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Coaching

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ADHD coaching is a relatively new field that has become more prominent in recent years. Coaching is an intervention that complements medication and other non-pharmacologic alternatives. As a specialty within the broader field of coaching, ADHD coaching is a practical intervention that specifically targets the core impairments of ADHD such as planning, time management, goal setting, organization and problem solving.

Although predominately used for college students and adults, some coaching programs have also been offered for adolescents with ADHD. Coaching programs for children and adolescents may need to focus on working simultaneously or exclusively with parents so they can better understand and help their child cope with ADHD. This information, however, will focus on coaching for college students and adults.

 

What is ADHD coaching?

ADHD coaches work collaboratively with their clients who have ADHD or ADHD-like symptoms to address specific needs and personal goals. Most current ADHD coaching programs acknowledge the biological underpinnings of the disorder in addressing the core symptoms of ADHD (inattention, hyperactivity and impulsivity); however, coaching addresses the academic, vocational, emotional and interpersonal life difficulties that are a result of these symptoms and helps clients find ways to overcome these challenges. Through individualized or group assistance and support, coaches help people concentrate on where they are now, where they want to be and how they can get there.

A coach helps people with ADHD carry out the practical activities of daily life in an organized, goal-oriented and timely fashion. In close partnership, an ADHD coach helps the client learn practical skills and initiate change in his or her daily life. A coach may help an adult with ADHD:

  • maintain focus to achieve identified goals
  • translate abstract goals into concrete actions
  • build motivation and learn to find ways to use concrete and abstract rewards effectively

Coaches help individuals with ADHD learn how the symptoms of ADHD play out in their daily lives. Coaches primarily ask questions to help the client reflect and discover their own answers to these questions. The following are examples of questions coaches may ask:

  • What changes do you want to make in your daily life?
  • What small steps can you take today in the direction of your goals?
  • How can you motivate yourself to take action towards this goal?
  • When must this action be completed?
  • What steps have you taken already, and when will you take the remaining steps?
  • How will you evaluate the impact of your plan?

Coaches support clients by providing encouragement, feedback and practical suggestions to address specific challenges as well by supporting them and holding them accountable for following through on their goals. They may offer reminders or suggest time management methods. Regular meetings and check-ins are an essential part of the coaching process. These sessions can be conducted in person, online, by phone, by e-mail or by text message depending on the client’s preference. However, before the coaching process begins, the client and the coach should have an initial session that addresses issues such as client needs, expectations of the client and of the coach, fees and payments (coaching services are often not covered by traditional health insurance) and length of time for the coaching contract.

The first coaching session is typically an in-depth, 1–2 hour meeting to allow clients to reflect on their satisfaction in all areas of life and to develop clear, long-term goals to guide future coaching sessions. Regular coaching sessions may last 30 to 60 minutes and are used to report progress on the previous week’s goals, reflect on factors enhancing and inhibiting progress and develop a step-by-step plan for identifying and achieving the next week’s goals.

At the end of the specified coaching contract period, an evaluation session is held to determine objectively if progress has been made and to decide upon the client’s next step. Clients may choose to continue with the same meeting schedule, readjust it or terminate coaching.

 

Research on coaching

The majority of coaching studies have investigated its impact on college students and adults. Although limited in number, these studies have found consistent results. Overall, college students who received individual coaching were found to develop better executive functioning skills and self-determination skills. Those receiving coaching engage in more positive thoughts and behaviors, such as taking greater responsibility for their actions, using goal-attainment skills, modulating emotions, managing stress effectively and increasing positive expectations for performance. They also reported improved study skills and learning strategies, such as time management and effective ways to improve concentration. Study participants also reported increased self-awareness, self-esteem, and satisfaction with school and work.

Group (rather than individual) ADHD coaching programs have also been evaluated with generally favorable results. These studies show improvements in anxiety, homework, interpersonal interactions, planning, organization, assertiveness, self-efficacy, motivation, time management and test-taking strategies. In a large-scale study, first-year college students who were coached were more likely to persist in college and have significantly better retention and graduation rates than those that did not receive coaching.

 

How is coaching different from traditional interventions?

Coaching versus cognitive behavior therapy

An individual with ADHD may engage in coaching and/or may seek therapy for their concerns. Most coaching is based on principles found in cognitive behavioral therapy (CBT). Both coaching and CBT often use the following elements: goal setting, prioritization, motivation, organizational skills, planning and scheduling, problem solving, stress management, impulse control, confidence and self-esteem building, relationships and communication skills, memory improvement and homework activities. However, coaching is viewed as a wellness model and not designed to help a client heal or deal with psychological barriers to growth.

