Therapy, Psychotherapy, Coaching & Counselling - What do I need?

 Seven small fishing huts painted in colourful ways representing different types of therapy

The big picture

Psychotherapy, therapy, counselling, and coaching can all refer to very similar and sometimes identical approaches to supporting clients in developing insight, solving problems, and making progress on goals. The differences within each category can be as great as the differences between them. For example, two psychotherapists may use widely different therapy models, and a psychotherapist and a coach may use similar approaches when addressing a particular challenge or goal. With that in mind, there are some generalizations that can be made.

First, "therapy" is simply an abbreviation for psychotherapy. They both refer to the same thing. There are many other types of therapy that are not psychotherapy, such as massage therapy, respiratory therapy, and physiotherapy but these are rarely abbreviated as simply "therapy."

What is psychotherapy?

Psychotherapy is sometimes distinguished from counselling and life-coaching as a process that explores an individual's psychology in more depth. This depth may allow for the development of insight into foundational aspects of the self (e.g. issues of identity, sexuality, self-in-relationship, mental health concerns, and existential issues).

What is counselling?

Counselling often refers to a process of support and guidance for particular life challenges or in more specific circumstances (e.g. school counselling, career counselling, pastoral counselling) but may involve some of the same approaches that would be used in psychotherapy. 

What is coaching?

Coaching is often oriented more toward career related goals and performance and is not intended to treat mental health concerns, relationship issues and other life challenges. It usually involves helping clients clarify goals and access motivation to pursue goals in relation to career and livelihood.

Differences in education and training

A more important difference between counsellors, coaches and therapists may be the scope and amount of education and training that each has. Typically life-coaches are not trained psychotherapists or counsellors and under the new psychotherapy regulations in Ontario, they are no longer able to call themselves psychotherapists or offer anything that resembles psychotherapy unless they have the appropriate training and experience.

Finding what you need

In my own practice, I support clients in all the ways described above, as necessary, to meet their specific goals and needs.  My approach in terms of the focus on past, present, or future, depth of exploration, goal orientation, accessing motivation for change and targeting specific skills or domains for improvement all depend on client needs and are determined through consultation. There are many therapists and other mental health professionals who, like me, customize their work for each individual client. There are others who have one specific way of working that will either be a good fit for you or not. In order to ensure that you get what you are looking for, it is important to speak with the potential helping professional about your goals and needs in advance and see if their approach makes sense to you. For more information on how to choose a therapist see my article "How do I find a good therapist."


 Therapist Nat Roman

Nat Roman is a Registered Psychotherapist with a Master of Science in Couple and Family Therapy and a BA in Psychology and additional specialized training in Nonviolent Communication (NVC) processes, community based restorative conflict circles, and fifteen plus years studying, practicing and teaching mindfulness meditation practices and Buddhist psychology. In an earlier stage of life Nat worked as a professional musician and strongly believes that creativity is an essential part of life, whether one is engaged in a formal creative discipline, problem solving, or attempting to get kids off to school in the morning.