What is Coaching and How is it Different from Psychotherapy

What is Coaching?

Coaching is a powerful process uniquely designed to empower clients to create personal solutions based on identifying and tapping into their own inner abilities.  It provides accountability, a non-judgmental confidant, a place to brainstorm, vent, overcome past adversities, fears or challenges, and recognize opportunities. Coaching is a means of empowering you to move from where you are now to where you want to be. You will uncover answers, make important decisions, refine your purpose and vision, strategize, and plan, and make the necessary changes to succeed. 

Coaching refers to the activity of a coach in developing the abilities of clients. Coaching tends to focus on helping clients achieve specific goals or skills. The methods used in coaching tend not to be directive or interpretive but rather relies on powerful questioning to facilitate the client in moving toward solutions that they identify as important to them.  Coaching lies on a scale on which mentoring, and training are on one end, and psychotherapy and counseling on the other.

Today, coaching is a recognized discipline used by many professionals to achieve personal development and obtain personal or professional goals.  However, as a distinct profession, it is relatively new (since 1990) and self-regulating (except for international professional associations). No independent supervisory board evaluates practicing coaches; however, there are schools that provide certification to coaches (e.g., Institute for Professional Excellence in Coaching or iPEC) and professional associations that provide accreditation for individual coaches based on fulfilling rigorous educational and practice requirements (e.g. the CCF).

Life coaching is a future-focused practice with the aim of helping clients determine and achieve personal goals. Life coaches select from among several methods to help clients set and reach goals. Coaches are neither therapists nor consultants; psychological intervention and business analysis are outside the scope of practice. Life coaching has its roots in executive coaching, which itself drew on techniques developed in management consulting and leadership training. The coach may apply mentoring, values assessment, behavior modification, behavior modeling, goal-setting, and other techniques designed to help a client. 

Multiple coach-training schools and programs are available, allowing for many options (and sometimes causing confusion) when an individual decides to gain “certification” or a “credential” as they apply to the coaching industry. Various certificates and credential designations are available in the field of coaching. 

Government bodies have not found it necessary to provide a regulatory standard for coaching, nor does any state body govern the education or training standard for the coaching industry; the title of “coach” can be used by any service provider. Critics assert that life coaching is akin to psychotherapy without restrictions, oversight, or regulation.  The State legislature of Colorado, after holding a hearing on such concerns, disagreed, asserting that coaching is unlike therapy because it does not focus on examining nor diagnosing the past (Colorado General Assembly, Digest of Bills – 2004, Professions and Occupations Retrieved April 3, 2006).  Instead, coaching focuses on effecting change in a client’s current and future behavior. Additionally, life coaching does not delve into diagnosing mental illness or dysfunction.

Coaching & Psychotherapy

As indicated earlier, while I do have a Ph.D. in clinical psychology, I am not a Licensed Psychologist.  It is important to understand the distinction between coaching and psychotherapy. While there are similarities (e.g., both coaching and psychotherapy utilize knowledge of human behavior, motivation and behavioral change, and interactive counseling techniques), the major differences are in the goals, focus, and level of professional responsibility. Psychotherapy is a health care service and is usually reimbursable through health insurance policies. This is not true for coaching.

The focus of coaching is development and implementation of strategies to reach client-identified goals to enhance performance and personal satisfaction. Coaching may address specific personal projects, life balance, job performance and satisfaction, or general conditions in the client’s life, business, or profession. Coaching utilizes personal strategic planning, values clarification, brainstorming, motivational counseling, and other counseling techniques.

The primary foci of psychotherapy are identification, diagnosis, and treatment of mental or psychological disorders. The goals of psychotherapy include alleviating psychological symptoms, understanding the underlying dynamics which create symptoms, analyzing past relationships responsible for current symptoms, changing dysfunctional behaviors that are part of serious emotional problems, and developing new strategies for ameliorating psychological symptoms. The targets of psychotherapy are the range of serious psychological disorders described in the Diagnostic and Statistical Manual-5 published by the American Psychiatric Association in 2013. 