Coaching is more likely to focus on practical daily living issues as well as forming habits for a balanced, healthy lifestyle such as finances, maintaining a home, nutrition, exercise and sleep. In contrast, CBT will more likely include issues of emotional regulation and direct treatment of co-morbid conditions such as anxiety, depression or substance abuse. Coaches deal with problems in everyday living and focus on what, when and how but rarely why. They are not trained to address psychiatric, emotional and interpersonal problems, unless they are also licensed mental health professionals. Through formal educational programs, mental health professionals (e.g., psychiatrists, psychologists, clinical social workers, psychiatric nurse practitioners, and marriage and family therapists) are trained to diagnose and treat mental health issues such as depression, anxiety, personality disorders and interpersonal difficulties. They also must have a license to practice. Coaches do not have these requirements.

 

Coaching versus educational interventions

Coaching is not tutoring. Tutoring involves teaching content to a student on a one-to=one basis and breaking learning down in an individualized manner. Tutors can teach basic academic skills like reading, math and written language or subject matter like history or geography. Coaching is also not teaching learning strategies such as how to read a textbook, take notes in lectures, study for tests, take tests and manage time effectively etc. Both tutoring and learning strategies are directive interventions in which the educator is viewed as the expert who teaches, tells or shows the student what to do and provides practice opportunities for skill development. Coaching is a collaborative relationship that presumes the individual being coached is the expert. Coaching promotes reflection and self-discovery by asking curious, open-ended questions to help students develop a personalized approach to meeting his or her goals and an enhanced understanding of their strengths and weaknesses. Educators who are trained as coaches have a wealth of knowledge of techniques and strategies that are offered in coaching as suggestions to be considered. Coaching collaboratively involves the student in deciding on which ideas to try, developing the best way to learn and implement the new idea.

 

Getting the most from ADHD coaching

To be ready for coaching, clients must be able to admit that they have a problem, want to make changes, be willing to spend the time necessary to create strategies for improving their behavior and be willing to adhere to those strategies to the best of their ability.

There are several issues that can complicate the coaching process and often require a referral to a medical or mental health professional, including the following:

  • The client has not applied self-management or organizational strategies to achieve goals, despite the coach’s resources and reminders.
  • The client has untreated co-existing psychiatric condition such as depression, bipolar disorder, anxiety disorder, substance abuse or personality disorder.
  • The client has stressful life circumstances such as marital problems, divorce, or death of a loved one.
  • The client has a serious physical illness or other chronic medical condition.

Under such circumstances, the coach should work collaboratively with the medical or mental health professionals involved in the client’s care. In such cases, the client may benefit from the addition of traditional treatments such as medication and psychological therapy. In some cases, the client may be better served by terminating coaching and pursuing other treatments.

 

Coaching professionals

Coaching can be offered by a variety of professionals in the mental health and education field, including the following:

  • licensed mental health professionals with an exclusive practice in which they only do ADHD coaching
  • licensed mental health professionals who do some coaching, but also have a general mental health practice
  • educators, such as a certified teacher or degreed professional at the college level, who are also trained in ADHD coaching and have a coaching practice or are hired to provide coaching in a school or college
  • individuals who are not licensed mental health or educational professionals and who only do ADHD coaching

If assistance is needed with emotional, psychiatric, or interpersonal problems, then a licensed mental health professional should be consulted. If an individual with ADHD needs both types of assistance, it may be helpful to select a coach and a licensed mental health professional and ask them to work with each other. It is also possible to find licensed mental health professionals who have the background and training to work with multiple issues.

ADHD coaches can have different educational and professional backgrounds and diverse knowledge about ADHD. Many coaches, including those who work with individuals with ADHD, seek credentialing through the International Coach Federation (ICF), an international association of personal and business coaching that is the governing body for this field. ICF recognizes ADHD coaching as a special area of expertise but does not provide specialized ADHD certification. However, there are ICF-approved coaching training programs that prepare coaches to specialize in ADHD coaching while allowing them to earn hours toward their ICF certification. The Institute for the Advancement of ADHD Coaching and the Professional Association of ADHD Coaches offer ADHD coaching certifications as well.

