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I want to explore the differences between coaching, therapeutic practice, and therapy as a clinical / medical approach. Before diving into my thoughts and feelings on these processes, let’s begin with some structure. Although I may not entirely agree with this structure, I believe it offers a solid starting point and a framework on which to base various observations.


Difference Between Coaching and Therapy

1. Focus: Coaching focuses on personal and professional growth, goal setting, and achieving specific outcomes. It’s forward-looking and action-oriented.
2. Regulation: Coaching is generally unregulated, meaning there is no requirement for a license or professional status. Coaches may have certifications from coaching organizations, but these are not legally mandated.
3. Approach: Coaches work on the premise that the client is healthy and capable of making changes. They provide guidance, support, and accountability.
4. Techniques: Common techniques include goal setting, motivational strategies, action plans, and performance enhancement.
5. Client Base: Clients are usually individuals looking to improve specific aspects of their lives, such as career, personal development, or business goals.

1. Focus: Therapy (or counseling) focuses on mental health, emotional well-being, and resolving psychological issues. It often involves exploring past experiences to understand current behavior and emotions.
2. Regulation: Therapy is a licensed and regulated profession. Therapists must have appropriate qualifications, such as a degree in psychology or counseling, and must be licensed to practice.
3. Approach: Therapists diagnose and treat mental health conditions. They work with clients to understand and address emotional and psychological issues.
4. Techniques: Techniques vary widely and can include cognitive-behavioral therapy (CBT), psychodynamic therapy, talk therapy, and more.
5. Client Base: Clients include individuals experiencing mental health issues, such as depression, anxiety, trauma, and other psychological conditions.

Therapeutic Practice vs. Clinical Medical Practice

Therapeutic Practice:
1. Focus: Therapeutic practice includes a wide range of approaches aimed at improving mental, emotional, or physical well-being. This can include therapy, counseling, massage therapy, and other holistic practices.
2. Regulation: The level of regulation varies by practice. Some therapeutic practices, like counseling and therapy, are regulated and require licenses. Others, like massage therapy, may have less stringent requirements.
3. Approach: Focuses on improving overall well-being, managing stress, and addressing specific issues through various therapeutic methods.
4. Techniques: Techniques are diverse and can include psychological counseling, physical therapies, alternative medicine, and more.

Clinical Medical Practice:
1. Focus: Clinical medical practice is focused on diagnosing, treating, and preventing medical conditions and diseases. It is based on scientific and medical knowledge.
2. Regulation: Highly regulated. Practitioners must have medical degrees, undergo rigorous training, and be licensed to practice. This includes doctors, nurses, and other healthcare professionals.
3. Approach: Clinical practice relies on evidence-based medicine, involving physical examinations, diagnostic tests, and medical interventions.
4. Techniques: Techniques include medical procedures, surgeries, prescribing medications, and other clinical treatments.

In summary, coaching is goal-oriented and unregulated, focusing on personal development, while therapy is regulated, focusing on mental health. Therapeutic practice encompasses a range of regulated and unregulated approaches to well-being, whereas clinical medical practice is highly regulated and focuses on medical treatment and disease management.


These are my reflections and opinions. They are current views that I’ve held, though I’ve changed my mind several times in the past as I’ve gained more understanding and different perspectives. I don’t doubt that I will change my mind again as part of the learning process. I welcome constructive criticism, feedback, direction, and recommended reading from anyone who believes my opinion could benefit from additional information.


My first observation is that the framework above is a modern construct that attempts to categorize human relationships for professionalization, regulation, and monetization. Cavemen didn’t differentiate between casual chats, counseling, or therapy—it was all part of human interaction. These classifications and theories are relatively recent, emerging mainly after Freud and Jung, with many theorists seeking fame by creating rival schools of thought. We must recognize that these distinctions are somewhat artificial. The essence of human relationships can be either antagonistic or therapeutic, and how we engage with each other can have positive or negative effects. These structures are meant to guide and understand interactions, but ultimately, it’s all about human relationships.


I’ve already mentioned the classification and categorization of people, often to monetize misery. This professionalization and aggrandizement of certain schools of thought and professions is a way to extract money through insurance and reflect societal norms. However, these classifications don’t always help people. I’m particularly interested in the Power Threat Meaning Framework, which suggests we should move away from diagnostic labels and instead understand individuals in their context to find the best interventions.