The relationship between the coach and client is specifically designed to avoid the power differentials that occur in the psychotherapy relationship. The client sets the agenda, and the success of the enterprise depends on the client’s willingness to take risks and try new approaches. The relationship is designed to be more direct and challenging. You can count on your coach to be honest and straightforward, asking powerful questions and using challenging techniques to move you forward. You are expected to evaluate progress and when coaching is not working as you wish, you should immediately inform me, so we can both take steps to correct the problem. To discuss coaching further, please contact me at: dmgarner@gmail.com.

Comparing Anorexia Nervosa and Bulimia

A PhD graduate of York University, Dr. David M. Garner led the Sylvania, Ohio’s River Centre Foundation beginning in 2000 until 2021 in his role as the president of the board of directors. Now based in Arvada Colorado, Dr. David M. Garner has published numerous articles over the course of his career, including several leading papers with the medical journal Psychological Medicine on the topics of anorexia nervosa and bulimia.

Anorexia nervosa and bulimia are two eating disorders that share many similarities, but that also have several key differences. The most significant similarity between the two conditions is that individuals exhibit distorted images of their bodies. These images precipitate harmful food-related behaviors.

In both disorders, individuals typically restrict their eating in an attempt to lose body weight.. This can range from a severely limited intake of food to no food whatsoever. Patients with both disorders typically lose significant body weight, the difference being that it anorexia nervosa, the individual losses to a relatively low body weight and typically experiences severe starvation symptoms that can be life-threatening.

Individuals living with bulimia nervosa seek to control their distorted body image severely limiting their food intake with alternative bouts of eating excessive amounts of food and then purging or pursuing some other method of weight gain prevention. Of interest, about 50% of anorexia nervosa also exhibit the pattern of binge eating followed by some form of purging behavior. Individuals with both disorders may engage in a dangerous amount of exercise to limit weight gain. They will continue to exercise as a form of body control to the point of injury.

Eating disorders like anorexia nervosa and bulimia nervosa are fairly common in the United States, impacting upwards of 30 million people. While these disorders are not intrinsically linked to gender, they have had a disproportionate impact on women. Around 1 percent of US women will develop anorexia at some point in their lives, while 1.5 percent experience bulimia nervosa.

Cognitive-Behavioral Therapy for Anorexia Nervosa Treatment

David M. Garner, Ph.D., is based in Arvada Colorado and continues his long career as an eating disorder researcher. Dr. David M. Garner has co-authored numerous articles in his field, including the chapter “Cognitive-behavioral Therapy for Anorexia Nervosa” (Handbook of Treatment for Eating Disorders, 1997). The context of this book chapter was one in which cognitive-behavioral therapy had established a compelling track record over the past decade when it came to bulimia nervosa treatment. This was reflected in its status as the “treatment of choice” when addressing the eating disorder.

By contrast, cognitive-behavioral therapy’s effectiveness in treating anorexia nervosa was not as well demonstrated. While there had been five dozen follow-up studies of anorexia nervosa over the past 44 years, few had offered controlled trials that compared various treatment approaches.

One major aspect of this limited research was the relatively low incidence of anorexia nervosa compared to bulimia nervosa, as well as the extended length of required treatment. Additionally, treatment required hospitalization in a number of cases, with the needs of emaciated anorexic patients often extending beyond inpatient care to include outpatient psychotherapy for a period of years.

According to Harvard Health, the current paradigm for anorexia nervosa treatment is a multidisciplinary one encompassing psychological counseling, nutritional support, and behavioral modification. Cognitive-behavioral therapy is employed as a way of enabling patients to recognize and change thought patterns about food that are “distorted or maladaptive.”

Dr. Garner currently practices as a certified life coach helping clients realize potential personal and career goals, benefit from life transitions, improve communication in personal and work relationships and overcome obstacles or challenges that interfere with choosing a life-enhancing course of action.  I use a solution-focused, problem-solving approach and areas in which I specialize include family communication, parenting, personal development, health care advocacy, life transitions, goal achievement and developing healthy eating patterns.

