As a consumer, here is something that you should know. We (mental health providers in private practice) can/do diagnose. In order for you to use your insurance, and for us to get paid by them, we have to diagnose you with a mental illness, as per the Diagnostic and Statistical Manual of Mental Disorders, from the American Psychiatric Association. I'm serious. And if it is couples therapy, it's sort of a toss up...one of you has to be mentally ill. That can put a negative spin on the therapy if one individual is being perceived as "crazy" and the person causing the problems. And what if you are coming in for something you're very sensitive about, or that you want private? What if you have a security clearance or have to apply for life insurance?
Not only is this not confidential (like you think), we have to keep records proving that you have a mental illness and be prepared to submit those to the insurance company or a court of law if subpoenaed.
In my opinion, many of the topics that are covered in therapy can best be addressed in coaching because there is no diagnosis and no record keeping to be audited or subpoenaed. Also, coaching allows for you (the client) to hold the reins, not me and/or the insurance company. Coaching is more goal-oriented and solution-focused. It gets wrapped up quickly.
With all that said, I am encouraging more coaching for clients, especially with any relationship or sexuality issues.