Coaching, Therapy or Gestalt: What determines a Client’s Choice?

Ever since the profession of coaching has entered the arena of mental health services, the topic regarding which profession is better suited to assist which individuals – coaching or therapy continues. Each branch provides evidence in support for their efficacy and pros and cons have become a much debated topic among the various healthcare professionals. The following paragraphs offer a brief expose’ of salient points for each.

The Coaching profession is the new kid on the block. While coaching as such has been around for awhile in the area of sports and performance, offering coaching to the public as a possibility to improve life is a relatively recent development. Coaches consider it essential that the potential client to fulfill the prerequisite that he is creative, competent, resourceful, and whole. The purpose of coaching is to assist the individual in evaluating and creating a life he really wants according to personal values and potential, and aspirations. The coach-client relationship is one of equality and the client is believed to know best what needs to change and how. A coach assists and supports the client on this path by reflecting, offering feedback, asking questions, is sometimes challenging, and with permission offers possibilities. Homework assignments are also part of this process. The coaching profession encourages its professionals to develop specialization in various areas to better serve a broader range of services. While professional certification for coaches is encouraged, i.e. ICF, it is not required nor is in-depth knowledge of human development. Anyone hang out a shingle claiming to be a coach.

Unlike coaching, therapy has been around for a very long time. Ever since Papa Freud introduced the possibility that emotional suffering can be explored and alleviated with the “talking cure”, the focus was and remained on exploring “what is wrong”. Over time, new developmental theories flourished, as did research (assumptions) and methods to best effect “healing” human suffering. While the roots of psycho-therapy lay in the 18th century, the focus and practice in the 21st century is considered to have grown up, so to speak; it is today hardly recognizable for what it once was. In Freud’s original writings, he considered suffering a matter of the soul, and termed mental illness Seelenkrankheit (soul sickness). Today, however, findings in neurosciences have contributed largely to the change of therapeutic focus and practice. Current therapies generally reflect the values of society that the mind – thinking over doing – being – matters. While there is certainly validity in this research and practice, the humanistic practice of earlier years i.e. Rogers etc. has fallen by the wayside. Moving away from integration and Holism to fragmenting the whole person into constituent parts and treating separately i.e. body, mind, spirit, behavior, other etc. hoping to effect the whole, has been considered by many to have taken the “soul” out of therapy. The therapist has become the expert and the client is assumed to follow the expert’s advice.

Therapists are State licensed and supported by health insurances that restrict therapeutic application based on the provider’s diagnosis. One can safely claim that today the insurance companies know best, not the therapist or client.

To summarize, coaching works in the here and now toward the future, therapy concentrates on healing or lessening the pain of past or present ills.

Yet, as clear as the above sounds, the determination which service to choose requires careful consideration and frank client/professional consideration to find the best approach to accommodate the client’s needs and wants. Here is an example:

Tom approached me for therapy hoping I could put an end to his misery. He was a soft-spoken, deeply troubled single man, in his late thirties who was sober continuously for eight years after sixteen-years of cocaine/crack and ‘you name it’ addiction. He worked AA’s rigorous 12- step program, very quickly became labeled a ‘Saint’, a role model, and was in great demand as sponsor. He simultaneously spent ‘years’ in therapy to resolve extreme abuse issues from various family members. Once in the process of gaining sobriety, he began and graduated college, interned at a large international firm and within a short time became a top-level executive. “None” was his description of strengths. “If I had any, I would not be an addict.” Yet he remained extremely depressed; still he wanted to figure out what he was really all about and what was missing because he thought that he already had everything – sobriety, money, and was still unhappy. In addition, he wanted to stop feeling responsible for living the lives of others. He couldn’t imagine how his life would be different if he would wake up one day and have the life he wanted because he lived one day at a time and hated it. He hoped that things would change before he relapsed into self-destructive behavior once more (Tom had stopped attending AA several years ago).

As a Gestalt therapist and Gestalt Coach who has worked for many years with the addicted/recovered population, I was struck by his defeated attitude and posture without any awareness of his strengths demonstrating resilience, creativity, and perseverance. After exploring both therapy and coaching as a possibility to proceed, he enthusiastically (good sign) chose coaching because he was tired of “the same old, same old, been there, done that”. He agreed to see a therapist in case coaching would be insufficient.

Gestalt Theory and methodology differ greatly from the above coaching and therapy descriptions. Gestalt Therapy is a model for health. Erving Polster, the Premier Gestaltist of our times, has insisted for years that Gestalt is too good to be used only for the sick. Extremely, abbreviated, emphasis is on the Here and Now, with a holistic focus on the individual in the context of the environment creatively and interdependently cocreating experience each moment of life. Questions are posed in terms of What and How of experience and awareness of self/other is facilitated by the prudent use of experiments in the context of the paradoxical Gestalt theory of Change.