Coaching ≠ therapy: What is the real difference?

Coaching, Psychotherapy, and the 2×2 Matrix: Mapping Expertise, Co-Creation, Causality, and Meaning

TL;DR:

Coaching and psychotherapy are often distinguished by “past vs. future” or “illness vs. health,” but those categories blur in practice. A more useful distinction is a 2×2 matrix: Expert Knowledge vs. Co-Creation and Causality vs. Meaning. Traditional psychotherapy tends toward authoritative causality (expert explains causes, applies interventions), while coaching as defined by the ICF lives in collaborative meaning-making (co-constructing interpretations and action). Postmodern therapies like solution-focused or narrative therapy also fall here, making them philosophically closer to coaching. Other quadrants—authoritative meaning (e.g., Jungian, spiritual guidance) and collaborative causality (e.g., systemic therapy, action research)—show the wider spectrum. The model highlights overlaps, invites ethical reflection, and cautions coaches to refer when out of their depth. In short: it’s not just about past/future or health/illness, but about the stance we take—expert vs. co-creative, causal vs. meaning-focused.

Introduction

When I am asked, “So what exactly is the difference between coaching and psychotherapy?” I usually take a deep breath. It is a deceptively simple question with a very complex answer. Accreditation agencies, like the International Coaching Federation (ICF) or the European Mentoring and Coaching Council (EMCC) have clear definitions of what coaching is and they are adamant that it is coaches’ ethical duty to stay within the remit of their competence. Psychotherapists and their associations have their own traditions and schools of thought.

ICF defines coaching as “partnering with clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential” (International Coach Federation, 2017). The American Psychological Association (APA) adopted a resolution in which they define psychotherapy as "the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable" citing Norcross (1990). In their document “Referring a Client to Therapy” (Hullinger & DiGirolamo, 2018) the ICF likens a coach to a athletic trainer and the psychotherapist to a medical doctor specializing in sports medicine (Ibid, p. 6). According to this publication (Ibid.), the focus of coaching is moving to the future, the purpose is performance improvement, and the target population are well functioning individuals. The focus of therapy is psychopathology, the past and emotions, the purpose is healing or trauma recovery and the target population is individuals with dysfunctions or disorders (Ibid.). The ICF distinctions are useful for ethical decision making for coaches, however they buy into a view of humans beings as either “mentally healthy” or “not healthy” (or a spectrum thereof). This view in itself is a positioning which is not shared by all psychotherapeutic schools and epistemologies.

In the following, I would like to describe an alternative way of looking at useful distinctions. One way to bring more clarity is to use a visual map. Of course, reality is much more differentiated then depicted in this map – please forgive my oversimplifications for clarity’s sake. I also want to mention that I am interested in differences and not in evaluation!

I am proposing a 2×2 matrix with two axes:

1. Expert knowledge ↔ Co-creation

o Does the practitioner provide expertise, diagnosis, or solutions?

o Or do practitioner and client co-construct insights and actions?

2. Causality ↔ Meaning

o Is the focus on causes, mechanisms, and “fixing problems”?

o Or is it on meaning, interpretation, and sense-making?

Placing coaching and psychotherapy on this map yields a surprising insight: postmodern therapies are closer to the ICF definition of coaching than to “traditional psychotherapy”. This matters, because it reframes how we think about professional boundaries, ethical practice, and the evolving helping professions.

The Two Axes Explained

Expert Knowledge vs. Co-Creation

The expert knowledge end of the spectrum reflects the idea that the professional has useful expertise about what is happening, why it is happening, and how it can be changed, and it is part of their job to share these insights with the client. The therapist might diagnose depression, explain attachment styles, or teach coping strategies.

At the co-creation end, knowledge is not imposed but constructed together. The practitioner assumes the client is the expert in their own life. The work is dialogical: coach and client jointly explore, reflect, and build new narratives or possibilities without a fixed framework of diagnosis or recommended actions.

Causality vs. Meaning

On the causality side, interventions look for what causes difficulties and how to address them. The question might be: “Why do you feel anxious?” or “Which intervention reduces this behavior?” This reflects the medical model and much of traditional psychotherapy: once a “root cause” (the trauma, the attachment style, the limiting belief) has been identified, the client can change it and thereby their experience.

On the meaning side, the focus is on how people interpret their experience. Instead of asking “why,” the practitioner is curious about the stories of the client’s experience, their preferred stories, the stories that strengthen them and about how the client is making sense of things. They may ask questions like: “What does this experience mean for you?” or “What relationship would you like to have with this experience?”

The Matrix

Now we combine these two axes into a 2×2 map:

Each quadrant represents a distinct stance in the helping professions.

Expert Knowledge + Causality

Label: Authoritative Causality

This is where much of traditional psychotherapy sits. The therapist investigates underlying causes of distress, guided by expertise. Examples:

• Classical psychoanalysis: the analyst interprets unconscious drives and early childhood causes.

• Cognitive-behavioral therapy (CBT): maladaptive thoughts and behaviors are identified and corrected.

• Medical psychiatry: symptoms are explained by biological causes, treated with medication or clinical protocols.

The practitioner operates as an expert problem-solver: the goal is to uncover what is wrong and apply the appropriate intervention.