For example, the idea of diagnosing people as “broken” has led to harmful practices. Not long ago, homosexuality was considered an illness. Samuel Adolphus Cartwright coined “Drapetomania” to describe the so-called psychological disorder that caused enslaved Black people to escape bondage before the Civil War. These extreme cases were not seen as extreme at the time.

The tendency to categorize, classify, and diagnose people is problematic. Professional therapists often rely on these tools, while amateur coaches might accept the whole person without these classifications. However, this lack of structured methodology can also be harmful, as untrained individuals might worsen situations. Conversely, following a prescribed course of interventions, including psychopharmacology, can sometimes exacerbate problems.


1. Psychodynamic Coaching
Explores personal history and key experiences to understand how emotions, thoughts, and actions are shaped, focusing on self-awareness and emotional insight.

2. Cognitive Coaching
Uses structured models to challenge and change faulty thinking patterns, promoting Performance Enhancement Thinking (PET) over Performance Inhibiting Thinking (PIT).

3. Solution-Focused Coaching
Emphasizes current actions and future goals, encouraging practical problem-solving and self-directed learning through client-defined success metrics.

4. Person-Centered Coaching
Centers on empathetic listening and client-led discussions, supporting self-growth and self-determination without directing or advising.

5. Gestalt Coaching
Focuses on the present moment, helping clients recognize and update old patterns of behavior to create new, constructive ones.

6. Existential Coaching
Helps clients navigate life crises by exploring identity, meaning, and purpose, emphasizing being rather than doing.

7. Ontological Coaching
Addresses how one’s way of being affects communication and results, integrating language, emotions, and body for transformative learning.

8. Narrative Coaching
Focuses on understanding and re-framing clients’ stories, enabling them to see new perspectives and possibilities for their future.

9. Psychological Development Coaching
Supports development through various life stages, helping clients master fundamental skills before advancing to higher levels of self-fulfillment.

10. Transpersonal Coaching
Works with the whole person, including body, mind, spirit, and unconscious processes, to transform limiting beliefs and achieve deeper self-awareness.


Coaching is a process focused on improving performance by concentrating on the present rather than the distant past or future. It emphasizes the individual’s ideas and opportunities, helping them define goals, set their path, and achieve success. Coaching involves listening, reflecting, asking questions, and unlocking potential.

Coaching isn’t solely about personal and professional performance, progress, productivity, goal setting, or achieving specific outcomes. Many people seek coaching without a clear goal or objective. They may not be after increased productivity, wealth, power, or fame. Some are experiencing an existential crisis, feeling lost, and needing to recalibrate and find themselves.

Coaching doesn’t always have to be goal-oriented. The relentless pursuit of goals might not be the best approach for everyone. Sometimes, finding quiet satisfaction in who we are, understanding what life means to us, and discovering a sense of purpose, comfort in relationships, and satisfaction can be more beneficial.

This approach can be more valuable than the endless pursuit of improvement or concern about how we perceive ourselves or how others perceive us. I challenge the notion that coaching should always be about growth, depending on how you define growth. Growth can mean accumulating wealth, power, fame, strength, or speed. It can also be spiritual, intellectual, philosophical, artistic, or about developing talent. It could mean finding happiness or contentment.

Some coaching models hint at these different emphases, scopes, processes, and outcomes.

The ABCDEF model…
is a cognitive-behavioral coaching model that is often used to help individuals overcome negative thinking patterns and beliefs. The acronym stands for:

Activity (event): Identifying the specific activity or event that triggered the negative thinking pattern
Belief: Examining the individual’s belief or interpretation of the event
Consequence: Identifying the consequences of the negative thinking pattern
Dispute (change belief): Challenging the negative thinking pattern and identifying alternative beliefs or interpretations
Effective new response: Identifying new, more positive responses to the event
Future focus: Focusing on the individual’s goals and identifying strategies to achieve them

The OSKAR model is a solution-focused coaching model that emphasizes a positive and goal-oriented approach. The acronym stands for:

Outcome: Identifying the desired outcome or goal
Scaling: Rating the individual’s current progress on a scale of 0-10
Know-how: Identifying the individual’s strengths and resources
Affirm and Action: Affirming the individual’s progress and identifying specific actions to achieve the goal
Review: Reviewing progress and adjusting the plan as necessary

