Coaching and Cognitive Behavioral Therapy  similarities and differences.
Tomasz Szymanski MSc, MA, BA (business coach)
Katarzyna Jakuszkowiak-Wojten  PhD, MD (psychiatrist, psychotherapist)

Introduction
Coaching and psychotherapy have the same roots. Modern psychotherapy is the result of more than a hundred years of research, it is a method of treatment of mental disorders. In the mid-twentieth century psychological counseling and therapy began to change direction, recognizing that patients have the ability to change and development themselves.

This change of perspective gave rise to the field of coaching in the early nineties.

Coaching has developed through progress in psychotherapy and has been applied in counseling and personal development trainings. Coaching, both the one used for personal and professional  development, has become one of the hottest trends in the field of self-improvement and in recent years has gained a reputation as one of the most powerful tools for personal and professional development.

Cognitive  Behavioral Therapy has been applied in the treatment of an impressive number of mental disorders i.a. affective disorders, anxiety and personality disorders. Cognitive behavioral therapy techniques are also used to treat people with somatic illnesses, eg. diabetes, hypertension, cancer.

Cognitive behavioral therapy
Cognitive-behavioral model integrates the knowledge of the etiology of mental disorders and their treatment. The therapist not only helps the patient overcome the symptoms of the disease and its psychosocial consequences, but in certain psychiatric disorders prepares for the inevitable recurrence (in case of stress, changes, without any specific reason).

Therapy is all about stability of life, compliance with medical recommendations, preventing relapse of disorders and hospitalization, it causes self-observation of feelings, activities, problem solving. Objectives and methods of treatment are established with the patient. In order to determine a hierarchy of therapy objectives, clinical assessment of the patient’s mental state is required.

Cognitive-behavioral therapy is limited in time, based on cooperation; motivation and commitment of the patient is crucial, the quality of the therapeutic relationship. One must keep in mind that the symptoms of cognitive and affective mental disorders have an impact on the course of therapy sessions.

At the beginning of therapy the therapist explains the cognitive-behavioral model; the patient learns the simplest methods of monitoring emotions, thoughts and behaviors. The first step of proper cognitive-behavioral therapy is conceptualization – answers to questions which constitute a problem for the patient, why it was not recognized by the patient and what led up to it.

Therapist formulates hypotheses and in the course of further treatment verifies them. Albert Ellis ABC model is considered to be the most useful and a starting point for other models of psychiatric disorders. It is a model of understanding patient’s problems, in which A is an event activation, -B belief, C – consequence (emotions, physical symptoms and behavior). According to this model, it is not the situation that is important but its interpretation.

People perceive reality in a specific way. Beck introduced the concept of cognitive distortions that occur in all humans, but in psychopathology their occurrence is more intense, some of which are specific to particular disorders. In cognitive-behavioral therapy in order to improve the mental state of the patient’s welfare, cognitive and behavioral methods are applied.

Table 1. Selected techniques of cognitive-behavioral therapy.

cognitive techniques
behavioral techniques
guided discovery
exposure techniques
downward arrow
modeling
clarification
changing conditions with dysfunctional behavior
Flashcards

looking for evidence of particular beliefs
activity planning
examining the consequences of predictions, ideas
behavioral experiments

Decatastrofization biofeedback
role playing
breathing exercises

Recognizing cognitive distortions
relaxation training
Paradoxic intervention
mindfulness training
distracting and directing attention
progress reports
record  of automatic thoughts

COACHING
Coaching is a partnership with the client in a thought provoking and creative process that inspires the customer to maximize their personal and professional potential. The word provocation carries an important meaning here, coaches’ questions  are to trigger strong emotions in a way that the clients, who are often also referred to as coachees, use them in the most efficient way to achieve their goals.

The coaching  relationship should remain free from advice, as long as the coach is an expert in the field discussed with the customer, and can answer their questions beyond the coaching session. Coach must completely accept the client’s values and beliefs. If the coach encounters in their work people whose views or preferences they are not able to accept, they should not enter into cooperation.

Coaching presupposes that the client has all the resources they need, the coachee takes responsibility for their lives and decisions made during the coaching sessions. The job of a coach is only to help draw conclusions, and indicate where to find resources and create an atmosphere of trust, acceptance and full confidentiality. The objective in Coaching is determined exclusively by the client.

Coach is merely accompanying the client in the development, clarification and verification of the feasibility of the goal. Within business coaching, the goal may be set by the coachee’s employer. Coaching is time-limited, depending on the complexity of the situation, the number of sessions may vary in certain cases. Coaching takes into account the existence of psychological problems that result from negative, self-limiting thoughts and beliefs, emotional problems and unproductive behavior.

Coach takes into account in their work achieving a particular purpose, e.g. Procrastination, hesitancy, low self-esteem of the client, cognitive distortions. In coaching, when working with cognitive distortions, cognitive-behavioral methods are applied. They are used, however, in relation to people whose functioning is not affected to the extent of completely distorting their lives.

