Occupational Therapy vs. Coaching: What’s the Difference for Neurodivergent Adults?

When seeking support as a neurodivergent adult, you may come across both occupational therapy (OT) and coaching. While these services can overlap in some ways, they are distinct in their approach, training, and scope. Understanding the differences can help you make an informed choice that best suits your needs. This is my personal opinion based on my knowledge, which I’m not claiming to be absolute.

What Is Occupational Therapy?

Occupational therapy helps people develop, recover, or maintain the skills needed for daily life. For neurodivergent adults, this often includes executive functioning, sensory processing, emotional regulation, and workplace or home adaptations. OTs take a holistic approach, working collaboratively with clients to build on their strengths, set meaningful goals, and create practical strategies for navigating daily life. Many OTs also incorporate coaching or therapeutic principles such as Acceptance and Commitment Therapy (ACT).

Key Features of OT:

• Regulated profession: In the UK, OTs must be registered with the Health and Care Professions Council (HCPC).

• Supervision and insurance: OTs are required to have professional supervision and appropriate insurance to practice safely and ethically.

• Holistic and flexible approach: OTs focus on a person’s strengths, interests, and environment to create tailored strategies.

• Individualised support: Designed to address specific challenges, such as sensory sensitivities, burnout, or executive functioning difficulties.

• Evidence-based and informed by lived experience: Techniques are grounded in research, best practices, and often influenced by neurodivergent perspectives.

• Use of other modalities: Many OTs incorporate coaching techniques, goal-setting, and accountability. Others may apply therapeutic approaches such as ACT or sensory integration strategies.

• Multidisciplinary collaboration: OTs may work alongside psychologists, GPs, speech and language therapists, and other professionals to provide comprehensive support.

What Is Coaching?

Coaching, particularly neurodiversity coaching, is a strengths-based approach that helps individuals set and achieve goals. Unlike OT, coaching does not involve clinical assessment or therapy but instead focuses on self-development, accountability, and problem-solving.

Key Features of Coaching:

• Unregulated profession: Coaches do not require formal qualifications or registration, though many pursue specialist training.

• Goal-oriented and action-focused: Coaching supports individuals in setting and achieving personal or professional objectives.

• Flexible and client-led: Sessions often focus on productivity, confidence-building, career progression, or self-advocacy.

• Not a clinical service: Coaching does not address medical, sensory, or functional needs in the way OT may.

Similarities Between OT and Coaching

• Support for neurodivergent challenges: Both can help with executive function skills, time management, and self-advocacy.

• Person-centred approach: Both professions tailor their support to the individual’s needs and goals.

• Focus on practical strategies: Whether it’s sensory-friendly workspaces or productivity hacks, both aim to improve quality of life.

Key Differences

• Regulation:

  • OT is HCPC-regulated and requires supervision and insurance.

  • Coaching is unregulated, with no formal oversight.

• Training:

  • OTs require a degree and clinical placement.

  • Coaches do not need formal qualifications but may complete specialist training.

• Approach:

  • OT is holistic, flexible, and strengths-based.

  • Coaching is strengths-based and goal-oriented.

• Cost:

  • OT can be NHS-funded or private (£50-£150 per session).

  • Coaching is private only (£50-£200 per session).

• Scope:

  • OT addresses sensory, functional, and daily living needs.

  • Coaching focuses on personal growth and goal achievement.

• Use of Coaching Strategies:

  • OTs can integrate coaching techniques.

  • Coaches cannot provide OT techniques.

  
  

Final Thoughts

Both occupational therapy and coaching offer valuable support for neurodivergent adults, but they serve different purposes. Understanding these differences can help you choose the right approach—or a combination of both—to support your well-being, work, and personal development.

I offer 1:1 occupational therapy and OT based “access to work” coaching via the government scheme.

*This is my personal opinion based on my knowledge & understanding. This is not an exhaustive list there are many other aspects to both professions and many OTs & coaches will work differently to the above.