“Should I see a coach or a therapist?” It’s one of the questions I’m asked most often. Both can be hugely helpful, they overlap in places, and many people benefit from both. But they’re different tools, designed for different jobs.
The key differences
Therapy (counselling or psychotherapy) helps you understand and work through emotional difficulties. It might explore the past, patterns in relationships, trauma, anxiety, depression or identity. It’s often the right choice when distress is affecting your daily life, or when something from your past keeps showing up in the present.
Coaching is more practical and forward-focused. It helps you set goals, build systems and take action. ADHD and neurodivergence coaching, for example, might focus on organisation, time management, routines, study or work. It assumes you’re broadly coping, and helps you do more of what you want to do.
A simple way to think about it: therapy often asks “why?” and “what’s going on?”; coaching often asks “what next?” and “how?”.
What the evidence says
There’s a strong evidence base for psychological therapies for many mental health difficulties, with the quality of the relationship one of the most reliable predictors of success (see “‘Will I Have to Explain Myself?’ Why the Fit with Your Therapist Matters”). Evidence for coaching, particularly ADHD coaching, is promising but still developing (see “Does ADHD Coaching Actually Work? An Honest Look at the Evidence”).
A grain of glitter on regulation ✨
In the UK, neither “therapist”, “counsellor” nor “coach” is a protected title, so technically anyone can use them. For therapy, look for someone on a register accredited by the Professional Standards Authority, such as those held by the BACP, UKCP or National Counselling and Psychotherapy Society. For coaching, there’s no equivalent statutory system, but professional bodies such as the International Coaching Federation, the EMCC and the Association for Coaching have codes of ethics. For ADHD coaching specifically, ask about training and experience with neurodivergent clients.
When you might want both
- You’ve had a late diagnosis and want to process the emotional impact and build practical systems.
- Shame or anxiety is getting in the way of putting strategies into practice.
- You’re working on goals, but old patterns keep tripping you up.
As someone who’s trained in both, I can help you work out which approach suits you best, or blend them where that makes sense. And if you need something I can’t offer, such as an assessment or medication, I’ll help you find the right route.
Some days a unicorn needs a good long talk in the stable. Other days, it needs someone to help plan the route across the meadow. Both are worth having.
Further reading
- Professional Standards Authority: Accredited Registers
- Lauder, K., McDowall, A. & Tenenbaum, H. R. (2022). Frontiers in Psychology