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The Alternative Board Blog

Couch or Coach: Can your business coach also be your therapist?

Nov. 25, 2020 | Posted by Jodie Shaw
listening therapist


Coaching differs greatly from therapy.

That’s according to a Harvard Business Review survey which makes the distinction that coaching focuses on the future, whereas therapy focuses on the past. The majority of the survey’s respondents maintained that coaching clients tend to be “healthy” mentally, whereas therapy clients have psychological problems.

Business and executive coaching does not and should not aim to cure mental health problems. However, in my experience not all coaching clients are mentally robust. In fact, studies have found between 25% and 50% of those seeking business or executive coaching have clinically significant levels of anxiety, stress, or depression. I am not suggesting most business owners or executives who engage coaches have mental health disorders. But some do, making it extremely important to engage the right business or executive coach who understands the differences between coaching and therapy.

Business owners and executives are far more likely to complain of difficulties in their time management, interpersonal communication, or feeling disengaged from the workplace than anxiety. Many business owners and senior executives believe stress and anxiety are just part of the job description. The majority of business owners and executives are highly unlikely to ask for treatment or therapy and may even be unaware they have problems. Plus it is not always easy to recognize depression or anxiety without proper training.

As a coach, you were most likely attracted to this career path, or calling, because you have an innate need to help others. While noble, recognize this may be your potential blind spot. Coaches who are not trained therapists can sometimes be myopic because they believe that coaching is the answer to becoming “a better version of you”.


It is critical that as a business or executive coach you understand the difference between symptoms of normal life lows, versus symptoms that require professional treatment.

As a business or executive coach the mood of your client is a prominent feature in your coaching sessions. Red flags indicating deeper issues include signs of depression, anxiety attacks, alcohol or drug addictions, personality disorders, and paranoia. If your coaching client is stuck in a victim role or emotional drama, not showing up, not following through, has serious emotions in more than one coaching session, or is expressing to you that they cannot go on, these are definite signs professional help is needed. When the client tells you their coach, "You are the only one who cares about me," this should be seen as a red flag. Other red flags include persistent anger or aggression, suicidal thoughts and ideation, self-destructive impulses or behaviors, and extreme dependency.

Depression varies from person to person, but there are some common signs and symptoms. The more symptoms your client has, and the stronger they are, and the longer they’ve lasted—the more likely it is that your client may be dealing with depression. When these symptoms are overwhelming and disabling, that's when it's time to recommend to your client that they seek help.


Signs and symptoms of depression include:

  • A bleak outlook—nothing will ever get better and there’s nothing they can do to improve their situation.
  • No interest in former hobbies, pastimes, or social activities. Your client has lost their ability to feel joy and pleasure.
  • Significant weight loss or weight gain—a noticeable change in body weight in a month.
  • Insomnia, especially waking in the early hours of the morning, or oversleeping
  • Your client feels agitated, restless, or even violent. Their tolerance level is low, their temper short, and everything and everyone gets on their nerves.
  • Feeling fatigued, sluggish, and physically drained. Your client complains their whole body feels heavy, and even small tasks are exhausting or take longer to complete.
  • Your client harshly criticizes themselves for perceived faults and mistakes.
  • They verbalize thoughts of self-loathing and have strong feelings of worthlessness or guilt.
  • They engage in reckless or escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • They have trouble focusing, making decisions, or remembering things.
  • They complain about unexplained aches and pains such as headaches, back pain, aching muscles, and stomach pain.

As a business or executive coach you have a responsibility to understand when your client may need therapy, not coaching. I recommend you meet with a therapist (or two) in your area, that you can refer any of your clients to who are showing signs they may help outside of what coaching should provide.

Read our 19 Reasons You Need a Business Owner Advisory Board


Written by Jodie Shaw

Jodie is responsible for growing the brand internationally and helping TAB Business Owners attract new TAB Members in their local markets.

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