Expert Knowledge + Meaning

Label: Authoritative Meaning-Making

This quadrant is less discussed but highly relevant. Here the professional provides expert interpretations of meaning. The emphasis is not so much on causes but on helping the client understand their experience through a given framework.

Examples include:

• In Jungian analysis: therapist interprets dreams, myths, and symbols to reveal archetypal meaning.

• In directive existential therapy: practitioner explains life themes such as mortality, freedom, and isolation.

• Spiritual advice: spiritual leaders interpret the client’s experiences through a specific interpretative lens (e.g. astrology).

In these approaches, meaning is not co-constructed but conveyed by the authority of the professional worldview.

Co-Creation + Causality

Label: Collaborative Problem Analysis

Here, client and practitioner work together to explore causes. Instead of a one-way expert model, the process is joint investigation.

Examples:

• In systemic family therapy: therapist and family map out interaction patterns, feedback loops, and causal cycles.

• In motivational interviewing (in behavior change contexts): client and practitioner co-analyze triggers and obstacles to new habits.

• In organizational action research: consultant and client co-study problems, identify causal drivers, and test interventions.

The stance is still causal (“what leads to what”), but authority is shared.

Co-Creation + Meaning

Label: Collaborative Meaning-Making

This is where ICF coaching explicitly lives. The coach assumes clients are creative, resourceful, and whole. Meaning and action emerge through co-created dialogue.

It is also the quadrant where many postmodern therapies belong:

• Solution-Focused therapy: practitioner and client jointly explore preferred futures, resources, and exceptions.

• Narrative therapy: client and therapist co-author new stories, externalizing problems and highlighting unique outcomes.

• Collaborative therapy: therapy is a mutual conversation, not the application of expert knowledge.

Here, the client is seen as the expert for their lives. The practitioner’s expertise lies in their dialogic abilities.

Why This Matters

1. Clarifying the Distinction

People often draw the coaching/therapy line in terms of past vs. future or illness vs. health. As stated above, this distinction fits well with expert / causal frameworks. It does not really fit within the frameworks of co-creation / meaning frameworks. Of course, it makes political sense to go along with the dominant frameworks of illness / health and expert for mental health (aka psychotherapist) and non-expert (aka coach). However, if these distinctions blur, we might need to think about other practical ways of making sure clients receive the help that they need. In any case, those distinctions can blur in practice. A client in coaching may bring grief or stress; a therapy client may set future-oriented goals.

2. Appreciating Overlap

Postmodern therapies challenge the stereotype that therapy is always expert-driven and causal. They demonstrate that therapy can also be collaborative and meaning-focused. This brings therapy closer to coaching. Rather than guarding rigid professional borders, we can see a spectrum of practices that share philosophical ground.

3. Ethical Awareness

The matrix reminds us that ethical practice depends not only on what we do but on how we position ourselves. If a coach starts giving prescriptive advice (“here’s what you should do”), they move toward the Expert Knowledge quadrants. If a therapist insists on interpreting meaning for the client, they may cross from co-creation into authority. The map helps practitioners reflect: “Where am I on this grid? And is this where I want to be?”

Critiques and Limitations of the Model

No model is perfect, and this one has limits.

• Oversimplification: In reality, most practitioners move across quadrants. A CBT therapist may co-create meaning; a coach may occasionally draw on expertise. The matrix is a heuristic, not a box.

• Cultural variation: Some cultures expect and value authoritative meaning-making. Others emphasize collaboration. The same quadrant may look different depending on context.

• Changing practices: Modern CBT, for example, incorporates co-construction. So where to place it may depend on how it is practiced.

What is surprising is that the ICF definition of coaching and postmodern practices align – even though ICF is espousing a different epistemology when engaging in credentialing. For practitioners it might be useful to reflect on their own stance.

Caveat

Does this mean that co-creation / meaning oriented coaches can go ahead and coach clients who are experiencing mental health issues? Of course not. However, this is not because of past / future orientation of the practice or healthy / unhealthy distinctions in the target population. It is rather about familiarity with the context and coping with the emotional charge.

Psychotherapists train for years to become familiar with people who experience life very differently than others. They also learn to cope with the emotional charge of trying to help someone who is suffering. They are trained in identifying when someone might benefit from medication. Psychotherapists spend years under supervision when starting to help their clients. Coaches are not trained that way: they are most often unfamiliar with the territory. Most coaches would feel very much out of their depth in such situations: that does not make for good coaching. If you are an executive coach, for example, you would also not want to start coaching elementary school children: context matters!

As I have signed the ICF code of ethics and also following my own desire to be helpful, I will personally always refer clients when I think that I am not the best person to serve them!

References:

International Coach Federation. (2017). What is professional coaching? Retrieved from https://coachingfederation.org/about/ on 02.10.2025

Hullinger, A. M., & DiGirolamo, J. A. (2018). Referring a client to therapy: A set of guidelines. International Coaching Federation. Retrieved from https://coachingfederation.org/wp-content/uploads/2024/12/icf-research-guide-referring-client-to-therapy.pdf on 02.10.2025

American Psychological Association. (2012) Recognition of Psychotherapy Effectiveness. Retrieved from https://www.apa.org/about/policy/resolution-psychotherapy on 02.10.2025

If you would like to co-create and meaning make with us, why not join one of our free coaching meetups and exchanges?

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