Tuesday, September 15, 2009

The AD/HD Coaching Model: An Interactive Approach for Positive Change

In previous blogs I’ve mentioned that the primary goal of AD/HD coaching is to help individuals with AD/HD self-initiate change in their daily lives. To that end, I’ve developed a model for AD/HD coaching. It’s built on three core principles – Partnership, Structure, and Process. In combination these three elements enable the coaching process to take form and shape. No one element stands alone—it is the synergy of the three working together that create the coaching dynamic.

Let’s take a closer look at each component:

Partnership: By co-engineering a partnership with the coach, the client takes charge of the process, customizes the service to meet their needs, and develops a user-friendly partnership to motivate and move them forward. The client thus plays a central role in molding and shaping the dynamics of the coaching process.

Structure: Coaching establishes both internal and external strength-based structures to improve a client’s ability to focus and channel their abilities toward achieving set goals. Structuring takes the client repeatedly through steps such as attending to details, planning, organizing, and prioritizing, allowing the client to essentially “fake it 'til they make it.”

Process: Through a process of inquiry, the coach guides the client through self-exploration and learning. The coach poses non-judgmental questions to assist the client in analyzing the situation at hand and work toward an achievable resolution. The focus is on problem solving and being in action. The client thus becomes empowered and more willing to take ownership of his or her actions or lack of actions, as a result of discovering their own solutions.


June represents a typical client who comes to me for coaching services. She is married with two kids. She has recently been diagnosed with AD/HD and learned about coaching through a local AD/HD support group. In our initial intake she said she has been disorganized and distracted as long as she can remember. She said she is always late to pick up her kids from school and to other appointments, forgets to pay the bills, looses her keys regularity, and finds herself rearranging the dishes in cupboards or doing “anything else but” her priority tasks. Her husband has threatened to leave her if she doesn’t become more responsible, and her kids have learned to not depend on her when she makes promises to them. She is desperate and feels that she has tried everything. She told me she has read countless self-help books on time management and organization, but is not able to consistently apply the concepts.

Since her diagnosis she has been taking medication for her AD/HD. She said it helps “if only I can remember to take it!” She also has been seeing a therapist regularly to deal with her feelings of being a failure as a wife and a mother. She said it’s helped her with her emotions, but she still struggles with trying to change her daily habits and behavior.

It was clear that June was experiencing difficulties in a variety of different areas due to her AD/HD. Together, through the coaching process, we identified a couple areas she wanted to work on immediately: Her ability to measure time and prioritizing tasks – namely her ability to assign and direct her attention to the most important tasks for that day and to complete them in a timely manner and, her ability to self-monitor.

Below are a few examples of how we worked together. Remember, coaching is very individualized and tailored to each client’s needs, so what worked for June might or might not work for everyone!

  • Measuring time and prioritizing tasks: By talking out actions and plans with me on a bi-weekly basis over the phone June was able to identify what her top priorities were for each day. We designated start and stop times for working on her priorities and created accountability around completion of them through e-mail check-ins. Independent of me, June also used a timer and created a "time card" for her-self on her computer so she would "clock-in" to work, so to speak, and "clock-out" for each task.
  • Self-monitoring: June would log in a journal what she did each day. In our phone check-ins she would report to me events that had happened during the week. We would review instances where she felt she had made bad choices, for example, attempting to run several errands on the way to pick up her kids when she was already over 45 minutes late!

By analyzing these occurrences, June was able to self-reflect and talk-through possible alternative courses of actions. She then "programmed" me to keep reminding her of her tendency to get distracted by non-important tasks. I would do reality checks with her by saying: "Remember, June, you tend to fool yourself into thinking that in the moment it’s important to rearrange the cupboards or stop run five errands on your way to pick up your kids– how can you keep yourself focused?"

Also, by tracking her medication intake more closely she was able to become more aware of how she behaved on and off medication and to be more aware of the warning signs of when it was wearing off. We designated specific times to take her medication as directed by her doctor and set her wristwatch as well as her cell phone to beep when she needed to take her next dose.

June’s direct involvement in the creation of strategies, including designing the coaching partnership itself, maintained her interest and motivated her to change her behavior. By providing structure and support and prompting her with questions, the coach was able to help June learn the skills to stay on track.

Until next time! And remember, if you have any questions please submit them!

Warmly, Nancy