Consumers need to be aware that coaching remains a very broad field with many areas of subspecialty, and it is still without a licensing requirement. Anyone can start a coaching practice. Many professionals use the word coaching but they are not utilizing the principals and skills of coaching described in this handout. Therefore, those seeking to hire a coach should thoroughly research a potential coach and learn about their education, training, credentials, their specific training and knowledge of ADHD.

 

Choosing an ADHD Coach

Step One. Coaching is a collaborative process, so it is important to find the right match in a coach. Asking yourself the following questions before contacting prospective coaches can help you figure out what to look for in a coach:

  • Is it important that my coaching sessions be face-to-face? If so, look for a coach who is geographically close and offers this as part of a service package. Many coaches conduct the initial session in person and then do weekly check-ins by phone, text message and/or e-mail.
  • Do I prefer to be coached by a man or a woman?
  • In addition to the coach’s knowledge of ADHD, would I benefit from a coach who has a background in areas matched to my issues, for examplebusiness, academia, parenting, gender issues etc.?
  • Am I looking for someone who has expertise in an area such as organizational or family issues?
  • Do I want someone who has a lot of energy or someone who takes a more subtle approach?
  • Is a sense of humor important? Would a more serious person make a better match?
  • Do I also struggle with issues such as anxiety and depression? If so, is coaching really right for me and am I being treated for these issues?

Step Two. Compile a list of potential coaches with training in ADHD coaching. To find possible coaches use the websites listed in the resource section below. You can also contact your local CHADD chapter or the medical, mental health or educational professionals in your area, who might know of local, reputable ADHD coaches. Then take the time to do the research by visiting their websites (if available) and interviewing them using the following types of questions:

  • What is your educational level and what areas of study did you major in?
  • How long have you been a coach?
  • What is your approach to coaching teens, college students or adults with ADHD?
  • How many clients with ADHD have you coached?
  • Have you received formal training in coaching? Did this include certification or credentialing of any kind?
  • Have you had specific training in ADHD coaching?
  • Do you have experience with college students/employment issues/relationship issues? (depending on your specific need)
  • What coach training courses or conferences have you attended? Were they ADHD-specific?
  • Are you involved in any local professional coaching groups? Are they ADHD-related?
  • What is your confidentiality/privacy policy?
  • What are your fees and policies for working with a client?
  • Are you also a licensed mental health provider who has expertise in associated mental health issues, such as anxiety and depression?
  • Are there former or current clients with whom I could talk?
  • Do you offer a trial coaching session? While there may be a fee attached, a trial of coaching might be the best way to evaluate whether a coach is a match for you.

Step Three. Take notes on each coach’s answers to these questions, as well as your own overall reaction to the personality and style of each coach.

Step Four. Review all of the information and select the coach that best meets your needs.

Although the field of coaching is still developing, it does have an emerging research base that demonstrates its effectiveness as an intervention for adults with ADHD. Many teens, college students and adults find that having a coach who is knowledgeable about ADHD can be invaluable in facing the challenges of daily life and eventually learning how to coach themselves. Because there is a great need for research evaluating the effectiveness of ADHD coaching, coaches and other professionals are strongly encouraged to pursue research on this emerging form of support for those dealing with ADHD-related challenges.

 

Suggested Web sites

ADHD Coaches Organization http://www.adhdcoaches.org/ 
International Coach Federation, www.coachfederation.org
CHADD Directory of Professionals, Products & Services
Edge Foundation-Coaching for High School and College Students: https://edgefoundation.org/

Suggested Reading

Hallowell, EM & Ratey, JJ. (2011). Driven to Distraction: Recognizing and coping with Attention Deficit Disorder. New York, NY: Anchor Books.
Prevatt, F & Levrini, A. (2015). ADHD Coaching: A guide for mental health professionals. Washington, DC: American Psychological Association.
Quinn, PO, Ratey, NA & Maitland, TL. (2000). Coaching college students with ADHD. Silver Spring, MD: Advantage Books.
Sleeper-Triplett, J. (2010). Empowering youth with ADHD: Your guide to coaching adolescents and young adults for coaches, parents and professionals. Plantation, FL: Specialty Press.
Solanto, MV. (2011). Cognitive-behavioral therapy for adult ADHD: Targeting executive dysfunction. New York, NY: Guilford Press
Wright, S. (2014). ADHD coaching matters: The definitive guide. College Station, TX: ACO Books.

© 2015 CHADD. All Rights Reserved

   

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