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by | Sep 2, 2024 | Articles, Features, Neurodivergent

How do you coach people with ADHD?
Sarah Bickers, an ADHD coach, who herself has ADHD, reports

 

Until recently many people hadn’t come across ADHD and among those who had, the stereotype of naughty boys predominated. The recent explosion of press coverage has seen increasing numbers of people recognising undiagnosed ADHD. 

Considering ADHD is thought to affect around 5% of the population, it’s likely that if you’ve been coaching for a while you’ll have coached ADHD clients. What makes an ADHD coach different from someone who has coached people with ADHD?

In our currently unregulated profession, people looking for an ADHD coach may be vulnerable to coaches who aren’t working within their sphere of competence. (Recently I heard of an ‘ADHD coach’ whose only qualification was that she had a young child with ADHD.)

A reputable ADHD coach won’t just have accredited certified general coaching training, but also additional certified ADHD coaching training (ADDCA/ IACT / PAAC/ Gold Mind). The vast majority of ADHD coaches will also have considerable lived experience of ADHD. They’ll be especially interested in this field and be up to date with the neuroscience and treatments/approaches available. As well as coaching skills, they’ll have a deep understanding of how ADHD impacts the client’s behaviours, executive functions and their mental health.

For many clients, especially those newly diagnosed, having a coach who ‘gets them’ on a deep level is both healing and empowering…

 

 

My journey: becoming an ADHD coach

The year 2020 was a significant one for everyone, most of us will remember it as the year Covid-19 struck. But for me, it was the year it was confirmed that I have ADHD. 

A couple of years prior to this we noticed our son was beginning to struggle at secondary school. My sister, who has two children with ADHD suggested we might want to get him assessed for ADHD. Sitting through the assessment process the penny started to drop.

As I listened to the psychologist’s questions I began to realise that these ADHD symptoms were things that I’d struggled with all my life. 

At school my teachers saw my potential but had been constantly frustrated by my underperformance. Often distracted by my own thoughts in class, I found it hard to pay attention, unless it was a subject I loved. Instead I whiled away the time writing notes, distracting others, reading under the desk, or asking off-piste questions generated by my wandering mind.

By A-levels, I realised that some of the more academic subjects were problematic – because of my working memory problems. As coaches we often encourage clients to identify and focus on strengths. This was when I first learned to avoid things that felt too challenging, and began to follow my interests. (The ADHD brain is often referred to as interest-driven – our brains are activated by interest – rather than importance). 

I decided to train as a physiotherapist (this naturally led on from my interest in the human body). I already knew I enjoyed working with people and this profession was practical and varied… Becoming more interested in how the brain worked, I then specialised in neurology, working with patients with long-term neurological conditions in their homes, supporting them to make the best of their challenges. I loved this role. I was able to manage my own workload and I developed a more people-centred approach to my patients. (Without even knowing I had ADHD I’d gradually worked my way into a pretty ADHD-friendly job!)

After taking a career break when our children were young, I finally set up my business as a professional organiser – this was perfect for me – practical, varied, fitting my skillset and interests. All my life I’d known that the less I owned (or had to manage) the simpler life felt and happier I was. I’d always enjoyed a good clear-out. However, for years I delayed starting my business because of a self-limiting belief:  I knew I wasn’t perfectly organised so imposter syndrome held me back for a few years. 

Over the years I’ve developed strategies to avoid accumulating clutter and I’ve always enjoyed organising (although no one would call me a minimalist!). Without understanding it,  I was instinctively creating external order to help manage the internal chaos of my ADHD brain. As is common with ADHD, my working memory was pretty poor, so I developed ways to ensure I didn’t drop too many balls (I learned to write down appointments immediately so I didn’t forget them).

Very quickly I noticed that clients with ADHD seemed to be coming my way (my oldest son was diagnosed in the year I set up my business). Within a couple of years I’d specialised in working with ADHD clients and my first hard lesson to learn was that not all of my clever strategies worked for my clients. Instead of telling my clients how to organise their life, I began to listen more and to work more collaboratively with them. I began to get curious about how their brains worked, and helped them test strategies which helped, both at home and in their work.

By this stage I was training other organisers to help them become more ADHD-friendly and business was going well. I was pretty confident I had all the ADHD traits but felt I was coping pretty well … until the peri-menopause hit me. In common with many women, falling oestrogen meant my dopamine function also worsened – impacting both my sleep and working memory. In 2018 I finally went to my GP asking for HRT and an ADHD assessment.

After being diagnosed with ADHD in 2020 I began to take stimulant medication (this is the first line of treatment and reduces symptoms for around 75% of patients). I couldn’t believe how it felt to think more clearly. (Prior to diagnosis I’d contemplated training as a coach, but felt I wouldn’t be able to focus clearly enough on the client. As lockdown progressed I began to work online with a handful of clients and finally felt ready to train as a coach. 

I trained with Animas as a transformational coach in 2022 and qualified that summer. I’m now PCC credentialled. Fortunately, already being since I was already fully booked with ADHD clients made it was easier to transition to coaching these clients. I now coach ADHD clients full time. Although I’m not currently working in homes as a professional organiser I find my background as an organiser has helped me understand many of the practical challenges ADHD clients often face (and with permission, I occasionally put my professional organiser hat back on during a session).

 

When does someone need a specialist ADHD coach?

For a long time, even after I was diagnosed, I didn’t really feel that having a qualified ADHD coach was necessary. I was comfortable with being coached by most coaches – and benefitted – the coaching process itself was enough for me.

