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“I think I might be burned out.”

“I’m really struggling.”

As psychologists and coaches, we often hear these things from prospective clients. And we hear them from our friends and family.

The last few years have been challenging for all of us.

When you say this, people suggest that “you should talk to someone.”

Some people automatically recommend a therapist.

Some people might never do that and would recommend a coach.

Others might say something unhelpful, like, “you know that’s the way life is.” That is not what we’re looking for here.

Working with a supportive person who is dedicated and committed to your well-being can be helpful.

Yet how do you know what you need? Therapy or coaching?

And the mental and behavioral health and coaching industries make this challenging.

There is a guru for everything these days trying to sell us some quick fix on wellness and happiness.

In our practice, at this time, each one of us is a licensed clinical psychologist, and we also work as executive performance coaches in entirely separate businesses. And even for us, these distinctions are complicated.

Here, we offer tips to help you decide whether a therapist or a coach is the best choice and address the following 6 topics:

  1. Why is it so hard to be happy in the first place?
  2. Why is self-help so hard?
  3. How can a coach or therapist help me perform at a higher level?
  4. What does it mean to be “well”—in therapy and coaching?
  5. What are the key differences between a therapist and a coach?
  6. What questions should I ask to help me figure out which one is best?

Why is it so hard to be happy in the first place?

Let’s start with why it can be so hard to be happy in the first place.

First, being human means that we all experience pain every single day.

Second, as humans, we are also hardwired to avoid pain. Our brain’s number one person is “don’t get killed!” As a result, we’re pre-programmed to avoid threat and discomfort. This means our brain is very biased towards negative information.

Without more from us, our brain defaults to staying “safe” and in the “comfort zone.”

Third, along with the “don’t get killed” priority, our brain also has many other defaults.

One big one is that our brain defaults to problem-solving. This default works fine when we’re dealing with a clear external threat. Yet when the threat is internal—uncomfortable thoughts, sensations, and emotions—we usually try to “get the hammer out” and fix it.

Why is self-help so hard?

Without self-awareness, which is unbelievably harder than you might think, our brain stays on auto-pilot.

As a result, we often mistakenly assume that all pain and discomfort is terrible and should be “fixed.”

And, there’s the rub.

Many of the best things in life involve pain.

Learning involves pain. Love involves loss.

Often, pain comes before or after something that matters to us. If I lose someone, that pain and grief is a result of intense love and joy. If I put in the grueling hours of training for a marathon, the pain makes the joy at the end so much sweeter.

Dr. Susan David summarizes this paradox: “Pain is the price of admission to a meaningful life.”

A leading model of therapy (Acceptance and Commitment Therapy) and coaching (Acceptance and Commitment Training) suggests that pain is not what causes us the most problems.

It’s all the things that we do to avoid the pain that causes the bigger problems. Trying to escape from, get rid of, and avoid pain actually ends up causing more suffering.

Humans have incredible resilience, so self-help can be a powerful option. Even when it comes to trauma, resilience is the rule, not the exception.

However, seeing when we are stuck in the “comfort zone” and how our actions are blocking us from doing what matters can be really challenging on your own.

How can a coach or therapist help me perform at a higher level?

Performing at higher levels often requires a few key things:

  • Being fully self-aware
  • Leaning IN to pain and discomfort
  • To go towards what matters most to us

Bottom line is that’s a whole lot of stepping outside of the “comfort zone.”

“Feeling like it” has nothing to do with it.

In your head, it sounds more like: “I’m willing to be present with this discomfort to take action towards what matters to me at work, in my business, in my marriage, etc.”

Being aware, leaning into the pain, and doing what matters can be much easier with a professional providing space for you to explore and practice actions.

What does it mean to be well?

When I’m wearing my psychologist hat, so to speak, I often must use the Diagnostic and Statistical Manual of Mental Disorders, 5th Version (DSM-5) for legal reasons. It is something that insurance companies require for reimbursement. But people don’t fit into neat categories. As Dr. Kelly Wilson says, “people are more like sunsets than math problems.”

When doing coaching, I look at things through a different lens.

Yet, I’m looking at three main things, whether it’s therapy or coaching.

“People are more like sunsets than math problems.”


Three Fundamental Factors in Wellness

Ask yourself how the following are going for you:

  • How is my relationship with my body and physical health (including sleep, diet, and exercise)
  • How is my relationship with other people (including friends at work and away from work, family, partner, children, community, church, etc.)
  • How is my relationship with myself (this would mean how aligned your actions are with your core values and how do you treat yourself—with love and compassion or judgment and criticism?)

