Now, moving on to some of the differences between ADHD coaching and therapy, very generally speaking, ADHD coaching is going to be quite focused on taking action and working towards goals.

And so an important part of the process is going to include goal work.

And a goal can be all sorts of things.

It can be something very tangible like opening a business. That’s pretty black or white. You either opened it or you didn’t.

Or it can be something that’s maybe a little more abstract like, wanting to feel more confident in social situations.

You will see some variation among coaches when it comes to goal setting, but pretty much all of us are going to tell you that it’s important to have an idea of where you want to go so that we can start working on how to get you there.

With my clients I like to do what’s called “rough draft goals,” which is where we talk a bit about what they want to accomplish but also why, knowing that, sometimes goals can change and that that’s perfectly okay.

The Insight Model of Coaching

Now that said, it’s not just about doing a bunch of stuff.

I personally coach my clients using something called the insight model. The insight model has roots going all the way back to Socrates.

If I had to put it into my own words, I would describe it as, uncovering the limited beliefs that are holding us back.

For example, let’s say that you are trying to get more movement and exercise into your day, but it’s just not happening, like, at all.

Now, when you say this to someone, that’s when you tend to hear all this advice like, “sleep in your workout clothes,” or “just take the stairs,” or “you need to buy this app that will send you a notification.”

And that’s all decent advice, but what if there’s something going on under the hood, so to speak, that’s keeping you stuck?

By uncovering this limiting belief, or what some other people call a thought error, your coach can help you break through those mental blocks that are holding you back.

So maybe you talk to your coach, and together, through a series of questions, you uncover that you have a belief that exercise means putting on special clothes, going to the gym, and working out super hard for at least an hour, otherwise, it’s not really exercise.

In other words, kind of being a bit black and white about it, or maybe even a bit perfectionistic about it.

And when you uncover this belief, it might make you realize why it’s so hard for you to exercise and why you’re not doing anything at all.

You’re making it too hard from the get-go and giving yourself icky feelings about it because it just seems so hard.

So by working with your coach you will come up with a new way of thinking about exercise.

Maybe you will decide that for you, for now, going for a walk in whatever clothing happens to be on your body at lunchtime is a-ok. And later maybe you’ll revisit the idea of going to the gym, but for now, you’re just going to get started on something simpler.

Strengths-Based Coaching for ADHD: I'm Not Really a Fan

Many ADHD coaches also work a lot with what’s called “strengths-based coaching.”

The theory behind this is that a coach should help their clients recognize their strengths and then build off of them.

I’m going to ruffle some feathers here by throwing in my own opinion and experience, but I really don’t see how this plays out session by session.

What I mean by that is, let’s say that you identify one of your strengths as creativity. Cool. And this week, you decide that what you need the most support with in your session is your relationship with your boss.

I’m having trouble seeing how, in a practical setting, during the course of a coaching conversation, you will be able to find a way to lean on your creativity to help you with this problem, but maybe I’m just not creative enough. (Side note, I am.)

So, I do think it’s great to talk about strengths when beginning coaching, but not necessarily to help with taking action so much as to remind the client of their positive qualities as our work often involves improving self-esteem. And that’s just me, and if you disagree with my philosophy, you go on and work with a strengths-based coach, and we’ll still be friends, no problem.

My All-Time Favorite Coaching Question: What's Going Well?

Now, that said, something that I do do, and that nearly all coaches across the board will do, although it’s not something I’ve ever come across personally in therapy, is giving some attention to the wins.

So, while I don’t spend much time focusing on a person’s character strengths after the initial meeting, you’d better believe in every session, we’re going to spend at least a little time talking about what’s going well.

Why? Usually I work with my one-on-one clients on a weekly basis. And they know that setting the agenda for the session is up to them. I always bring 2-3 themes to each session just in case the client doesn’t have a particular issue they want to work on that week, but I also don’t want my clients to only be thinking of the negative and the problems in between sessions.

I also want them to be looking out for the positive.

This is something you might not have heard before, but did you know that those of us with ADHD tend to have a proclivity for negativity?

Yup, it’s extra easy for us to focus on the negative and focus on it for a freaking long time. So we usually need a little nudge to remind us that there are some things that are actually going well.

And instead of only talking about problems, which is super important and needs to be done, it’s important to discuss successes and to examine why they happened. So, while I don’t devote so much energy to talking about a person’s good character, I devote energy to talking about a person’s good actions (as what is character anyway but a series of repeated actions).

Deep Work on Feelings in Therapy

Now, how does this all compare to therapy?

Well, in general, therapy will be a little less focused on taking action and more focused on dealing with feelings. In therapy you can work a bit more deeply on emotions, especially those stemming from trauma.

