CAMFT’s Legal Department routinely receives calls from pre-licensed and licensed members who want to better understand the differences between coaching and therapy and whether it is lawful and ethical for pre-licensees and licensees to provide coaching services. This article answers the most frequently asked questions. Show COACHING vs. THERAPY: Frequently Asked Questions CAMFT’s Legal Department routinely receives calls from pre-licensed and licensed members who want to better understand the differences between coaching and therapy and whether it is lawful and ethical for pre-licensees and licensees to provide coaching services. Here are answers to the most frequently asked questions. How is coaching different from
psychotherapy? Since coaching is self-regulated as opposed to government-regulated, the practice of coaching is broadly defined. For example, according to the ICF, coaching is the future-focused practice of partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. Professional coaching focuses on setting goals, creating outcomes, and managing personal change.2 The IAC defines coaching as a transformative process for personal and professional awareness, discovery and growth.3 According to the IFC, a coach is responsible for discovering, clarifying, and aligning with what the client wants to achieve; encouraging client self-discovery; eliciting client-generated solutions and strategies; and holding the clients responsible and accountable for meeting goals and creating outcomes. For these reasons, coaching often relates to career development, achievement, and advancement. While these definitions are instructive to a degree, the lack of a regulated scope of practice could make the boundaries of a coaching relationship somewhat nebulous. Without a universally recognized definition of coaching, perhaps it is more helpful to explain what coaching is not and when the actions of a coach may constitute an unlawful practice. Legally, coaches are not psychotherapists. Pre-licensees and LMFTs who are considering working as a coach must understand how and why coaching is distinct from the work of a psychotherapist. The practice of psychotherapy, whether as a marriage and family therapist, clinical social worker, psychologist, or professional clinical counselor, is defined under state law. According to Business and Professions Code Section 4980.02 (effective January 1, 2022), the practice of marriage and family therapy shall mean the application of psychotherapeutic and family systems theories, principles and methods in the delivery of services to individuals, couples or groups in order to assess evaluate, and treat relational issues, emotional disorders, behavioral problems, mental illness, alcohol and substance use, and to modify intrapersonal and interpersonal behaviors. This section of law also explains that the application of marriage and family therapy principles and methods includes, but is not limited to the following specific areas:
As part of their educational requirements for licensure, LMFTs receive cross-cultural training, specific instruction in alcoholism and other chemical substance dependency, as well as psychopharmacology. LMFTs diagnose and treat severe mental illnesses such as: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, obsessive-compulsive disorder, autism, anorexia, and bulimia. LMFTs also routinely work within county mental health agencies, hospitals, prisons, and jails treating serious mental illness and alcohol and drug dependency. Unlike licensed psychotherapists or properly supervised registered associates, coaches do not have the legal authority and, therefore, may not lawfully diagnose or treat their clients’ mental health illnesses. This is true regardless of whether a coach has received education and training similar to that of a psychotherapist. Furthermore, coaches may not delve into the past, provide a cure to a mental illness, or relieve mental and/ or emotional suffering. Coaches may not seek to resolve the deeper underlying issues that cause serious mental and/or emotional problems. A coach who addresses issues of mental health or relationships without being appropriately licensed may be unlawfully practicing medicine and/or psychotherapy without a license. For example, a pre-licensee who concludes a job or volunteer position as a properly supervised Registered Associate Marriage and Family Therapist, but continues to treat his or her therapy clients without proper supervision under the guise that he or she is doing “coaching” could be accused of unlawfully practicing without a license. Can Registrants or licensees advertise coaching services under their registration or MFT license? Do coaching clients have the same rights to confidentiality and privilege as psychotherapy clients? Confidentiality is both a legal and an ethical concept involving a restriction on the release of private information that is defined by various state and federal laws and ethical standards.5 Section 56 of the California Civil Code, otherwise known as the Confidentiality of Medical Information Act, describes confidentiality and its various exceptions, under California law.6 According to this statute, any information that a therapist maintains, whether electronically or in some other form, that documents or describes his or her assessment and/or treatment of a patient (whether or not still living), including information that contains any personal identifying information that would be sufficient to identify a patient, is confidential.7 The unauthorized disclosure of confidential information by a psychotherapist is designated as a form of unprofessional conduct under the California Business and Professions Code.8 California law further protects the confidential nature of psychotherapeutic relationships by recognizing that those relationships are privileged.9 The psychotherapist-patient privilege requires a psychotherapist to9. Client Education withhold records and testimony when a subpoena is served and the therapist has not received a release of