That last one is where people look at me strangely, yet it’s critical to wellness and probably involves the hardest work.

If you are out of sync or off balance in one of those areas and have tried but struggled to make a change on your own, a professional could help.

A therapist or coach can help you restore balance in these areas.

What are some of the differences between a coach and a therapist?

The main differences between therapy and coaching related to the following:

  • Licensure and Certification
  • Focus
  • Purpose
  • Population
  • Techniques

However, it is essential to qualify this by one primary variable: the individual therapist or coach and their training, experience, and approach to their craft.

For example, when I did my coach training, I had already spent several years as a clinical psychologist and a professor who trained therapists routinely. At the training, the trainer noted the main distinction: “therapy focuses on the past while coaching focuses on the present and future.” That distinction did not fit my training and approach.

Because my primary training was in behavioral psychology and neuroscience, everything I did was here-and-now and action-focused.

Also, when someone says that the past doesn’t matter, I realize that they probably don’t have training in behavioral psychology.

From a learning sense, our past learning experiences are always present. Many of our responses are automatic and auto-pilot, reinforced repeatedly by classical conditioning, operant conditioning, or observational learning. What can happen is that you can’t see the conditioning without help sometimes.

For example, an athlete who had a coach yell at them for years on the court when they did something might notice that when they are in a similar situation years later, they have a stress response or hesitate. That’s not a conscious decision – it’s a learned nervous system and motor response.

What are the basic definitions?

Let’s start with some basic definitions from the professional organizations themselves.


The American Psychological Association defines psychotherapy as:

“the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable.”


The International Coaching Federation (ICF), a leading professional organization for coaches, defines coaching as:

“Partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.”


Like most therapy training programs, the ICF definition of coaching does not include telling a client what to do or giving advice.

Therapy and coaching are both different from consulting. Consulting is more about telling the client what to do about a specific problem.

Read this article form the Forbes Coaches Council on the difference between consulting and coaching.


To the best of our knowledge, no state requires a coach to be licensed.

The ICF certifies coaches with a certain level of training and recommends certification.

As of 2021, 33,287 coaches in 136 countries were certified by ICF.

In contrast, all mental health professionals must be licensed by their state to provide psychotherapy or psychological services.

Often, each degree has its own specific legal and ethical requirements. Please check here for a breakdown of mental health professionals and what they do.

Although it is not a hard and fast rule, it’s probably fair to say that most licensed mental health professionals have more supervised training and experience than coaches.

At one end of the spectrum, psychologists are typically required to complete 4- 6 years of coursework, over 2,000 hours of predoctoral clinical training, 1,500 to 2,000 hours of clinical training during internship or residency, and 1,500 to 2,000 hours of clinical training in a postdoctoral fellowship—all with regular supervision hours.

If you are working with a coach, please ask about their training and experience in coaching.

In most states, only physicians (psychiatrists and primary care physicians) and nurse practitioners can prescribe medication. In some states, psychologists with a doctoral degree in psychology and additional training in psychopharmacology can also prescribe medication.

How to Check Credentials for Therapists and Coaches




Therapists and coaches tend to work with different client populations, which differ in terms of: daily functioning and presenting problems.

Daily Functioning

According to an ICF white paper, the most critical indicator for a coach to remember when determining whether coaching or therapy is appropriate is the client’s: level of daily functioning.

Unlike therapists, according to the ICF, coaches tend to focus more on working with “well-functioning individuals.” Coaching aims to help people already functioning at higher levels work through challenges and optimize or enhance their functioning.

The ICF defines daily functioning as “a wide range of activities for personal self-care, such as feeding, grooming, work, homemaking, and leisure.”

By contrast, a therapist can work with individuals who are functioning better daily and are also equipped to work with people who cannot function well daily.

Compared to coaching, therapy is always the better choice for individuals noticing impairment in their day-to-day functioning in one or more domains (e.g., work, relationships, physical health, etc.). 

If you’re not sure, you can consult with your primary care provider. You could also consult with a mental health professional. Therapists can assess and diagnose mental health problems, including assessing daily functioning and whether a mental health problem impacts that.

Presenting Problems

In general, therapists can treat a broader population of individuals. They can work with individuals with serious mental illness (SMI) or those dealing with an isolated job or relationship loss.

