What is ADHD Coaching?
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 teens, college students, and adults.
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-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 are 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. Midweek and short accountability and follow up sessions are essential for making sure that people are on task and on target with their goals.
Research on coaching
The majority of coaching studies have investigated its impact on teens, 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?
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.