Therapy Vs. Coaching: Which One Do I need as a Neurodivergent Adult?

This is a question that I see a lot in my work as a therapist in private practice. Neurodivergent individuals come to me and are unclear as to whether they need a therapist or a coach. It can get confusing—heck, it was confusing for me until I really understood the coaching world. The truth is, sometimes you need therapy, sometimes you need a coach, but often times when you can get the right blend of a phenomenal neurodivergent-affirming therapist AND a fantastic neurodivergent-affirming coach that is where the magic happens.So… what is therapy and what is coaching? And what even is the difference? Let’s break it down!

Therapists are licensed mental health professionals that have extensive training in working with emotional distress, trauma, and mental health diagnoses. Therapists treat mental health diagnoses like anxiety, depression, PTSD, bipolar, and mental health diagnoses that require clinical expertise. Therapists tend to focus on digging through and healing past wounds and developing coping strategies to move forward. Therapists can also help with situations such as grief, relationship issues, etc.

Coaches are focused more on the future – they help with the skills necessary to improve executive functioning, time management, building systems, and building routines. Coaching is more focused on the cold hard facts and how to solve problems. Coaching aims to help people do and is not focused on the deep emotional processing or diagnosing.You may be wondering what the common misconceptions are behind therapists and coaching and, well, unfortunately there are a lot of them. Just to name a few things I have heard personally..
“Coaches are just therapists without a license”.

ADHD coaches, executive functioning coaches, life coaches—they're not just knock-off therapists. Coaches have their own specific training, often in areas like behavior change, motivation, accountability, and goal-setting—especially tailored for people with neurodivergent brains.

“Therapists are only for people who are crazy.”

Crazy? What even is "crazy"? And who gets to decide that? People see therapists for all kinds of reasons—grief, burnout, relationship struggles, executive dysfunction, anxiety, trauma, even just needing a space to process life. And having a mental health diagnosis doesn’t make someone crazy—it makes them human. In fact, about 1 in 5 U.S. adults experience mental illness in any given year—that’s nearly 60 million people. (Source: National Institute of Mental Health, 2024)

“Coaches are just overpriced people who really don’t know what they are talking about”.

Wrong again. A few things here. Who decides what is “overpriced”? It’s all subjective. Everyone has their own opinion, and people are able to charge what they feel is fair and what they feel they deserve for their time and hard work. A lot of the coaches that I have met have something that cannot be taught in school – lived experience. The best coaches I know are some of the smartest, most compassionate, and supportive people that I have ever met and that is no exaggeration.So why does it seem like coaches and therapists are on two totally different islands with no collaboration?
Because in a lot of cases, that is the unfortunate reality. I say unfortunate because it really is just that – unfortunate. In my work as a therapist, when I collaborate with coaches that are also working with the individuals I serve, it really is when the magic happens. There is something to be said about being able to provide feedback to each other and work alongside each other, not against each other. Two hands are better than one, and therapists and coaches collaborating is an example of that. In the neurodivergent community where we already fight so many injustices on a daily basis, the people that we work with should be on the same team.When therapists and coaches collaborate, clients receive support that’s both emotionally grounded and practically actionable. Therapy helps people process trauma, regulate emotions, and navigate mental health challenges, while coaching offers structure, accountability, and executive functioning strategies to move forward in daily life. It’s not about staying in one lane or the other—it’s about merging our lanes to create a smoother, more supportive path.

This is especially true for neurodivergent folks, where emotional regulation, motivation, and executive functioning are deeply intertwined. A therapist can help someone unpack rejection sensitivity or anxiety around perfectionism, while a coach works with that same person to build realistic routines, manage time blindness, or break down overwhelming tasks. The therapist helps someone understand why they feel stuck; the coach helps them figure out how to get unstuck. It’s a dual approach that supports both the “inside stuff” and the “outside stuff.”

When collaboration happens, it also reduces the client’s frustration—they’re not repeating themselves to two different people, getting conflicting advice, or juggling competing priorities. Instead, they have a coordinated team who respects their autonomy and works in sync. It creates consistency, safety, and momentum. And honestly? It gives clients what they’ve always deserved: a care team that sees the whole picture and refuses to treat them like a problem to fix, but a person to support. That’s not just good practice—it’s equity in action.If that kind of collaborative, whole-person support sounds like what you’ve been missing, you deserve to experience it firsthand. At ND Outloud & ND Hive, our neurodivergent-affirming coaches and therapists work together to meet you exactly where you are—and help you get where you want to go.