Research Paper By Debra Graham
(ADHD Coach, UNITED STATES)
Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD) is a condition with a certain set of characteristics that in some settings causes impairment. Despite efforts at comprehensive care, ADD/ADHD is a very humbling set of conditions for clinicians to treat. In other words, clients get “better,” but don’t get “well.” Discouragement is common because of the frequent noncompliant client who understands what needs to be done but fails to accomplish his goals or tasks effectively and completely. Life coaching can provide the “missing link” to available, well-rounded treatment and support, and is increasingly used by therapists who treat ADD/ADHD as part of their treatment plan.
Coaching: The Missing Link in Treating ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a common condition with tremendous consequences to affected individuals. According to Craig Garfield, a researcher at Northwestern University and lead author of a study published in March 2012 in Academic Pediatrics, more children in the United States are being diagnosed with ADHD than ever before — 10.4 million in 2010 alone. Academic, social and personal issues arise from the disorder’s manifestations, hampering personal growth and accomplishment of goals. Frequently, individuals diagnosed with ADHD are labeled by teachers, parents, coworkers and bosses as irresponsible and unreliable. Over time, this leads to erosion of self-confidence in those who suffer from ADHD. Those individuals often blame themselves for their shortcomings, impairing their ability to reach their goals successfully.
Life coaches believe clients are resourceful and whole, and work from a client’s strengths, accessing positive emotions. At the same time, coaches encourage clients to accept responsibility for past actions and to develop solutions to live more effectively in the present and the future.
The gifts and talents associated with ADHD have led to the success of businessmen, artists, entrepreneurs, doctors, scientists and others with extraordinary ADHD minds. Creative thinking, high energy, charismatic sense of humor, brilliance and the ability to hyper-focus on desirable activities are apparent in many who struggle with ADHD (Hallowell and Ratey, J. 2005).
Research has traditionally focused on diagnosis and treatment but has frequently overlooked the need for comprehensive multimodal treatment because of the difficulties of evaluation. Despite efforts at comprehensive care, ADHD is a very humbling set of conditions and difficult for clinicians to treat. Clinicians experience much discouragement due to frequent noncompliance among patients, who generally understand what needs to be done but fail to follow through on the behaviors needed to accomplish their treatment goals. Realistic expectations are crucial to success, and coaching has been found to be effective in the treatment of ADHD individuals (Josephson, 2010). A coach acts, in effect, as an external frontal cortex — the executive functioning area — helping the individual to maintain arousal and remember motivation to succeed (Ratey, 2008).
The Missing Link. Coaching can provide the missing link to available, well-rounded treatment and is increasingly used by therapists who treat ADHD. The organization Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is the nation’s leading non-profit organization serving individuals with ADHD and their families. CHADD has consistently supported the addition of coaching in a patient’s treatment plan. ADHD coaches help clients with the disorder develop and implement practical strategies that help them attain their specific goals in either the personal or professional life, or both. As a new and emerging field, coaching continues to develop the educational and professional standards that have long existed in fields such as medicine, psychology, social work and other helping professions (Hallowell and Ratey, N. 1994).
The Personal and Professional Coaches Association defines coaching as “an ongoing relationship that focuses on the client taking action toward the realization of their vision, goals and desires.” An effective life coach will keep a patient on track and accountable for goals on a regular basis. A coach will help a client prioritize goals and discuss with them how to accomplish their goals one step at a time. A coach can help remove obstacles that are overwhelming a client and impeding action.
The combination of medicine, psychotherapy and coaching can enhance an ADHD patient’s chances of long-term success (Josephson, 2010). Coaching helps the ADHD individual by creating and implementing the tools needed to increase focus, to follow through on tasks and to manage time effectively.
Rather than trying to ”cure” the disorder, a coach works with the client to cope with the disorder and to strategize behavioral changes. By introducing helpful tools and organizational standards for dealing with their often weakened executive function skills, a coach teaches structure and accountability, creating programs on how to organize, approach tasks, and discover appropriate ways to think through resources and allocation (Ratey, N. 2008). If ADHD individuals can hold on to motive, remember the consequences and keep the reward in mind, they can move forward toward completing tasks and meeting goals (Ratey, N. 2008).
Executive Functions. Executive functions are the skills an individual of any age must master to deal with everyday life. They include a vast array of critically important abilities, including handling frustration, starting and completing tasks, recalling and following multi-step directions, staying on track, planning, organizing and self-monitoring (Boorady, 2011). Common client problems include difficulty in initiating and completing tasks, disorganization, verbal or physical impulsiveness, time management, indecision, low tolerance of frustration and a cluttered work or living space.
Purchasing a new planner or electronic organizer is in and of itself an ineffective solution to executive function issues. Clients need modeling, a routine, a planned work environment, instruction on breaking projects down into small tasks, support to organize steps and a system of rewards. A coach can help set realistic goals, set realistic consequences, and work on impulsive responses. A coach provides direct training in organization skills and task management, and instruction in breaking down large tasks into smaller and more manageable parts or sections. A coach teaches time management and awareness, using a timer and a set of exercises to enable the client to become more familiar and attuned to time. A coach will find the most effective way for a client to work with a planner, either paper or electronic. ADHD clients are frequently overwhelmed with tasks and consequently unable to complete them, and a coach will work with the client on prioritizing tasks, making daily goals attainable. Urgent deadlines with consequences are addressed first, and a list of important tasks is made that incorporates those activities and goals that will make the client feel good and successful. A coach will discuss both long-term and short-term goals with the client. This approach to designing individual strategies helps clients meet their responsibilities and goals. Clarifying goals and setting realistic expectations also helps a client with time structure. Breaking down strategies helps a client to feel less overwhelmed. Requiring accountability acts as a deadline and helps the client set and realize goals. A coach also helps a client find appropriate stimulus to focus on, which helps a client prioritize and sustain focus. Flash phone sessions help redirect the client back to focusing on tasks.
Students with executive functioning deficits need coaching and feedback from professionals who understand an ADHD client’s unique challenges and how best to teach the skills to address them (Eckerd, 2011). Coaching can help develop the skills that will lead to a positive outcome for the patient. The role of the coach fills the void by setting structure, prioritizing tasks and finding suitable ways to approach these tasks with evaluation. The coach and client work together to design and imprint upon the client the needed program for success.
Motivational Training. Motivational training is important to the ADHD client, and a coach is crucial to cultivating motivation over a long period of time. Coaching can act as an external force in the executive functioning area to help the client maintain arousal and motivation to succeed in areas that were previously unattainable. Using coaching as a combined modality, often with pharmacology, will help the client focus. Cognitive Behavioral Therapy (CBT) or Acceptance Commitment Therapy (ACT) is often combined with a doctor prescribing medicine, when necessary, for ADHD patients. When the additional support of a life coach is added to the two strategies above, a higher rate of success is reported. Frequent contact with a warm and enthusiastic coach assists a patient’s motivation by looking clearly at the consequences of uncompleted tasks and responsibilities, and in establishing positive rewards for tasks completed. A supportive coach will help a client set goals while posing probing questions that unearth the roadblocks preventing success. A coach provides active listening and intelligent questioning, which helps clients tap into their own wisdom and holds a client accountable for his goals.