Conduct”). This code includes important provisions put in place to protect the client receiving their services (e.g., provisions concerning maintaining confidentiality, practicing within the bounds of one’s competency, and more). Violation of the code of ethics can result in the placing of sanctions on the psychologist by authorized governing bodies and organizations. In contrast, since coaching is not centrally regulated and one can call themselves a coach without training or certification, there is no ethical code that all coaches must abide by as they practice coaching. That said, there are many coaches who are ethical, and would protect your rights if you were their client.
Depth and breadth – Clinical psychologists are trained to understand a wide range of mental and behavioral health concerns. They evaluate the cognitive, behavioral, emotional, and interpersonal functioning of the individual (or couple, or group). They then conduct psychological and behavioral interventions to improve the health and functioning of the person(s), using a wide range of interventions.
Coaches are not clinically trained, and are not experts in mental health per se. They typically specialize in one area of functioning and provide behavioral and cognitive interventions to help the individual perform more effectively in that area. For instance, they may specialize in helping people find a job, learn skills to deal with ADHD, or manage their finances. If the problems that affect that person’s functioning in the target area run deep, are rooted in the past, in trauma, or in psychopathology, many coaches would typically reach their professional limit.
Goals – When I think about (behavioral) coaches, I think about sport coaches, whose coaching is geared to winning a competition. Coaches focus on a task, a goal, a target, and devise an action plan that they think will help you reach it. Coaches help with skill improvement, motivation to move forward, and accountability. Coaches typically attempt to cheer you up and build your confidence.
That type of work is also carried out by psychologists. A psychologist would find out what your treatment goal is, and use their understanding of human behavior, motivation, cognitive and emotional factors when helping you move from a place of “stuckness” to a place of more effective functioning combined with a feeling of improved well-being. However, people who seek out psychotherapy with psychologists don’t always have a target behavioral treatment goal. Sometimes they are depressed and want to feel better. Sometimes they are not sure whether their current relationship is the right one for them and want to explore it. Sometimes they wish to process the loss of a loved one. Psychologists do not just work toward a behavioral goal. Psychologists’ scope of work is broader than that and can be more flexible and inclusive of different aspects of a person’s life. In that way, a psychologist can function like a coach, but a coach cannot function like a psychologist.
So, should I choose a coach or a psychologist?
If your goal in seeking out help is to address a very concrete, objective, behavioral goal, a coach can be helpful. For instance, I know coaches that do a great job helping students who struggle with ADHD by teaching them skills related to organization, prioritizing tasks, and staying on task. Psychologists who specialize in working on ADHD can do that same excellent job.
However, if the reason for your seeking out help is more general, involving more complex background (e.g., trauma, loss), and a combination of emotional, psychological, cognitive, and even physical factors, I suggest you reach out to a psychologist. And, again, the benefit is that a psychologist also can do the job of a coach, if that’s what you need.
And one important thing to remember, many medical insurance plans cover mental health treatment by a psychologist, but not by a coach. So, if money is a concern, working with a psychologist would come with lower out of pocket expenses for you.
Free therapy consultation in San Diego
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