The Difference Between Coaching and Therapy

  • May 4, 2020

It’s no longer a secret that running a startup is emotionally excruciating. While it may have been anathema for a founder to disclose that they were seeking support 5 or 10 years ago – or unrealistic for them to even have realized that they could have – now it’s commonplace (almost to the point of absurdity). 

Coaching and therapy are similar-seeming services in a fragmented market where the product itself feels like a secret delivered behind closed doors, so it’s normal for founders to have a lot of questions about what they are and when to engage with each.

​Here’s how I differentiate the two:

Therapy achieves personal growth via relationship

In general, therapy achieves personal growth by focusing on a founder’s relationships. Therapy focuses on the quality of a founder’s relationship to important stakeholders like their family members, friends, colleagues, investors, cofounder(s), and even their therapist. Critically, regardless of what content is being discussed, therapy’s relentless focus is on a client’s relationship with themselves as gauged by the client’s capacity to:

  • identify and skillfully manage their emotions,
  • observe and respond constructively to their thoughts,
  • define and maintain healthy boundaries/relationships, and
  • generally develop a healthy, respectful relationship with themselves in all aspects of their life.

The output of therapy is:

  • an increased awareness and mastery of emotion,
  • greater congruence between a founders’ internal experience and their external life (e.g. you learn not to do the stuff that hurts you because you either learn to stop doing the thing or you learn how to not hurt), and
  • an ability to use that knowledge effectively to maintain, adjust, strengthen, and deepen healthy relationships in the founder’s life. ​

A great use case for therapy is an early-stage founder (pre-Series A) struggling on the path to PMF because that journey is mostly about tolerating feelings of anxiety, discomfort, stress, and hopelessness while maintaining clarity of vision/hope, developing basic skill at communicating clearly and authentically, strengthening relationships through troubled times (e.g. with your cofounder), and continuing to meet your basic needs as an organism in distress. Therapy is also typically better-priced than coaching to match an early-stage founder’s budget.

Therapy is most frequently dosed once weekly, and the cost ranges anywhere from $80-250/hr. Many founders consider therapy a business expense, and the cost is occasionally supplemented by a founder’s health insurance depending on the therapist. In general, you can expect that it will take ~1-6 weeks for you to start thinking differently about yourself, ~3-9 months to start feeling differently about yourself, and ~1+ year for therapy to start transforming your life (if you stick with the process and deeply engage with it). If you’re in therapy but aren’t sure whether it’s ‘working,’ I highly recommend that you initiate an open and honest discussion with your therapist about your concerns. Keep in mind that the relationship is the primary catalyst of growth in therapy, so invest in the relationship with your therapist in order to get the most out of it.

If you’re looking for a therapist, read this blog post: How Founders Can Find (and Afford) A Good Therapist

​Coaching achieves personal growth via startup

Whereas therapy achieves personal growth via relationship, coaching achieves personal growth within the context of a founder’s startup. Coaching builds on the skills that therapy introduces by supporting the founder as they develop leadership skills on top of the strong interpersonal framework that therapy introduces.* If you think about a founder’s psychology as the product both services are designed to augment, therapy is designed to help you deeply understand and refine the foundational MVP of your psychology (your feelings, thoughts, and relationships). Coaching is designed to make the founder’s psychology feature-complete by ensuring that they’re thinking and feeling at a pace that matches – and slightly exceeds – the growth of their company.

To that end, coaching (with me) focuses on the following areas, often simultaneously:

  • Teaching founders how to effectively incorporate appropriate emotion (fear, frustration) into management and strategy decisions, or resolve it independently.
  • Teaching developmentally-appropriate management skills to founders to ensure they maintain a high-performance, outcomes-driven culture (e.g. goal-setting, public speaking, prioritization, delegation, delivering effective feedback, implementing effective meetings, introducing org-wide accountability practices, etc.).
  • Advising founders on the organizational and process changes needed to resolve short- and long-term functional breakdowns by redefining roles and responsibilities, implementing effective meeting schedules, developing internal processes that enable critical collaboration, reorganizing management structure, adjusting hiring plans, or shifting product timelines.
  • Helping founders understand the founder-specific, shared experience of anxiety, depression, burnout, stress, failure, insecurity, and exhaustion while sustaining extremely high levels of functioning.
  • Guiding founders in defining, communicating, and modeling their leadership style, company values, mission statement, vision, and culture to align their companies around shared company norms.
  • Empowering founders to move quickly in making ambiguous and highly consequential decisions
  • Analyzing and redefining deeply-held beliefs and values as related to issues of motivation, burnout, performance, and purpose. Brainstorming plans of action in alignment with updated schema.
  • Leading founders in scripting and delivering emotionally sensitive and strategically complex communications to a variety of stakeholders (e.g. when making layoffs, shuttering a product, holding key stakeholders like a cofounder or board member accountable, resetting cultural expectations, or redefining a companywide metric that impacts their strategic direction).

It’s extremely difficult to define a ‘best’ use case for coaching the way it is for therapy. The list above is what my work focuses on, but coaching is an unregulated field which means there are a near-infinite number of coaches who all have different specialties. I would say if you fall outside of the use case I described for therapy, and you’re a later-stage founder with at least 9+ months of runway, then coaching might be a good fit for you. You’re welcome to email me to ask.**

​Again, because coaching is unregulated there isn’t a typical cadence, structure, or pricing. Most coaches charge the company somewhere between $1000-$10k+/mo. It’s normal for coaches to meet with founders once-weekly or every-other-week (once-monthly also happens but is more rare), and it’s normal to spend 1-2 hours with your coach per session.


* This is why I think every early-stage founder should be in therapy. It makes later-stage coaching infinitely more effective and efficient.

** You’re welcome to email me if you think you need a coach but aren’t sure or aren’t sure where to start. I spend a 20% of my time each week talking to founders about what they’re looking for support around and referring them to the coaches or therapists I know who I think would be the best fit. (If I think I would be a good fit for you, then I’ll mention myself as one of your options and tell you why.)

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Amy Buechler

I've worked with thousands of the world’s best startup founders as Y Combinator’s first Batch Director and only embedded Founder Coach.

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