authorization from the client or the client has indicated that he or she does not intend to waive privilege. Although coaching clients have a general right to privacy regarding certain information, including, but not limited to, finances, sexual history, physical or mental health,10 the laws and regulations that govern a psychotherapy patient’s right to confidentiality and privilege do not apply to coaching relationships or the information shared by a coaching client. In other words, because coaching is not psychotherapy and because clients are not considered patients under the laws that protect psychotherapy patients, coaching clients could not successfully assert the psychotherapist-patient privilege in regard to records that may exist and/or information that may have been shared as the result of a coaching relationship. Unfortunately, this point is not made clear in the Code of Ethics for coaching being promulgated by the IAC. The provisions of the IAC’s ethical code regarding the confidentiality of coaching relationships are misleading because they mischaracterize a coaching client’s right to privacy as a right to confidentiality. However, it is important to understand that those rights are not one in the same and that a mischaracterization may create an unreasonable expectation on the part of coaching clients that they enjoy a right to confidentiality as afforded by California law. Therefore, prior to establishing a coaching relationship with a client, coaches should make clear that although they will do their utmost to respect a coaching client’s right to privacy, that right to privacy is not the same right to confidentiality that is enjoyed by psychotherapy clients. Are agreements for coaching the same as agreements for psychotherapy? Can pre-licensees or LMFTs simultaneously provide therapy and coaching services to a client? Pre-licensees and LMFTs who simultaneously provide therapy and coaching services to a client, may be engaged in an unethical dual relationship with that client. According to section 4.8 of the CAMFT Code of Ethics, marriage and family therapists, when engaged in professional roles other than treatment or supervision (including, but not limited to coaching), act solely within that role and clarify as necessary, in order to avoid confusion with consumers and employers, how that role is distinguished from the practice of marriage and family therapy. In order to avoid the creation of an unethical dual relationship, professionals who are already engaged in a therapeutic relationship with a client should refrain from offering concurrent coaching services to that client. Therapists and registrants may, however, utilize coaching techniques as part of their therapy practice in order to aid clients in achieving their treatment goals. Can a coaching client subsequently become a therapy client and vice versa? Psychotherapists who are thinking about transitioning from a therapeutic relationship to a coaching relationship may want to put themselves in the shoes of their therapy clients and consider how difficult, if not impossible, it may be for a therapy-turned-coaching client to alter his or her understanding of the relationship and to maintain the boundaries of the new relationship. If it is clear that a client is unable to maintain proper boundaries, it is the coach or psychotherapist’s responsibility to consider whether it is in the best interests of the client to terminate that relationship. Furthermore, coaches and psychotherapists should explain to their clients that once one type of relationship is established it may be ethically inappropriate to terminate that type of relationship for the sake of beginning another type. For example, a client who is moving from California to New York might ask a therapist if it possible to terminate the therapeutic relationship and enter into a coaching relationship so that they can continue working together. If it is the therapist’s professional belief that based on client’s presenting issues and/or diagnosis the client should continue seeing a therapist, it would be unethical for a therapist to terminate the therapeutic relationship and begin coaching the client just so that he or she could continue seeing the client. Before making a decision about whether to engage in a therapeutic relationship with a former coaching client or a coaching relationship with a therapy client, it would be wise to consult with a member of CAMFT’s Legal Department and obtain clinical consultation from colleagues. Does the malpractice insurance I have as a MFT pre-licensee or
licensee cover my work as a coach? Conclusion Sara Jasper, JD, is a staff attorney for CAMFT. Sara is available to answer member calls regarding legal, ethical, and licensure issues. Endnotes 1 The website for the International Coach Federation is www.coachfederation.org. The website for the International
Association of Coaching is www.certifiedcoach.org Are life coaches the same as therapists?The major difference between therapy and life coaching is the focus of the work: therapy focuses on mental health and emotional healing, while life coaching focuses on setting and achieving goals.
What is the difference between a coach and a therapist?Therapists manage mental illnesses and diagnoses, coaches do not. Coaches work with clients for short periods of time. Therapists can work with clients for long stretches. Often therapists are focused on the past and present, while coaches are future-oriented.
Is coaching better than therapy?Generally speaking, coaching is more focused on helping you achieve your future goals, while psychotherapy tends to have more of a past and present focus.
What does a life coach do exactly?A life coach is someone who counsels and encourages clients through personal or career challenges. A life coach helps guide clients to reach their ultimate goals. A life coach can help individuals in different areas of their life. But because each human being is different, so will their goals.
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