Would You Recommend a Coach or a Therapist? – Psych Congress Network

Posted: October 1, 2020 at 1:56 am

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We may be near the high-water mark for recognizing the virtues of coaching. There was a time when coaching was a sports reference. Each sport has its pantheon for revered coaches, and it is interesting how different they are from one another. Temperaments range from resilient to rageful, and their methods for motivation are as difference as their personalities.

We have progressed in our time to having coaches for a wide range of non-athletic pursuits. Whatever the skill being pursued, students now recall experiences of being pushed and demeaned by a coach. Yet some praise their coach as being transformative in their personal development. Journalist Michael Lewis studied coaching, and he proudly noted that his high school coach was inspired by Goethe:

If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be.

This aphorism made an impression on me for two reasons. First, it is brilliant, and it captures the abiding need for bold aspirations in life. Second, it is reported as the guiding vision for a coach feared by every student for his explosive, destructive rage outbursts. The physical demands he placed on each player paralleled the emotional ones. This coachs application of Goethe seems a bit extreme.

I encountered a surprising fondness for coaching in the business world. A senior management meeting years ago focused on the introduction of a product that included health coaching. The CEO of this large health plan gave his hearty support for coaching as being non-stigmatizing. He noted that even Michael Jordan has coaches, and so no one should feel demeaned about needing one.

This seems like a non-judgmental bonanza. Coaches can quote Goethe and unload their anger like gifts. Everyone can use a coach, recognizing that even great athletes humbly accept the need. The very term coach has more virtuous than pejorative connotations. It is little wonder that today many seek to change through coaching rather than therapy. How about a life coach? Lifecoach.com says:

Entrepreneurs, executives, business leaders, actors, musicians, creative people, managers, small business owners, start-ups, professionals and homemakers all reach their goals with the help of a life coach. If there is a gap between where you are now and where you want to be, there is room for life coaching. Not only will your life coach help you close the gap, your life coach will help you break through your limited beliefs and challenge you to think bigger.

It would appear the life coaches are also reading Goethe. The need for therapists might be shrinking as coaching proliferates. A final example closer to home epitomizes this concern. An innovative medical practice, Iora Health, uses a team model with a health coach joining the doctor and nurse. This decision to use a coach rather than a therapist to focus on motivation and behavior change is noteworthy.

Is it all the same if the results are the same? Therapists do not carry win-loss records as a testament to their accomplishments, and yet storied athletic coaches are like celebrated therapists. There are few of them, and the anecdotes seem more important than the statistics. Yet results do matter, especially in healthcare. In fact, evaluations of outcome have become a source of worry for some therapists today.

Psychotherapy research has found that therapy is quite effective, with each major clinical model roughly equivalent in results. Yet wide disparities in effectiveness are found at the level of the individual therapist. Clinical results are not predicted by the therapists education, degree, or training. This would seem to provide a legitimate opening for non-professional or peer therapists to offer their services.

How can we start recommending peer therapists within behavioral healthcare without also recognizing the value of coaches? There are two important points here. First, peer therapists as a group are not equivalent to professional therapists. Individuals may stand out, but as a group, the professional one is likely to be better. Second, no profession or specialty owns the ability to facilitate personal change.

Let us start with some common observations. Some individuals are natural healers. They easily foster emotional development while others are inept despite all training. At the same time mediocre coaches have helped people develop successfully. Similarly, children have been able to thrive despite horrific parenting. There is often a disconnect between input and output in human development.

A results orientation does not mean that anything goes or that positive ends can justify any means. Psychotherapy research instructs each therapist to work within the validated clinical model they prefer. Likewise, parents should trust their instincts and yet also learn from research on parenting. The training of the professional therapist matters in terms of broad clinical judgment. Therapy results are one factor.

Let us move to medical care. It is fine to place coaches in healthcare settings to connect with people and motivate them. They are not therapists. They generally lack the skills to evaluate a wide range of psychological issues, to probe in judicious ways about possible underlying problems, and to handle complex comorbidities. Therapists are higher level staff who cost more and can deliver more value.

There is a degree of dishonesty in the warm embrace of life coaches and health coaches. They are less expensive facilitators. They are being hired to some extent because they are less expensive. While there are few outright claims that talented facilitators are as valuable as psychotherapists, the implicit suggestion is often that one replaces the other. Yet education matters.

Here is my recommendation: I would employ licensed therapists to guide life-changing steps toward greater health and wellbeing. Therapists vary, and the abilities of any group can be plotted on a bell curve. Some are high or low on the measured skill, while two-thirds cluster in the middle. Find a therapist, preferably a good one, if you are serious about personal change. Coaching is a good second choice.

If you select a coach over a professional for any reason, be sure that person is supervised. People without advanced education do not know what they do not know. Let us take advantage of the extraordinary skills some possess to motivate, educate, or heal. Yet provide support and monitoring. People survive bad coaching or therapy, but we need ways to reduce the likelihood of that experience.

Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.

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Would You Recommend a Coach or a Therapist? - Psych Congress Network

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October 1st, 2020 at 1:56 am