A coach cannot assess, diagnose, or treat mental health disorders. If they are not sure, they should refer the individual for assessment by a mental health provider.

Competency is another consideration for therapists. Most licensing boards require therapists to be competent to specialize in working with a particular client population. For instance, it would not likely be ethical for a therapist to provide behavioral therapy for ADHD if he or she had never had any supervised training or coursework to work with ADHD.

Coaches could technically help individuals with a variety of problems. If they are ICF-certified, they should be competent under those guidelines. However, no regulatory body requires this, so potential clients must do more research to ensure appropriate training.

There are some problems for which coaching is more appropriate. For example, therapy is likely inappropriate if a person is dealing with a problem that relates exclusively to their business.

Overall, while both professions can help you make meaningful change, a therapist will always be the best choice if you feel you are dealing with a mental health problem or significant or intense emotional and relational concerns.


Coaching and therapy organizations provide guidance on purpose. Many therapists who are also coaches would likely say that distinction is overstated.

Again, the purpose likely strongly depends on the individual therapist or coach and his or her training and approach.

According to the ICF, the purpose of coaching is “frequently about performance improvement, learning, or development in some area of life.” In contrast, according to the ICF white paper, therapy often “dives into deep-seated emotional issues to work on personal healing or trauma recovery” and “works more with developing skills for managing emotions or past issues than coaching.”

Therapy and Coaching Can Address Similar Topics and Skills

For example, when I work with therapy clients, I am often teaching them about nervous system awareness so they can learn to identify and regulate their stress response. This skill is often first for a client seeking PTSD treatment or behavioral therapy for ADHD.

Often, unless I’m working with an athlete, physician, or someone who is already highly aware of their nervous system and potentially working on their heart rate variability (HRV) already, this might also be the first skill in coaching.

It’s challenging to help a coaching client who is breaking the habit of looking at their phone during family time or struggling with procrastination if he or she isn’t aware of their nervous system and dopamine system.

Being “addicted” (hate this word!) to your phone isn’t the result of laziness or failure—it’s the result of not understanding your nervous system like social media does. Without awareness, it’s very difficult for any brain to beat the Instagram, Tik Tok, and LinkedIn behavioral algorithms.

Most people never learn about the neurobiology of their stress response and how it impacts their relationship with their body, others, and themselves.


According to the ICF, coaching focuses more on “visioning, success, the present, and moving into the future.” On the other hand, therapy emphasizes “psychopathology, emotions, and the past to understand the present.”

Coaches should not focus on treating psychopathology, which would likely mean a disorder that falls under a DSM-5 classification.

Again, however, the other distinctions are likely mediated by the therapist or coach’s approach. While therapists do treat psychopathology, they can and must focus on the present and future to help their clients.

As far as coaches not working with emotions, that’s simply not true.

On the coaching side, Amanda Blake, a well-regarded coach specializing in “somatic leadership” focuses most of her practice on embodied self-awareness, which focuses on emotion and sensation. By the standard definition from ICF, this could sound more like therapy, but it is not intended.

However, a competent coach uses it for the right population and purpose, it would seem to meet other definitions of coaching as long as the person wasn’t struggling with a mental health disorder.

What are some of the different types of coaching?

Similarly, coaches have different specialties. The Harvard Institute of Coaching lists several including:

  • Leadership and Executive Coaching
  • Organizational Coaching
  • Health and Wellness Coaching
    • Psychologists specializing in sports and performance, health and wellness, and rehabilitation could be more appropriate for problems that are more complex
  • Life Coaching
    • Of the specialties, this one is the most difficult to really classify. It’s important to ask the coach to be very clear on their expertise and evidenced-based methods they use.


If you read from the list of coaching specialties by the Harvard Institute of Coaching, you will notice that most of these draw on tools and techniques from psychology and neuroscience.

Often, coaches likely draw on strategies used in therapy with clients, and therapists regularly draw on coaching strategies. One of our therapists, Dr. Kayleigh Hunnicutt, describes her style as “therapy plus life coaching.”

Some evidence-based treatment (EBT) models have strict guidelines on their use that require you to be a licensed mental health professional. Some coaches may draw from these bare noted and be appropriately trained to use them.

One of the most important questions to ask either a therapist or a coach is:

“What approaches or models do you use? What scientific research supports them? How were you trained in them?”


1.What is your goal?

When people consider therapy or coaching, they focus on the problem first.