The TGROW model is a modified version of the GROW model that includes a focus on the emotional and intuitive aspects of coaching. The acronym stands for:

Topic: Identifying the topic or issue to be addressed
Goal: Identifying the specific goal or outcome
Reality: Examining the current reality and identifying any challenges or obstacles
Options: Generating a range of options and strategies for achieving the goal
Will: Committing to an action plan and addressing any emotional or intuitive barriers to success

The CLEAR model is a coaching model developed by Peter Hawkins that emphasizes collaboration and relationship-building. The acronym stands for:

Contracting: Establishing a clear and collaborative coaching agreement
Listening: Actively listening to the individual and demonstrating empathy and understanding
Exploring: Asking open-ended questions to explore the individual’s thoughts and feelings
Action: Identifying specific actions and strategies to achieve the goal
Review: Reviewing progress and adjusting the plan as necessary

The PERMA model is a positive psychology model that can be used to promote well-being and flourishing. The acronym stands for:

Positive Emotions: Focusing on positive emotions such as joy, gratitude, and contentment
Engagement: Engaging in activities that provide a sense of flow and absorption
Relationships: Cultivating positive relationships with others
Meaning: Identifying and pursuing activities that provide a sense of purpose and meaning
Accomplishment: Setting and achieving goals to build self-esteem and confidence

Don’t get me wrong; coaching can absolutely be about achieving significant outcomes. I’ve helped rowing teams achieve podium success, business teams with mergers and acquisitions, and change teams create transformational outcomes for their organizations. However, I believe coaching is much more than that.


For something to be therapeutic, it means it has a positive effect on a person’s mental, emotional, or physical well-being. Here are some key aspects:

1. Healing: It contributes to the healing process, helping to alleviate symptoms of illness or distress.
2. Comforting: It provides comfort, relief, or solace, making a person feel better emotionally or physically.
3. Supportive: It offers support and understanding, often in a nurturing and empathetic manner.
4. Restorative: It helps restore a sense of balance or well-being, rejuvenating the person in some way.
5. Holistic: It addresses various aspects of a person’s health and well-being, not just the symptoms of a specific issue.
6. Preventive: It can prevent worsening of conditions or maintain health by promoting good practices and lifestyle choices.

In essence, anything therapeutic is beneficial and contributes to improving or maintaining a person’s overall health and happiness.

Coaching propels you forward, focusing on performance, goals, and maximizing potential, emphasizing the present and future achievements. Therapy, in contrast, explores deeper feelings, beliefs, and behaviors, providing a space for reflection, understanding, and healing. I believe in a blend called “Therapeutic Coaching,” which seamlessly integrates coaching and therapy, tailored to the unique needs of each client.


I was struck once during a conversation with my peer group about emotions and feelings. One person said, “Oh, I don’t do grief,” as if grief were a medical condition that needed a specialist rather than a coach. This idea that certain emotions are good or bad, acceptable or unacceptable, is flawed. All emotions have their place as part of the human condition. It’s appropriate to feel happiness, sadness, grief, or anger at certain times or under certain circumstances. Separating positive emotions as coaching topics and negative emotions as therapeutic topics needing a medical practitioner is wrong.

Labeling someone as needing medical intervention pathologizes and classifies them in a way that suggests they are abnormal or broken, which can worsen the situation. Instead, acknowledging their tough time and offering support and understanding is more helpful.

However, I recognize that there are clear professional boundaries and guidelines for when to refer someone. There are times and circumstances where referral is necessary due to the client’s needs or the coach’s lack of skills or experience. So, while there is a time and place to refer, instantly doing so because a coach can’t handle certain emotions reflects more on the coach than the client.


This is a complex and often debated area. My starting position is to refer to the International Coaching Federation’s ethics and guidance on referrals. Except in extreme cases where there is a real and serious risk of harm (e.g., suicide or murder), I would always consult with the client before making a referral. In many cases, I guide the client to start with self-help resources as a good starting point. This can help them clarify their issues, thoughts, and feelings, and determine the best approach for seeking professional help. This process puts the client in control, which is crucial.

As coaches, our role is not to direct but to serve. Even when referring, the client should, except in extreme circumstances, always be in a position of knowledge, information, decision, choice, and control.