The most commonly applied model in coaching is GROW created in the late seventies and eighties by Alan Fine’a and Graham Alexander, then disseminated by John Whitemore. GROW model consists of four stages: Goal, Reality, Options – Opportunities, Will – Way Forward. The first of them – Goal focuses coachee’s attention on what they want to achieve. Please note that the client is temporarily moved away from the negative emotional aspects of its implementation.

This approach reinforces the commitment and motivation of the customer in the implementation of the intended goal. Numerous clients tend to recognize their objectives and actions in a pejorative way, which may take the form of complaints and denial. The job of a coach is to reformulate the client’s goal from a negative form to a positive one e.g. ,,I do not want this job”  to ,, I want another job.”

GROW model focuses on client’s concerns and broadly defined problems in its subsequent stages. There are numerous tools applied in the formulation of goals. One of them is the SMART model (Specific; Measurable  Achievable; Realistic, Time based). This model allows to achieve a strictly defined goal, i.e. the client knows exactly what they want to achieve, if achieving the objective is possible and when it will be achieved and what will indicate that the goal has been achieved.
An essential element of properly defined objective is to determine whether it is consistent with the beliefs and values of the client. In the absence of compatibility between them, the goal should be reformulated or changed. The second stage of the GROW model, is Reality- focus on the current situation of the client. The job of the coach at this stage is to help the client in understanding their situation, emotions, the reasons for which they want to achieve the goal, and change various aspects of their lives.

It is likely that at this stage negative emotions may occur, destructive cognitive distortion, dissatisfaction with the current situation, professional or personal, resistance to change, defensive behavior. At this stage, the coach is working on weakening of the influence of factors that disturb the process of achieving the desired goal, it also focuses on accumulating resources.

Resources can include e.g. Time, money, knowledge, skills, personality traits, knowledge, i.e. everything that can bring the client closer to achieving the objective. The third stage is the Options or Obstacles. This is the stage of planning. Coach creates a space in which the customer will be able to objectively assess whether specific objectives have a chance of success.

Clients verify their current situations, predict what type of obstacles may encounter whilst attempting to achieve the goal, prepare for possible failures, plan alternative courses of action.

The fourth stage  WILL focuses on implementing individual plans in the client’s life. Coach using detailed questions supports the client in clarifying previously created plans. The client embeds them in a specific time frame, specifies individual actions and introduces contingency plans in case of failure.

The task of the coach at this stage is to assist the client in maintaining motivation and energy. Celebrating the achieved milestones. This is especially important in the implementation of long-term objectives.

Table 2. Selected techniques and tools used in coaching.

Techniques and tools used in coaching
Map of goals and dreams
Mirror method
Time management matrix
Association and dissociation

Change of perspective
Brainstorming
First step
Wheel of priorities
Visualization
Starting with a vision of the end
Presentation of experience
Disney strategy
SWOT analysis

Visualization method of making choices
4 levels of skill development
Dilts logical levels model
Planning activities
Behavioral experiments

Anchoring
Scaling
Cartesian diamond
Dramatic triangle
Questions about the miracle

Table 3. Main differences between coaching and cognitive behavioral therapy, The list of differences is much longer due to the multiplicity of approaches and therapeutic tools as well as the coaching ones, however, for the purposes of the article, we focus on the most significant ones.

Coaching / Cognitive-behavioral therapy CBT

who is it addressed to

COACHING
client, coachee

CBT
patient with a diagnosis of mental disorders, patients with chronic somatic illness

Time focus

COACHING
focuses on the present and the future

CBT
can also touch the past, focused on the present and future

Objective

COACHING
focuses on the development and maximization of personal and professional potential and the acquisition of new skills, which are expected to bring improvement in the client’s situation

CBT
often focused on aspects of psychopathology, but also learning new skills and development

source of problems

COACHING
problems usually have their origin in the customer’s relationship with the environment, often stem from a desire to broader environmental change

CBT
problems can be a source of both external interactions and result from intrapsychic processes and problems

confidentiality

COACHING
All information is strictly confidential, but in the case of business coaching client – employee, coach and employer jointly agree on the goals of the coaching session

CBT
All information obtained during the session must remain strictly confidential

The length and place of meetings

COACHING
meetings usually last from 60 – 90 minutes, in coaching the number of meetings can range from a few to several meetings held at the place chosen by the client or coach

CBT
sessions usually last 60 minutes and are usually held once a week in a place designated by the therapist

Choosing a coach / psychotherapist

COACHING
the client chooses the coach / in case of business coaching coach is chosen by the employer

CBT
The patient chooses a psychotherapist

Summary
Coaching and psychotherapy often look and sound similar. In both cases we are dealing with forms of support. They are very often conducted  in the same way, through regular meetings or by telephone.

Most importantly, both forms of support are focused on the transfer of a person from the place they found themselves, to the place where they wish to be. Experienced coaches tap into cognitive behavioral therapy – and other therapeutic approaches oriented on solutions, from cognitive psychology and the latest developments of positive psychology.

In justified cases, coaches recommend the client to take part in psychotherapy. By comparing the process of coaching and cognitive-behavioral therapy we would like to expand the perspective that can be used to create and use tools from both fields supporting the development of the client.

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