What if we flip that?

What would it look like if we could take a magic wand and get rid of the problem or barrier? What would your life look like?

Map that out precisely in terms of behaviors. If you think, “I would not be anxious anymore.” Without going into a big thing, that’s a Dead Man’s Goal. If a dead person can do it better than you, it’s not likely the best goal for a human being.

Instead, what would you do if the anxiety, your boss, or whatever barrier you identified was removed?

Would you be more present with your family? Would you be closing more deals? Would you travel more?

Based on what you’ve read in this article already, which would be more helpful: a therapist or coach?

For example, an executive or leadership coach might be the best choice if the goal is more squarely work or business-related. If your struggling in your new business, but you are noticing that you’re having nightmares and flashbacks related to a traumatic event, it could be helpful to see a therapist first and consider whether therapy or therapy and coaching with someone else might be beneficial.

2. What is the barrier or problem?

Not all pain is created equally. That is common if you are dealing with sadness, irritability, and less interest in things you enjoy a few days after losing your job. Losing your job is a significant stressor. In this example, the loss is very recent and would feel more acute.

If you are bummed but still feel motivated and haven’t noticed a change in your relationships or health, you are probably functioning well. If you want to shortcut the transition, you might opt for coaching here to work on revising your resume, crafting a networking plan, and launching a career search. So far, this sounds like it would fall in the coaching camp (or therapy if you prefer that modality for specific reasons)

In contrast, if you were still struggling with these symptoms several weeks after the loss most of the day for most days of the week, this pattern is more characteristic of, but not necessarily, a major depressive episode. In addition to symptom severity and duration, reduced functioning must be considered. For example, if you also notice more frequent arguments with your partner and a sudden stop in your exercise routine, this would point to therapy.

Challenges Typically More Appropriate for Therapy

When looking at the barriers, some problems always land in the mental health camp. Based on the ICF guide, if you are experiencing or think you might be experiencing symptoms of any of the following, assessment by a mental health professional would be most appropriate:

  • Suicidal ideation
  • Anxiety disorders including phobias, obsessive-compulsive disorder (OCD), panic disorder, or body dysmorphic disorder
  • Posttraumatic stress disorder
  • Depression especially if you have had a depressive episode
  • Substance use or dependence (including nicotine, cannabis, alcohol as well as illicit substances)
  • Eating disorders
  • Thought disorders (e.g., mania, delusions, auditory or visual hallucinations)

Again, if you aren’t sure, you can first check in with your primary care physician for further guidance or a referral.

3. What are the symptoms? How are you doing?

Important questions to consider here:

  • The quality and nature of the symptoms or signs of a problem
  • How often are you experiencing these signs and symptoms, including how many hours of the day and how many days per week
  • How are these issues affecting your functioning at work, school, relationships with family and friends, and physical health (e.g., sleep, diet, and exercise)?

The ICF white paper provides a list of symptoms that are key indicators that therapy or evaluation by a therapist would be appropriate:

  • Marked changes in mood such as irritability, anger, anxiety, or sadness
  • Decline in performance at work or school
  • Withdrawal from social relationships and activities
  • Changes in weight and appearance, including negligence of personal hygiene
  • Disturbances in sleep, either oversleeping or difficulty falling or staying asleep

Can you do both therapy and coaching at the same time?


In general, a person can have a coach and a therapist, but it would be crucial that the client and the practitioners are clear on who is doing what and how the providers are helping the client meet his or her goals.

In general, a licensed therapist who is also a certified coach can’t have a client as both a therapy and coaching client. It’s one or the other. Moreover, in most cases, if a licensed therapist works with a therapy client, the therapist could not coach that client.

Hopefully, this information and questions have helped you understand more about when therapy vs. coaching is more appropriate.

Now, how do you find the right person? Check out our article on finding the right coach or therapist!



As well as having extensive training in the treatment of anxiety and its related issues, our team of therapists also offers a wide variety of online therapy services in North Carolina and all PSYPACT states. We work with lawyers, entrepreneurs, students, parents, and teens who are dealing with stress and burnout, trauma and loss, ADHD, depression, and life transitions. Our goal is to help you find success both professionally and personally so you can gain Momentum to excel in a bright future.


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The information provided on this website and in this blog is for educational purposes only. The contents of this website and newsletter are provided solely for informational purposes, and are not meant to provide professional medical or psychiatric advice, counseling, or services.