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Barbara Jordan
Nov 23, 2010

Coaching and Attention Deficit Disorder

As you may know, coaching is emerging as another way of helping people with Attention Deficit Disorder (ADD). But, what exactly is this "coaching"? Generally, ADD coaching involves a collaborative relationship that is very goal-driven, structured, and focused on helping the client create practical strategies to accomplish specific goals. Highly individualized, the relationship focuses on the unique needs of the particular client and addresses many areas of life: work, exercise, nutrition, stress/time management, relationships, social activities, recreation, finances, sleep, etc.

If you work diligently with clients having ADD and address their symptoms as well as the way in which it impacts their relationships, you may wonder why these clients seldom implement treatment goals consistently. Be careful that you don’t misinterpret the client's failure to follow through as laziness or "resistance" to treatment. Often, the problem with ADD is not a lack of desire or motivation. Instead, it usually involves lack of follow-through, memory, focus, and achievement. These clients aren’t lazy or stubborn; they usually just fail to do that which they know they should do.

Current therapies incorporate many types of cognitive, empathic, existential, and psychoanalytical approaches to help individuals gain insight and understanding, deal with painful emotional problems, and overcome self-defeating beliefs and destructive behaviors. But, when you work with an individual having ADD, you must be much more pragmatic and behaviorally oriented. Insight by itself is futile without an action plan that provides specific strategies to overcome impulsivity, inattention, and impatience of ADD. Even behavior therapies have limits when it comes to helping individuals with ADD who live in the moment, respond to the immediate, have difficulty anticipating consequences and looking ahead, or simply forget the goals established just days ago. This is where ADD coaching is so beneficial. It can take planning, organization, time management, and accountability to another level. Collaborating with an ADD coach in the treatment of these individuals may increase your success as a counselor.

What are the similarities and differences between counseling and coaching? One difference is the nature of the relationship. Compared to the traditional doctor/patient relationship, the connection between coach and client is less formal. Interacting more like colleagues, coach and client mutually agree on the best approach and activities. They may meet under social and business circumstances without the risk of ethical violations such as dual relationships.

Both coaching and therapy deal with feelings and beliefs, but at different levels. A therapist commonly helps the client work through painful feelings and negative or self-defeating beliefs and behaviors. A psychotherapist is usually more concerned with resolving whatever underlying causes may be affecting the client. On the other hand, a coach does not get involved with emotional, cognitive, or behavioral problems of clinical significance (depression, anxiety disorders, personality disorders, addictions, issues of abuse or trauma, angry or violent outbursts, rapid mood swings, etc.). Instead, a coach must refer the person to a therapist to help deal with these issues. Nevertheless, feelings do play a part in ADD coaching. They may involve frustration, fear of failure, avoidance behavior, and lack of confidence. As the client overcomes obstacles that have held her back and she accumulates success, she increases her self-esteem while reducing stress, disappointment, and worry. Of course, these may be viewed as therapeutic benefits even in the context of coaching.

There are other differences between coaching and counseling. Coaching is more focused on prevention and the present. It does not address pathology, and is instead "wellness" oriented. It aims to improve daily functioning for people who do not have significant psychological impairment. This makes coaching more educational and less therapeutic. And, because coaching is inappropriate in cases of clinically significant impairment, it has limited benefit. What this means is that a coach should know enough about psychopathology that he/she is able/willing to refer when necessary. Whereas therapy is covered by health insurance, coaching generally is not. However, because I am a licensed professional counselor, I sometimes bill insurance for coaching services.

Since much of the work can be done over the phone, coaching is more flexible. For example, I may coach a client in Denver from my office in Wisconsin yet never meet that client in person. Between sessions, correspondence with my clients may involve a five minute phone update or an e-mail confirmation that a goal was accomplished. Considering these differences, there are times when it is in the client's best interests for his therapist to refer that client to a coach and for a coach and therapist to collaborate in working with the same client.

Counseling/therapy can help the client who has AD/HD as they seek to understand and live with their condition. However, psychotherapy alone is usually not enough. This individual also needs practical strategies for accomplishing even the most mundane daily tasks like getting to work on time, keeping organized records, and other basic life skills. According to Joel L. Young, MD and David Giwerc, MCC, who wrote Just What is Coaching? ADD Coaching, “the adult with AD/HD is often trapped in a frustrating cycle of failure that severely limits quality of life. One of the hallmarks of AD/HD is the gap between ability and performance. This gap must be closed or reduced if the (person) is to enjoy the full benefits of treatment.”

Despite the differences, coaching and counseling are very similar. Like a therapeutic relationship, a coaching relationship is safe, respectful, and supportive, never coercive or punitive. Similar to a therapist, an ADD coach helps the client understand how ADD impacts all areas of life. Like coaching, counseling enhances the client's motivation and actively involves the client in making positive changes. So how exactly does ADD coaching work? Next week, I will follow-up with part 2 of ADD coaching by explaining in more detail what ADD coaches do to help clients.

Barbara Jordan is a counselor, counselor educator, author, trainer, and leadership coach. For more information go to

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