Four Tips for Supporting a Person with an Eating Disorder

Currently based in Toledo, Ohio, Dr. David M. Garner studied at the Toronto-based York University to earn his PhD in clinical psychology. Dr. David M. Garner is a leader in the fields of psychology and psychiatry, and has served as a professor, researcher, and the founder and president of an eating disorder treatment facility.

Providing support to someone who has an eating disorder can encourage them to seek the help they need to hopefully recover from their illness. Consider the following strategies when dealing with a person who has an eating disorder:

1. Encourage the person to seek expert assistance. Ask them to start by getting a professional assessment from an eating disorder specialist, but be careful not to push them to make a commitment to undergo treatment.

2. Offer resources on where to seek help. Provide the person with information regarding professional services, but allow them to read it at a time of their choosing.

3. Let the person know you are there to support them. Since it is common for people with eating disorders to feel isolated, it is important to let them know you care about them and want to help them.

4. Acknowledge them as a whole person rather than simply someone who has an eating disorder. Refrain from focusing on the person’s eating behaviors, and instead see them as an individual with other positive qualities.

The Int. J. Eating Disorder’s Widely Cited 1983 Article on EDI

The president of the board of directors of the River Centre Foundation in Greater Toledo, Ohio, Dr. David M. Garner holds a PhD in clinical psychology and certification as a life coach. Over the course of his career, he has authored or coauthored more than 200 articles and abstracts. Dr. David M. Garner has also written book chapters and edited entire textbooks.

His most widely cited article is “Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia.” Published in the March 1983 issue of the International Journal of Eating Disorders, this article has since amassed more than 5400 citations in other peer-reviewed articles.

“Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia” describes a new assessment tool in the form of the Eating Disorder Inventory (EDI) questionnaire. Allowing patients to report on their own psychological and behavioral traits, the EDI assesses 64 items according to multiscale criteria. Each of these items cover characteristics that are common to both anorexia nervosa and bulimia. The subscales of the EDI consist of bulimia, drive for thinness, body dissatisfaction, perfectionism, ineffectiveness, interpersonal distrust, interoceptive awareness, and fears of maturity.

New Study Connects Childhood Autism with Adolescent Eating Disorders

A former clinical assistant professor at the Department of Pediatrics at the University of Toledo Medical College, David M. Garner, PhD, serves as an academic researcher focused on completing research on eating disorders. David M. Garner has coauthored multiple works on the topic of bulimia nervosa, including the paper “Body dissatisfaction in bulimia nervosa: relationship to weight and shape concerns and psychological functioning.”

A new study by the University College London (UCL) suggests that adolescent eating disorders are more likely to occur among children who display autistic characteristics at age seven. The study centered on 5,381 adolescent participants in the University of Bristol’s Children of the 90s study, and researchers assessed whether autistic traits had developed among the participants across multiple ages, including 7, 11, 14, and 16.

An important note, the researchers relied on the mothers of the children to report supposed autistic traits, meaning the study may have included adolescents who were not autistic as well as those who had yet to be diagnosed.

After assessing autistic traits, the researchers looked for signs of eating disorders among the participants. Its findings showed that children who exhibited higher autistic characteristics at age 7 were 24 percent more likely than other children to develop an eating disorder by age 14.

Research on Treatments for Eating Disorders

Dr. David M. Garner holds a PhD. in clinical psychology and held academic positions as Professor at the University of Toronto and Michigan State University and founded the River Centre Clinic before assuming his current role of President of the River Centre Foundation. In this role, Dr. David M. Garner has published extensively on treatment of eating disorders including pharmacotherapy, psychotherapy and approaches to nutritional rehabilitation. In addition, he has developed the two must widely cited psychometric instruments used in the eating disorder literature. Dr. Garner has been a pioneer in research on psychological and drug treatments for eating disorders.

In recent research on drug treatments for eating disorders, Dr. Garner and colleagues concluded that the prescription of psychotropic medication for those with eating disorders is widespread in clinical practice and is discrepant with published evidence-based guidelines. This study found that the majority of adolescent and adult anorexia nervosa patients were on some form of psychotropic medication despite practice guidelines showing that drug treatments for these patients are not simply not effective (see Dr. Garner on Research Gate or Google Scholar for a copy of this study).