Itâs not unusual for private practice therapists to seek to expand their practices through coaching. Some clients will engage in coaching, but not therapy, because of the stigma they associate with therapy. At the same time, some therapists note that the unregulated nature of coaching means that anyone can call themselves a âcoach,â regardless of qualifications. So âcoachingâ sometimes carries stigma in the world of licensed therapists.
Setting aside stigma, though, what are the actual differences between coaching and therapy? How different do these practices need to be in order for therapists to engage in both?
Legal Protection for Therapy
First, we need to examine the legal protections that exist for psychotherapy. California, like many states, provides therapists with both title protection and practice protection under the law. These protections function in different ways.
Title protection means that no one can use specific titles, like âLicensed Clinical Social Worker,â unless they have a current and active license. This is about how you are presenting yourself to the world. You canât describe yourself in ways that lead consumers to believe that youâre a licensed therapist if youâre actually not.
Practice protection works differently. It protects the scope of practice of a profession, making it so that no one can engage in that specific practice â regardless of what the person is calling it â unless theyâre licensed or otherwise legally qualified to do so. With practice protection, it doesnât matter whether you call your work âtherapy,â âcoaching,â âconsulting,â âinterpretive dance,â or âa ham sandwich.â If you are operating within the scope of practice of a licensed mental health professional, you have to be licensed or otherwise legally allowed to do that work.
This is where some coaches, and therapists who also do coaching, get themselves into trouble. They believe that as long as they simply donât call their work âtherapy,â and as long as they donât describe themselves as a âtherapistâ in their coaching work, they can avoid trouble. But those steps only address title protection in the law. They donât address concerns with practice protection.
Different practices
The scope of practice language for therapists in many states is written quite broadly. While the specific language differs by state and license type, generally speaking, a therapistâs scope of practice encompasses the use of knowledge and principles within the profession to achieve specific ends, such as âto modify intrapersonal and interpersonal behaviors,â as Californiaâs MFT scope puts it.
With such broad scope language, you could interpret all kinds of work that uses psychological knowledge or techniques as being therapy, and requiring a license. But states have no interest in prosecuting ordinary people who happen to use some level of psychological knowledge or techniques in their daily lives. Think of all the hairdressers, bartenders, and others who would need therapist licenses if practice protection was taken too far.
When trying to determine in a concrete way whether someone is operating within the scope of practice of a licensed mental health professional, states tend to look at a more specific set of intentions in the personâs work: Are they assessing, diagnosing, or treating mental illness?
Differentiating coaching from therapy
Thatâs the clearest distinction between coaching and therapy: Coaches work with clients toward the achievement of personal goals, and steadfastly avoid assessing, diagnosing, or treating mental illness. Good coaches refer to licensed mental health professionals when they sense that a client may be having a mental health issue.
Some of the other differences you may read about from time to time do not reflect real, reliable differences between the professions. For example, while some coaches do not have significant training, many do. And while some therapists do not operate from a strength-based perspective, many do. But no coach should be assessing, diagnosing, or treating mental illness in work that is described as coaching and not therapy.
State lines
Many therapists rightly complain about the difficulty involved in working with clients who are traveling across state lines. Furthermore, in therapy, a clientâs family members may want to be involved in the clientâs treatment but live outside of the therapistâs state of licensure. Therapists sometimes seek to sidestep concerns about practicing in another state without a license by calling their work with individuals in other states âcoaching,â while they call their work with clients in their state of licensure âtherapy.â
As you have seen, though, if the work the therapist is doing is fundamentally the same â if in both cases they are assessing, diagnosing, or treating mental illness â then this relabeling of the work does nothing to address other statesâ practice protection laws. The therapist could still be seen as practicing in the other state without a license, and prosecuted for doing so.
Clear separation
However, if the therapist truly differentiates between therapy and coaching, it is possible for them to also serve coaching clients, including those in other states. The therapist would just need to keep the two practices clearly separate. Some potential ways of doing so include:
- Having different intake paperwork that clearly distinguishes coaching work from therapeutic work, addressing the different legal obligations that go with each
- Ensuring that no coaching services are described or billed as therapy
- Having different websites for the two practices
- Having different bank accounts for the two practices
- Having different business entities for the two practices (note that if you have two separate business entities, state and local laws may require you to have separate business licenses or permits for each)
- Avoiding moving clients back and forth between the practices, which can create confusion and misunderstanding
These are just some examples. Pieces like separate websites, bank accounts, and business entities may be legally required in some states, and optional (although still potentially good ideas) in others. As always, itâs helpful to know the specific laws of your state in order to ensure youâre fully compliant with them.
Additional steps
If youâre a therapist wanting to engage in both therapy and coaching, there are several good business coaches out there. They can help you with the process of setting up a coaching practice and developing your marketing plans for it.
Consulting with an attorney can help ensure that you are compliant with all applicable laws. Consulting with a tax or financial professional can help ensure that issues of money and taxation are handled appropriately.
Along the way, you may also want to contact your professional liability insurance carrier to ensure that your coaching work will be covered.
As usual, this is meant for general informational purposes only and shouldn’t be taken as legal advice. For guidance specific to your situation, consult an attorney.