Key Points / Guidance On Referring A Client To Therapy

Key Points / Guidance on Referring a Client to Therapy

Find Self-Help Resources

Self Help Resources


The phrase “Serve to Lead” is a fundamental principle in military leadership. It emphasizes that true leaders prioritize the needs and well-being of their team above their own. In the army, this means that leaders are responsible for supporting, guiding, and protecting their soldiers. The concept is based on the idea that by serving those they lead, leaders earn trust, loyalty, and respect, which in turn fosters a strong, cohesive, and effective unit. The phrase encapsulates the selfless nature of military leadership, where the primary goal is to ensure the success and safety of the team rather than seeking personal glory or advancement.

One of the most important questions in coaching is: Who is in charge? Who do the questions serve? If you are guiding or directing the client, then you, the coach, are in charge. If your questions are meant to give you information and help you gather knowledge and understanding, then you, the coach, are benefiting from the session. However, the opposite should be true.

It is the client who should be in charge. You might ask questions like, “What would you like to explore next?” or “Where would you go with that?” or “What thoughts does that provoke in you?” These questions are designed to provoke awareness and ask for direction from the client. They encourage the client to think about what they want to do, how they want to do it, what resources are available, and different ways of looking at things.

Your questions should provoke awareness in the client, not improve your knowledge and understanding as a coach. Coaching is a collaborative venture where both parties bring something to the discussion. However, coaching is not an interview or an assessment where you gather information and make a prognosis, diagnosis, or appraisal.

This is where coaching differs from the clinical medical approach. In medicine, gathering information, compiling medical notes, offering a diagnosis and prognosis, and prescribing treatments are essential. Medical or psychological interventions require record-keeping and resource allocation to address identified symptoms and achieve agreed outcomes.

In coaching, the focus is on facilitating the client’s self-awareness and empowering them to take charge of their own development, rather than diagnosing or treating them.


Earlier, I discussed the notion of “fixing” people who are deemed not “normal.” Traditional psychology often pathologizes individuals, suggesting there’s something inherently wrong with them, instead of addressing the cultural and societal circumstances that contribute to emotional issues like depression, anxiety, or defensiveness. In truth, there may be nothing wrong with the person; their response may be entirely appropriate given their circumstances.

Jiddu Krishnamurti’s quote, “It is no measure of health to be well adjusted to a profoundly sick society,” challenges the idea that adapting to a flawed system indicates mental well-being. True health involves recognizing and addressing societal issues.

We are increasingly shifting towards coaching approaches that avoid pathologizing individuals and instead focus on addressing contextual issues. These include power discrepancies and their impact on people, such as sexism, racism, bullying, abuse, misogyny, rape, and the marginalization of minority groups, those considered of lower worth, or those with perceived low intelligence or achievement.

The British Psychological Society’s Power Threat Meaning Framework (PTMF) offers an alternative to traditional psychiatric diagnosis by focusing on the role of power and threat in emotional distress and behavior. Instead of labeling individuals with diagnoses, it explores the impact of power dynamics and societal messages on individuals’ experiences and responses to threats.

Key elements of the PTMF include:
1. Understanding Power and Threats: The framework examines how power imbalances and threats influence emotional and psychological well-being.
2. Response to Threats: It identifies various ways individuals respond to threats, which are often labeled as symptoms in traditional models.
3. Creating Narratives: PTMF helps individuals create personal narratives that make sense of their experiences and highlight their strengths and resources.

The framework is not meant to replace existing methods but to enrich and support non-diagnostic approaches, respecting diverse cultural contexts. It has implications for clinical practice, service design, professional training, and social policy, emphasizing the importance of social justice and equality.

For more detailed information, you can visit the British Psychological Society’s website on the Power Threat Meaning Framework.



In conclusion, the boundaries between coaching, therapeutic interventions, therapy, clinical psychology, and psychiatry are on a continuum. It’s not always clear where one ends, and another begins. There are transitional points where goal-focused coaching becomes more therapeutic, moving into counseling, and then becoming more medicalized or prescribed. This shift leads into clinical psychology and psychiatric interventions.
As observed in the work of the British Psychological Society, some elements of clinical practice are becoming more like coaching, just as some aspects of coaching are becoming more therapeutic.

The most crucial factor is the relationship between the coach and the coachee, ensuring it meets the needs of the client. If a coach is not best suited to serve due to issues like transference, countertransference, experience, or comfort, they should withdraw. Likewise, clients should always have the choice about what they want to do, how they want to do it, and with whom they want to work, as it is a partnership.