However, something shifted after I came across the graphic equaliser model of ADHD coaching. ADHD clients may each need varying degrees of the three elements: coaching, psycho-education and skills development. (And this can vary from session to session.)

Personally I wasn’t looking for the psycho-education element, because since specialising in ADHD I had hyper-focused on this area. Since setting up my business, I’ had also strengthened many of my coping strategies to manage symptoms. So I was pretty comfortable with the second and third elements. (And this was why I hadn’t chosen a specifically ADHD coaching course – I knew I wanted to focus on the coaching element.) 

Let’s be clear, a really good coach (who puts aside any assumptions) may well be able to successfully coach a client with ADHD – especially if their client has a good grasp of their ADHD and has integrated it thoroughly into their understanding. 

However, in many situations (for example, when newly diagnosed), the client may want to use an ADHD lens to understand their ADHD more. In such a case, a trained ADHD coach plays an essential role in giving them a space where they feel heard and understood, to deepen their understanding of ADHD and how it shows up in their feelings, thoughts and behaviours. The ADHD coach will also be aware of the client’s executive function challenges and be equipped to empower them to explore more ADHD-friendly strategies and find out what works for them.

Figure 1: ADHD coaching – three elements

 

How to be more ADHD-friendly when coaching an ADHD client

So how can you support your ADHD client who is looking for general coaching? Every ADHD coach has heard clients tell us about the coach who thought they had the answer for them. For example suggesting to the client with time-management issues that they  ‘could just add in more buffer time and leave earlier’.

There’s a famous quote which I find helpful, by Dr Russell Barkley (2014): “ADHD is not about knowing what to do, but about doing what one knows”. “People with ADHD know what to do, but they can’t do what they know”. So if clients with ADHD often already know what to do you may be coaching them so they can find a way to do it.

  • Know your limits and be ready to refer them on to a specialist ADHD coach. If they’re mainly focussing on their ADHD you may not be the right coach for them right now.
  • Every client is different – just because it worked for another ADHD client you had, doesn’t mean it will work for them.
  • Avoid rescuing (remember unconditional positive regard – Carl Rogers). Do you respect them and believe they have the potential to change and grow?
  • Many people with ADHD struggle with self-esteem and confidence. If they struggle to generate solutions, perhaps throw in several suggestions they can explore/push back against. (Having a suggestion they recognise won’t help might help them come up with something better.)
  • Don’t expect consistency – or completed homework (although it may be worth exploring what got in their way – with curiosity). 
  • Contract with them about if and when you might need to interrupt them. (No-one wants to get to the end of a session and realise they rambled off the topic they wanted to focus on).
  • If they have ADHD they may well have other neurodivergencies – only 30% have ADHD alone.
  • Be careful how you empathise – they may experience it as a minimisation of their struggles (unless you yourself have ADHD of course!). ADHD affects all executive functions – and all of us have some executive function challenges – that’s why their anecdotes may feel familiar. 

 

About the author

Sarah Bickers initially trained as a coach with Animas. She now works online as an ADHD coach (PCC). She brings to coaching her own lived experience of ADHD (herself and two of her children) as well as over 10 years of experience as a professional organiser. 

She works with clients to help them find their own more ADHD-friendly approach to both life and home. Clients describe her as an informed, calm, and supportive ally.

Sarah loves beauty, whether in street art, her garden, or a fjord (she is currently based in Norway).

 

Reference

  • Barkley, R. (2014). The Neuroanatomy of ADHD and thus how to treat ADHD – CADDAC [Video]. Youtube. https://bit.ly/4dY9Wn5 (Starts at 28.08)

 

Useful resources

 

 

ADHD Facts

  • Adulthood ADHD was only recognised by UK (NICE) in 2000. Until 2008, ADHD was thought only to impact children – with persistence of ADHD into adulthood. NICE guidelines were finally updated in 2018 to acknowledge that ADHD was under-recognised in women: https://bit.ly/4ekrR7R
  • Although barely recognised in the UK until 2000, ADHD is likely to have always been present in the population:
    https://bit.ly/3ALqzUL
  • The Lancet and NICE give a childhood incidence rate of 5% and an adult incidence rate of 3-4% (a total estimate of 2.6 million people in the UK with ADHD: 694,000 children and 1.9 million adults).
    The Lancet: https://bit.ly/3MrDduJ
    NICE: https://bit.ly/3yViHzw
  • We are STILL playing catch up – over 80% of people with ADHD in the UK don’t yet have a diagnosis.
  • ADHD UK:
    https://bit.ly/4dB1ZV4
  • ADHD is not thought by most to be caused by poor diet and parenting – genetic factors seem to be responsible for 70-80% of heritability:
    https://bit.ly/4cMjlx8
  • ADHD (and treatment with medication) is often stigmatised and misunderstood:
    https://bit.ly/4cMFdsf
  • Adults with ADHD are five times more likely to try to take their own life than those without ADHD (14.0% vs 2.7%): https://bit.ly/4eks4YH
  • The failure to identify and support individuals with ADHD is resulting in an increased proportion falling into crime: 24% of males in UK prison have a positive screen for childhood ADHD, while 45% of individuals in UK youth offenders have a positive screen for ADHD:
    https://bit.ly/3AIHJ5l
  • Adults with ADHD have a higher mortality rate than those without ADHD:
    Dalsgaard S. et al. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study, The Lancet, 385, 2190-2196