Psychotherapy C & C | Feelingawareness

Psychotherapy, Counselling & Coaching

When people look for solutions to personal problems they often turn to doctors, psychiatrists, psychologists, psychotherapists, social workers, marriage therapists, counsellors, coaches, or some other guide. Although these professionals seem very different, there is one common element: a person with a problem meeting another person for a solution. A human connection.

People are not simple machines held together with certain bolts that require specific wrenches. You may have a problem that could be addressed by both a psychologist or a counsellor. When I offer psychotherapy, counselling, and/or coaching these are approaches with a great deal of overlap. During one session the issues presented may require a seamless movement from psychotherapy to counselling to coaching and back again. It would be pointless to say, “Now I'm switching to counselling.” The reality is that when I'm asked to assist with a problem, I attend to that in the best way possible.

In spite of the fact that the helping professionals are like a blended spectrum, there are certain legal limitations that the government attempts to define. For instance, a psychiatrist can talk to you about anything—just as your friend could—but they can also prescribe medications but your friend can't. A psychotherapist can talk to you about anything just as a counsellor can, but according to regulations, a counsellor cannot use a “psychotherapy technique," but a psychotherapist can. What constitutes a psychotherapy technique is difficult to define.

I am a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO), and they define psychotherapy as a government “controlled act”:

"To treat, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception, or memory that may seriously impair the individual’s judgment, insight, behaviour, communication, or social functioning."

To be a registered member of the CRPO, a practitioner has to prove adequate training and experience in the field. A counsellor or coach, in contrast, is not government regulated and is not obligated by law to prove their training and experience. This does not mean that their profession has less value or that any individual counsellor or coach is not highly trained and effective. These are just the legal frameworks that are in operation.

Psychiatry, Psychology, or Psychotherapy?

Psychiatrists are medical doctors (MDs) with a specialty in psychiatry—psychological conditions and medical interventions. They can officially diagnose mental illness and prescribe psychiatric medications. In the past, like Freud, they would take time to discuss matters with clients and practice psychoanalysis, but now they mostly prescribe medications.

Clinical Psychologists have PhD degrees in Psychology. They can diagnose mental illness but cannot prescribe psychiatric medications. They tend to practice psychoanalysis or some kind of talk therapy with clients.

Psychotherapists have different educational requirements depending on the country, state, or province in which they practice. They are often expected to have training in their preferred modality of practice, which may include activities, techniques and interventions to assist with troubling emotional states. I believe that the most responsible psychotherapists will have explored their own psychotherapy in order to know the process from the inside out. A psychotherapist cannot prescribe medications or officially diagnose mental disorders, though they can help clients reflect on these issues as a part of their understanding.

In summary:

• Psychiatrists diagnose mental illness and prescribe medications
• Clinical psychologists diagnose mental illness and provide talk therapy
• Psychotherapists offer interactive therapy options and modalities to actively engage and resolve client problems.

Psychotherapy, Counselling or Coaching?

What is the difference between Psychotherapy, Counselling, and Coaching?

Counselling usually refers to a talking session with someone who will listen and offer reflections, advice and possible solutions to the problems at hand.

Coaching has always been a relationship of a mentor helping an athlete set targets, train, and work towards a goal. In the last 50 years, this term and relationship was extended to the business world—and then to anyone seeking improvement in life.

In my own practice, I would say that these three—psychotherapy, counselling, and coaching—are different modes appropriate to different client needs. If at some point a client asks for guidance to improve work or life, then the session may take on a coaching mode. While looking at actions for improvement, a client may need, for instance, to talk more about their resistance, and in doing so, the session will shift to a counselling mode. If then, this exploration brings up strong emotions, a psychotherapy mode may be needed to follow the feelings, understand their origins, express, and resolve them.

There are countless examples of this blending of modes. It has been common for me, for instance, to take on a client for executive coaching who while strategizing business decisions uncovers their “imposter syndrome.” With those feelings of shame arising, the direction of sessions switches to the origin—a cruel and narcissistic father. When such a discovery occurs, a psychotherapeutic approach is necessary because the coaching intended cannot happen until the traumatic block is managed.

There are times, in contrast, when a person wants deep psychotherapy but discovers they can't explore traumatic feelings with bills and finances hanging over their head. At times like this a counselling/coaching focus may be necessary to build greater financial stability before the needed emotional work can happen. Our needs often take a different path and require different responses than originally planned. That's life.

To simplify:

• Psychotherapy deals with more emotional issues such as anxiety, depression, grief, anger, and shame that may be connected to trauma, and require careful exploration, expression, insight, and active resolution.

• Counselling usually refers to working on more practical and relational problems, with sharing, mediation, understanding, and action.

• Coaching engages problems, plans, and success in self-improvement, creative development, career direction, and executive/business management. This usually requires discussion, assessment, action, and regular review.

As my examples in the above paragraph indicate, these three professions could be seen as covering a spectrum of needs and approaches—but there is no clear division between them.

One human with another.

In the meeting of one human with another, any number of things can happen, needs appear, responses occur. My approach is: be human. Say hello. Ask what's happening. Listen. Respond.

If my client feels safe enough to be honest, the exploration begins and I follow. When they ask questions, get confused or feel stuck, I respond with whatever “approach” will assist them to stay on the path. Sometimes it looks like psychotherapy, sometimes like counselling and sometimes like coaching. It doesn't matter to me, as long as the client is getting their needs met.

My website shows that I offer Therapy, Counselling, Coaching, Parenting, and Zen, and you may think it's a choice—but it isn't. These are listed because it gives a sense of my range. The needs you have, however, are yours, and the approaches and solutions that meet those needs will have a unique flavour and trajectory that is you.

Every Problem has a Solution.