Ultimately, I am guided by Carl Rogers’ work, even though he was a psychotherapist, not a coach. His principles remain relevant and persuasive.

Key Elements of Carl Rogers’ Humanistic Psychology

The Necessary and Sufficient Conditions

Rogers identified six conditions that were necessary and sufficient to facilitate therapeutic change.

Therapist-client psychological contact: the therapist and client are in psychological contact
Client incongruence: the client is experiencing a state of incongruence
Therapist congruence: the therapist is congruent, or genuine, in the relationship
Therapist unconditional positive regard: the therapist has unconditional positive regard toward the client
Therapist empathic understanding: the therapist experiences and communicates an empathic understanding of the client’s internal perspective
Client perception: the client perceives the therapist’s unconditional positive regard and empathic understanding

These elements are central to Carl Rogers’ client-centered therapy, emphasizing the importance of a supportive and non-judgmental therapeutic environment to foster personal growth and self-discovery.


Having read the paper reference below I have some additional thoughts.

I haven’t modified my text after reading “International Journal of Evidence Based Coaching and Mentoring”, as that would feel disingenuous. I believe you should see my unfiltered thoughts. The article below is superior and well-researched, unlike personal reflections. I highly recommend reading the article.

International Journal of Evidence Based Coaching and Mentoring [Alison Maxwell, Alison Maxwell Coaching Ltd., Stamford, Lincs PE92SU]


I’ve realized that I haven’t actually discussed corporate coaching. My previous comments focused on the relationship between a coach and a coachee. However, this dynamic changes in corporate coaching, where there is an organizational sponsor, or in team coaching, where multiple parties are involved. This clearly alters the dynamic, though the key principles of confidentiality, support, creating a thinking environment, and the importance of rapport and relationship between coach and coachee remain. When multiple people with different expectations and interests are involved, the dynamic does indeed change.

A good example of group coaching and therapeutic coaching is Alcoholics Anonymous (AA) and how they manage groups in a facilitated environment. While this is not my area of expertise, I would recommend exploring the AA model to understand how group-based, membership-based, 12-step programs operate. This example is relevant to the debate about coaching and therapy, as it illustrates how group support can help individuals achieve the changes they want to see in their lives. For more information, you can visit their official website.


A more common and personally familiar scenario involves an organization, often the HR department, sponsoring individual coaching to help someone achieve competencies, behavioural changes, or develop the capacity and confidence to deliver a specific project or corporate outcome. In this context, there is a three-way relationship, though coach-client confidentiality and the relationship remain core. However, the sponsor’s expectations shape the conversation and focus of the coaching relationship.

This scenario is interesting because the coach serves the coachee, who may bring in personal contexts such as family, history, or circumstances that are private yet relevant to the organization’s expectations for coaching outcomes. Therefore, it’s crucial to understand the boundaries of relationships, disclosure, and confidentiality, as well as the expected outcomes for both the coachee personally and professionally, and the coach’s obligations to the sponsor funding the coaching to achieve corporate objectives.

At all times, the coaching contract is critical because it establishes the rules of engagement, expectations, process, outcomes, and style. It clarifies what people feel comfortable with, some of which will be articulated upfront in the coaching contract, while other aspects will emerge through the coaching process as rapport and trust build. It is important to have various checkpoints throughout the relationship to assess progress, ensure alignment with goals, and determine if any adjustments are needed. This accountability for format, content, scope, process, and progress is always important, especially in a commercial, contracted, or corporate relationship where parties may seek evidential criteria to measure the benefits of the coaching relationship.

This is an area where coaching diverges from therapy. Therapy is typically a personal intervention, rarely a corporate one, even if a company funds therapy as a benefit or perk. Coaching, on the other hand, is usually seen as an intervention similar to training, learning, and development. It is an investment in the individual with the intended outcome of increased productivity or improvement, rather than solely supporting health and well-being.

Unlike a perk such as dental care, which doesn’t come with job performance outcomes, coaching is expected to yield performance-related results. This distinction raises interesting questions about each parties’ interests and accountability. If coaching were viewed purely as a perk, like an extra day off, it would be accounted for differently than if it were seen as part of business operations aimed at performance improvement.

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