A call with a potential client yesterday reminded me why I provide emotionally focused psychotherapy to individuals with learning differences instead of exclusively coaching them. He described how his challenges meeting deadlines and finding a professional path have provoked symptoms of depression and low self-esteem, and that while he was looking for concrete strategies to improve his organization, he did also genuinely want to rebuild his self-confidence and overall well-being. Experience and research tell us that learning differences are often comorbid with mental illnesses and other conditions (Silver, 2013). Therefore, mental health treatment is often highly indicated when working with these individuals. Unfortunately, there is a false dichotomy among mental health professionals between coaching and psychotherapy, one that may often lead someone to receive these services from different providers. However, I have found that treatment for individuals with learning differences is often most effective when both methods are offered by a trained psychotherapist, ultimately helping that person to achieve the success and outcomes he or she desires.
Many of the individuals I have worked with have stated that they found either exclusive psychotherapy and or coaching to be ineffective. When I discuss this with them, they may make statements such as “I felt like we talked about the same issues over and over again, but I never learned how to change my situation,” or “I feel like my coach wanted me to make all of these changes without understanding why it was so hard for me to make them to begin with.” In other words, while psychotherapy was helpful for exploring the emotional impact of a learning difference, it offered little in the way of concrete strategies for helping this person to manage the practical challenges they faced on a daily basis. On the other hand, coaching that does not take into consideration the emotional impact of a learning difference, may be met with understandable resistance, especially if that person faces mental health challenges that interfere with implementing the strategies mentioned by the coach. Emotionally focused psychotherapy, when it is combined with coaching, helps an individual to identify the emotional impact of his or her learning difference, while also offering some concrete solutions to help achieve his or her goals.
A young woman I work with illustrates why it is effective to combine emotionally focused psychotherapy and coaching. When her parents originally contacted me, they explained that she had been recently diagnosed with Nonverbal Learning Disorder (NVLD), but still wanted to become a nurse. The beginning of my work with her centered on helping her to, as she put it, “Understand how my mind works.” In other words, she reported that she never had the opportunity to fully understand her specific strengths and weaknesses, and how they might impact her during her nursing school training, from the visual spatial aspects of administering medications to passing a test of her professional nursing duties. I was able to provide her with some concrete strategies for achieving success in nursing school, including finding a mentor. As treatment progressed, she was able to explore some of the anxiety she experienced regarding her potential academic performance, which included deep-seated fears of letting down her parents, whom she described feeling indebted to since her adoption. A combination of psychotherapy and coaching helped me to better understand not only the practical challenges she faced, but also the anxieties and internalized pressure she experienced in pursuing her professional dream. Combining psychotherapy and coaching provides her with comprehensive services she needs for reaching her goal.
I want to be clear in stating that I am not suggesting that psychotherapists become coaches or vice-versa. As a Licensed Clinical Social Worker, my training is primary in psychotherapy and mental health services, and not in coaching. However, I am suggesting that as a therapist who works with individuals with learning differences, I do think it is critical for me to provide some form of concrete support when appropriate, especially as I have come to understand how a learning difference may impact a person’s everyday functioning. I suggest that therapists not only become more knowledgeable about learning differences, but also that they become more open to making practical suggestions that can help their clients to achieve success. Ultimately, emotionally focused psychotherapy that includes some coaching is most effective for assisting a young adult to overcome his or her obstacles.