You’ll be looking more deeply at past patterns than you will in coaching, and working more on healing. Of course, this can help you achieve your goals, but in general, therapy tends to be a little less focused on your week-to-week goals and more focused on overall recuperation of your mental health.

Coaching Requires the Client to be Functioning at a Certain Level

And here is another important distinction between the two. In coaching, we work with individuals who are functioning.

What do I mean by this? You’re able to take care of yourself, even if it’s not perfect.

So, for example, oops, you woke up a bit late today and you had to rush to the office without showering and you arrived a half hour late.

Okay, you’ll hopefully do better tomorrow.

On the other hand, if you haven’t showered in a month, and you haven’t been able to get to the office at all for weeks because you just can’t get out of bed, that’s a different story.

A therapist can work with both of these cases, but a coach can only work with the first one.

As coaches, we are not equipped to deal with these extreme levels of distress and we will advise you to seek help from a therapist.

Don't Freak Out . . . Your Coach Might Give You Homework

Another difference between coaching and therapy for ADHD is that coaches will often have self-study material that goes along with their programs.

In my case, my signature program includes weekly workbooks about holistic health including work on nutrition, sleep, stress management, relationships, confidence, your life’s purpose, and much more, and I have woven in ADHD-specific information to my program.

My background is in wellness and I know it’s critical to base all of your mental health work on a strong physical foundation as, in the words of the brilliant Dr. Georgia Ede, “Studies have shown conclusively that the head is part of the body.” So that’s my style, always focusing on the whole picture, as sometimes the answer is as simple as something like drinking less coffee in the afternoon, but if we only focus on our thoughts and feelings, we can miss something as simple as that and wind up really spinning our wheels.

In my experience, therapy, on the other hand, does not in general come with any self-study material, although in my post “CBT for ADHD? OMG” I talk about a homework assignment that my therapist gave me that was pretty eye-opening, so make sure you check out that blog post after this one.

Location, Location, Location

Yet another difference between coaching and therapy is that coaches can work with clients anywhere in the world, whereas therapists do have some restrictions based on licensing laws, so they are limited to people living in the same country as them and sometimes the same state or province. So that’s something to keep in mind when searching for support.

Let's Talk About Money, Honey

And hey, what about costs and insurance? So, costs vary but I would say in general, ADHD coaching is priced a bit lower than therapy, again it depends.

Is ADHD Coaching Covered by Health Insurance? What about Therapy?

In terms of insurance, most of the time, ADHD coaching will not be covered by insurance, however, I am starting to see ADHD health coaching being offered by some insurance companies and, if you’re in the U.S., you can most likely use your HSA or FSA account to pay for coaching if you have one.

In the U.K., ADHD coaching may be covered under the Access to Work program. Apart from that, your employer may have a program to help pay for coaching as well, as part of their professional development benefits. And if you are self-employed, you may be able to claim a tax deduction.

Therapy, on the other hand, is more likely to be covered by health insurance plans, although you’ll need to check with yours to see. Not all therapists take insurance. For those of you in the U.K., therapy is covered on the NHS, however I have seen that in some places, it can take a really long time to be seen. For example, I read on the BBC that in Sussex there’s currently a five-year wait to be seen for an ADHD assessment. Five years!

Can I Work With an ADHD Coach and Therapist at the Same Time?

Now what about working with a coach and a therapist at the same time? That is totally doable and many people do that. I give it a thumbs up.

Summary

So, to summarize, ADHD coaching and therapy for ADHD have some overlap but also some things that are particular to each one.

Both are tailored to the ADHD brain, when done right, and both include an educational component about the disorder. ADHD coaching will be more geared toward taking action and uncovering the strategies that work for you in the here and now, whereas therapy will be more geared toward emotional healing.

Coaching is designed for people who are currently able to take care of themselves on a basic level, even if not perfectly, whereas therapy can work with those who are both able and currently unable to take care of their basic needs.

You’re more likely to receive supplementary self-study models when working with a coach than a therapist.

Coaches cannot diagnose you with ADHD.

It’s sometimes hard to get an appointment with a therapist without a long wait time, whereas this may be easier with a coach, and therapy is more likely to be covered by insurance than coaching, although many options exist when looking into how to pay for either.

Last but not least, if you want both and therapist and coach, that’s definitely doable too.

All right! I hope this information has been helpful for you! If you’re curious about my experience with therapy, which also includes information about whether or not CBT is helpful for ADHD, check out this other blog post about CBT for ADHD. 

Thanks so much for being here. As always, I’m rooting for you. Have a happy and healthy day.