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Therapy and Counseling Options

Life doesn’t always go according to plan. Relationships crumble; careers falter. Bad things happen to us or the people we love, challenging our ability to cope. Even when life is good, we may long for a change. Whether we’re looking to improve our emotional well-being, reach for our next professional goal, or learn new relationship skills, we need strategies for overcoming obstacles and moving forward.

Fortunately, we don’t have to figure everything out on our own. In addition to leaning on friends, family, teachers, or clergy, we can tap into the expertise of professionals trained to guide us on the path to self-improvement and healing. The wide range of licensed counseling services, however, can make it difficult to know which way to turn.

Many people look to coaches and therapists for help with personal issues. Though both offer support for making life changes, the lenses through which they view life’s challenges and opportunities tend to be different.

“Therapy sessions often begin with an exploration into what’s happening and how it may be related to wounding in the past, and bringing that forward,” explains psychologist and coach Belinda Gore, PhD. “Coaching is more focused on what you want to accomplish and achieve in the present and future.”

Choosing a coach or a mental-health professional is a personal decision informed by your goals, motivations, current skills, financial resources, and life circumstances. You may consult with one or both over the course of your life, depending on what you’re experiencing. The following guide can help you select the right option and find success — no matter which path you pursue.


Psychoanalysis and psychotherapy emerged in the late 19th and early 20th centuries to help people overcome deep emotional problems. They’ve evolved to benefit a wider clientele, including those seeking more satisfying lives and relationships.

Training and Licensing: Though some states don’t require licensing, “it’s usually best to choose a therapist who is licensed to practice as a psychologist, social worker, psychoanalyst, psychiatrist, family therapist, mental-health counselor, or psychiatric nurse practitioner,” writes Gary Trosclair, LCSW, DMA, in I’m Working On It in Therapy: How to Get the Most Out of Psychotherapy. He advises choosing a therapist with a minimum of a master’s degree in his or her field.

Model and Framework: Practitioners typically work from a medical model and use standardized criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders to diagnose mental-health conditions. Some therapists accept insurance.

Tools: Therapists use their training, assessments, and their patients’ personal experiences to explore the unconscious mind. “One goal of my work is to help individuals develop a better relationship to their feelings and to their unconscious,” explains Trosclair, “leaving them more prepared to deal with the challenges they face even after they leave therapy.”

When to work with a therapist:

  • You need help recovering from trauma.
  • You want to work through anxiety or depression that is impairing your ability to function.
  • You have problems in a relationship with a spouse or family member.
  • You use mood-altering substances to self-medicate, or have addiction issues.
  • You require medication for a mental-health diagnosis (not all therapists prescribe).
  • You want to use health-insurance coverage to pay for assistance.


In the 1970s, tennis pro W. Timothy Gallwey developed the Inner Game theory — the idea that an anxious brain can sabotage goals. It informs modern coaching models for offering guidance on life, business, leadership, and health. (For more about the Inner Game, see “Work Your Inner Game, Find Your Mental Focus.”)

Training and Licensing: Coaches are typically credentialed through organizations such as the International Coach Federation; they are not required to maintain a license. Be sure to ask about a potential coach’s credentials and level of training.

Model and Framework: Unlike therapists, coaches don’t make diagnoses. “Coaches generally work with people with normal or above-normal health and capability,” Gore says. “These are people who want to focus more fully on what’s happening now versus in the past.” Coaching is typically not covered by insurance.

Tools: Coaches use assessments such as Gallup’s CliftonStrengthsFinder, Myers-Briggs Type Indicator, and the Enneagram. Drawn from behavioral science, management literature, and spiritual traditions, these tools increase self-awareness and foster new insights. (Learn more about the Enneagram at “Peace Through Personality.”)

When to work with a coach:

  • You need help clarifying personal or professional goals.
  • You want to improve your communication skills.
  • You seek to build leadership or other career-oriented capabilities.
  • You are experiencing a sudden life change that you want to turn into a new opportunity.
  • You want help achieving better work–life balance.
  • You wish to improve your health, nutrition, or eating habits.

Make the Most of It

Despite different approaches, training, and licensing, coaches and therapists offer similar tips for ensuring a successful counseling experience.

Prepare yourself. Carefully consider your motivations and goals for counseling, along with your financial resources.

Find your fit. Solicit referrals from friends or family members. Ask professionals about how they work (including fees, approach, and the types of assessments and tools they use) and their background and training.

Be authentic. Give yourself permission to be completely honest and vulnerable. A productive relationship with a coach or therapist lets you feel you can discuss anything.

Be willing to rewrite your story. You may identify recurring themes, beliefs, habits, or behaviors that have limited your progress. Challenging these will help you reach your goals and improve your well-being and satisfaction.

Do the work. Successful therapy and coaching require collaboration. Coaches and mental-health professionals stress that you should be willing to work on issues outside of sessions.

So Help Me

If consulting with a life coach or a therapist is financially out of reach, here are some other resources to consider:

  • Keep a journal. This may help you pinpoint what you want to work on with a professional.
  • Visit your local library and check out self-help or psychology books.
  • Join a local meditation group or consult with a spiritual adviser.
  • Attend support groups such as Alcoholics Anonymous and Al-Anon.
  • Consult with professionals at community mental-health centers.
  • See if your city has a training clinic — typically affiliated with a local university — where graduate students practice under the supervision of licensed psychologists.
  • Don’t be afraid to negotiate a reduced price with a coach or therapist or even your insurance company. You never know until you ask!

This originally appeared as “Life Support” in the May 2018 print issue of Experience Life.

Illustration by: Carey Sookocheff

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