Neurodivergent Coaching or Therapy?

Trying to figure out the differences between neurodivergent coaching and psychotherapy can be confusing. Here's a quick guide to see how they compare.

Have you been looking for support but are unsure of whether coaching or therapy is a better fit for you? It can be confusing to sort through all the differences between the two, but there are some clear differences that can help you figure out which modality best meets your needs. This discussion pertains to how things are set up in the US, so it may be different if you live in a different country.

Let’s start with therapy. Therapists are going to at least have a master’s degree and their specialty is to work with deep-seated issues in the psyche. In a session, this typically involves extensive discussion about past events, especially early childhood. The therapist does not generally make overt suggestions for lifestyle changes, but creates a space for the client to come to their own conclusions.

A time when a therapist would be a better choice than a coach would be if there are issues in the past that need to be worked through, especially if abuse was involved. Or if the individual has complex psychological diagnoses that are beyond the scope of the coach’s training. Some therapists incorporate coaching elements into sessions, so it may be possible to focus on some current challenges as well (depending on the therapist).

Often a large chunk of the costs of therapy may be covered by insurance, although not all therapists accept insurance and you may have to pay out-of-pocket anyhow to get the therapist you want. There can be long waiting lists for therapists (especially neurodivergent ones). Possibly years.

Technically a therapist can diagnose something like autism but will not tend to do so unless they feel they are qualified to do so—if they are not specifically trained in neurodivergence, they may be hesitant to do so. More often a diagnosis comes from a psychiatrist (who is also the one you go to if you are looking to get on medication).
Coaching focuses primarily on the here and now and the future you are building towards. It’s not that the past is irrelevant, it’s just not the primary focus. It addresses those Achilles’ heels that hold us back. A coach is able to give you direct feedback on what they think would be helpful for you (unlike a therapist), and will (hopefully) be working collaboratively with you to address your goals.

Neurodivergent coaches often focus on things like nervous system regulation, boundaries, unmasking, customizing your environment to better meet your sensory needs, navigating employment and relationships, dealing with/preventing burnout, time and energy management (as well as other executive function challenges) and navigating chronic health issues if applicable.

A coach can not give you a formal diagnosis, although helping you figure out your unique wiring and discussing the pros and cons of getting diagnosed is absolutely an area a coach should be able to help you with.

With coaching, you have to pay out-of-pocket (although some employers will compensate you for it so it’s always good to ask). The state does not regulate it, which means the level of training coaches have varies dramatically and it is up to you to do your homework on a prospective coach to see if their training/background matches your needs.  

The lack of red tape in coaching can also be an advantage.  You probably won’t have to spend years on a waiting list. Also, consider that someone who has lived through and come out the other side of autistic burnout is not going to be qualified to be a therapist, but as a coach they are still able to get out there and share a lot of useful tips for folks currently going through or are heading towards the same kind of burnout.

These days, a lot of the neurodivergent community is fed up with so called ‘experts’ who do not lived experience with neurodivergence and still think they have all the answers for you. We are coming to a place where lived experience is considered an essential component (although I would argue that education and training are always desirable as well).

Another thing to consider is the time commitment that may be involved. Theoretically, therapy or coaching could go on indefinitely, and sometimes does. But expert coaching is better suited for short term goals as it is not realistic to expect you can unpack your whole childhood in a few months of therapy. 

When coaching is done long term, it is usually because you began by focusing on one issue, and that issue evolved to other areas of focus over time. Life does have a way of continually presenting new challenges! So while coaching may cost more upfront, it’s also possible that you can do it for shorter periods of time or just during particularly challenging times. 
​
In short, there is a time and place for both therapy and coaching. A key question to ask yourself if you are trying to decide between them is if you feel it is more important to work through events in your past or to focus on the present and future. Finding the right person is key, even if you have to wait for it. Do your homework, ask the questions that really matter to you, and don’t feel obligated to stay with someone who is not the right fit for you. Finding the right support can be truly life changing, and it’s worth taking the time to figure out what best fits your needs.

Would you like these posts delivered directly to your inbox each week?
Subscribe for free on Substack: arikarapson.substack.com