Therapy vs. Coaching: What’s the Difference and Why It Matters

When people feel stuck, burned out, or disconnected, they often wonder if they need a coach or a therapist. At first glance, the two can sound similar — both aim to help people grow and feel better. But the difference between coaching and therapy isn’t just in titles or techniques. It’s about training, accountability, and evidence.

If you landed on my page from a google search, I'd like to introduce myself. I’m Shira Hearn, LMFT, a licensed marriage and family therapist (that is what the LMFT stands for) based in Joplin, Missouri, serving clients across Webb City, Carl Junction, Carthage, and Neosho. I specialize in Emotionally Focused Therapy (EFT) and couples counseling, helping people repair connection and rebuild intimacy. Below, I’ll explain what research says about licensed psychotherapy vs. coaching and why the difference matters for your wellbeing.

Therapists Are Trained and Licensed to Heal

Licensed therapists hold graduate degrees, complete thousands of supervised clinical hours, and are regulated by state boards. We are trained to treat depression, anxiety, trauma, and relational distress using empirically supported models like EFT, CBT, and trauma-informed care.

The research on psychotherapy spans more than five decades. A classic meta-analysis by Smith and Glass (1977) found that “the average therapy client is better off than 75% of untreated individuals.” More recent studies confirm this:

• Cuijpers et al. (2021, World Psychiatry) found psychotherapy significantly outperforms control conditions across eight major mental disorders, with moderate to large effect sizes (g ≈ 0.45–0.80).

• Davies et al. (2022) reported large real-world improvements in depression (d = 0.96) and anxiety (d = 0.80).

• Jonker et al. (2017) found psychotherapy effect sizes around g = 0.60 for depressive symptoms.

• Even after adjusting for bias, Smits et al. (2019) confirmed psychotherapy remains effective, with meaningful symptom reduction (SMD ≈ 0.20–0.30).

In other words: therapy doesn’t just make people feel better — it changes lives. It helps individuals and couples move from distress to recovery, rebuild emotional safety, and sustain those gains long-term.

Therapists Can Do What Coaches Do — and More

One common misconception is that therapy and coaching occupy completely different spaces — that therapists focus on healing while coaches focus on motivation or performance. In reality, licensed therapists are qualified to do all of the same things coaches do — such as helping clients clarify goals, improve habits, increase productivity, and stay accountable.

Therapists regularly integrate coaching-style approaches into sessions when appropriate. We help clients identify core values, create action plans, overcome procrastination, and build better communication and leadership skills. The difference is that therapists do all of this within a deeper, research-based framework that also addresses emotional patterns, relational dynamics, and underlying psychological barriers.

A licensed therapist can help a client set and achieve goals while also understanding the emotional roadblocks that get in the way — something most coaches are not trained to identify or safely manage. Therapy encompasses the entire human experience: the past that shapes us, the present that challenges us, and the future we’re trying to build.

Coaches Help with Goals — Not Mental Health Disorders

Coaches, unlike therapists, are not licensed or regulated. Many complete short certification programs, while others have no formal training at all. Their work focuses on motivation, performance, and personal goals rather than emotional healing.

Research on coaching is newer and less comprehensive:

• De Haan & Nilsson (2023) reviewed 37 randomized controlled trials and found moderate effects (g ≈ 0.59) for goal achievement.

• Theeboom et al. (2014) found coaching improved performance and motivation (g = 0.43–0.74).

• Grant (2014) noted “tendencies toward improvement” but limited evidence for mental-health benefits.

• Jones et al. (2016) found coaching improved job performance (d = 0.86) and self-confidence (d = 0.32).

These studies show that coaching can be helpful for career growth, organization, or confidence — but not for trauma, anxiety, grief, or relationship repair. Coaching is about forward movement. Therapy is about emotional transformation — and it can include the best of coaching when clients are ready for growth.

Accountability and Client Protection

One of the most important differences between therapy and coaching is accountability.

Therapists are bound by ethics codes, confidentiality laws (HIPAA), and professional oversight. If a client is ever harmed or a boundary is crossed, they have the right to file a complaint with the state licensing board that governs therapists in Missouri. This structure protects clients and ensures professional integrity.

Coaches, on the other hand, operate outside any legal or ethical regulation. Anyone can call themselves a “coach.” If something goes wrong, clients have no official avenue for recourse. There’s no governing board, no code of ethics, and no guarantee of competency or privacy.

That’s why therapy offers not only scientific reliability but also consumer protection — something coaching simply doesn’t provide.

Which One Is Right for You?

If you’re feeling emotionally stuck, anxious, disconnected, or overwhelmed — therapy is the right choice.If you’re stable but need accountability toward a goal — coaching may help.

The difference is simple: therapy heals, coaching motivates. Therapy is evidence-based, regulated, and designed for people dealing with emotional pain, relational challenges, or trauma. Coaching is helpful for short-term structure and performance in otherwise healthy individuals.

When you work with a licensed therapist, you’re working within a framework built on research, ethics, and accountability. And that makes a world of difference.

About Shira Hearn, Licensed Marriage and Family Therapist (LMFT)

I’m a Licensed Marriage and Family Therapist based in Joplin, Missouri, serving the surrounding areas of Webb City, Carthage, Neosho, and Carl Junction. I specialize in Emotionally Focused Therapy and Sex Therapy, helping couples and individuals rebuild emotional safety and intimacy.

If you’re ready to transform your relationship or reclaim your emotional health, I’d love to help. Click here to schedule a free 15 minute session to see if we are the right fit.

Resources mentioned in this post:

Psychotherapy / Licensed Therapist Studies

• Smith, M. L. & Glass, G. V. (1977). Meta-Analysis of Psychotherapy Outcome Studies. American Psychologist, 32(9), 752-760.PDF Download Gwern+1PubMed Link PubMed+1

• Cuijpers, P., Miguel, C., Ciharova, M., Harrer, M., Basic, D., Cristea, I. A., de Ponti, N., Driessen, E., Hamblen, J., Larsen, S. E., Matbouriahi, M., Papola, D., Pauley, D., Plessen, C. Y., Pfund, R. A., Setkowski, K., Schnurr, P. P., van Ballegooijen, W., Wang, Y., Riper, H., … Karyotaki, E. (2024). Absolute and relative outcomes of psychotherapies for eight mental disorders: a systematic review and meta-analysis. World Psychiatry, 23(2), 267-275.Wiley Online Library Wiley Online Library+1PMC Full Text PMC+1

  
  

Coaching / Non-Clinical Growth Studies

• De Haan, E. & Nilsson, V. O. (2023). What Can We Know about the Effectiveness of Coaching? A Meta-Analysis Based Only on Randomized Controlled Trials. Academy of Management Learning & Education.DOI / Journal Link journals.aom.org+1PDF Download erikdehaan.com

• Theeboom, T., Beersma, B., & van Vianen, A. E. M. (2014). Workplace coaching: a meta-analysis and recommendations for practice. (PMC Full Text)PMC Link PMC

• Nicolau, A., Candel, O. S., Constantin, T., & Kleingeld, A. (2023). The effects of executive coaching on behaviors, attitudes, and personal characteristics: a meta-analysis of randomized control trial studies. Frontiers in Psychology.Full Text frontiersin.org