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A Program sf CHADD


                            Coaching and AD/HD in Adults

    Coaching is a relatively new field that has become more prominent in recent years. In
    general, coaches help individuals reach their fullest potential in life. As a specialty within the
    broader field of coaching, ADIHD coaching has emerged among the many approaches,
    services and treatments for ADIHD. This inforrnation and resource sheet will:

        0   describe ADIHD coaching and how it may help
            discuss who may benefit from AD/I-ID coaching
            describe the credentialing process available to AD/HD coaches
            provide practical suggestions for selecting a coach

    Coaching in General

    Coaching is an emerging field that seeks to help individuals accomplish their life goals. The
    coaching relationship is intended to help people achieve better results in their lives:
    academically, professionally, socially, or in any area of life they want to improve. Through
    individualized assistance and support, coaches help people concentrate on where they are
    now, where they want to be, and how they can get there.

    Currently, there is no published research evaluating the effectiveness of coaching as an
    intervention for individuals with ADIHD. There is anecdotal evidence (reports based on
    individual cases rather than a research study) suggesting that coaching may be a helpful
    supplement to other interventions for which there is a more established evidence base. This
    inforrnation and resource sheet and the suggestions it offers are based upon the emerging
    standards of coaching practice and the principles of behavior change, not on scientific
    literature.

    What is ADIHD Coaching?

    Although the concepts of professional and personal coaching have been around for several
    decades, the concept of ADIHD coaching was first addressed in the 1994 book, Driven to
    Distraction,' by Edward M. Hallowell, M.D., and John J. Ratey, M.D.

    ADIHD coaching seeks to address the daily challenges of living with ADIHD. A coach helps
    people with AD/HD carry out the practical activities of daily life in an organized, goal-
    oriented, and timely fashion. Through a close partnership, an ADIHD coach helps the client
    learn practical skills and initiate change in his or her daily life. A coach may help an adult
    with ADIHD:

        e    Maintain focus to achieve identified goals
        e    Translate abstract goals into concrete actions
        e    Build motivation and learn to use rewards effectively
I
    Through regular interactions, coaches learn how the symptoms of ADIHD play out in the
    daily lives of their clients and then provide encouragement, recomendations, feedback, and
practical techniques to address specific challenges. They may offer reminders, raise questions, or suggest
time management methods (see the related information and resource sheets on time management and
organizing the home and office). Coaches ask questions to help the client come up with strategies and act
on them. Examples of such questions are:

        What can you do about it?
    e   How can you motivate yourself to take action towards this goal?
    0   When must this action be completed?
        What steps have you taken already, and when will you take the remaining steps?

Regular meetings and check-ins are an essential part of the coaching process. These sessions can be
conducted in person, by phone, or by e-mail, depending on the client's preference. However, before the
coaching process begins, the client and the coach should have an initial session that addresses issues such
as client needs, expectations of the client and of the coach, and fees and payments (coaching services are
often not covered by traditional health insurance). The first coaching session is typically an in-depth, 1-2
hour meeting to develop a step-by-step plan for identifying and achieving the client's goals.

Who Benefits From ADIHD Coaching?

ADIHD coaching may be beneficial particularly for adults with ADIHD. It is important that clients are
ready for coaching before they commit to the process. Clients are ready for coaching when they are able
to admit that they have a problem, can spend the time necessary to create strategies for improving their
behavior, and can adhere to those strategies to the best of their ability.

Obstacles to Effective Coaching

There are several issues that can complicate the coaching process and often require a referral to a medical
or mental health professional:

    *   The client can not use simple self-management or organizational strategies to achieve goals,
        despite the coach's resources and reminders.
    e   The client has a co-existing psychiatric condition such as depression, bipolar disorder, anxiety
        disorder, substance abuse, or personality disorder.
    *   The client has stressful life circumstances such as marital problems, divorce, or death of a loved
        one.
    e   The client has a serious physical illness or other chronic medical condition.

Under such circumstances, the coach should work collaboratively with the medical or mental health
professionals involved in the client's care. In such cases, the client may benefit from the addition of
traditional treatments such as medication and psychological therapy.

ADfHD Coaching Credentials

There is currently no specialized schooling or licensing required to become a coach or a coach who
specializes in ADIHD. ADIHD coaches often have different educational and professional backgrounds
and diverse knowledge about AD/HD. Many coaches, including those who work with individuals with
ADIHD, seek credentialing through the International Coach Federation (ICF), an international association
of personal and business coaching that is evolving as the principal governing body for this field. General
requirements and more information on guidelines and accredited coach training programs can be found on
the ICF Web site (www.coachfederation.org). The ICF recognizes ADIHD coaching as a special area of
expertise. Because coaching is a very broad field with many areas of subspecialty, adults with ADIHD
should ask potential coaches about their experience with ADIHD and coach-specific training in ADIHD
as well as their credential status.

Because the coaching field is still in its infancy, much remains to be done to establish practice standards
and ethics. In 2002, a task force of coaches organized by the Attention Deficit Disorder Association
(ADDA) wrote "The Guiding Principles for Coaching Individuals with Attention Deficit is order."^ This
document proposes the essential elements of ADIHD coaching, establishes standards, and outlines ethical
principles to help people better understand ADIHD coaching and field standards.

Finding and Choosing an ADlHD Coach

Step One. Coaching is a collaborative process so it is important to find the right match in a coach. First,
ask yourself the following questions before contacting prospective coaches:

    e   Is it important that my coaching sessions be face-to-face? (If so, look for a coach who is
        geographically close and offers this as part of a service package. Many coaches conduct the initial
        session in person, and then do weekly check-ins by phone and/or e-mail.)
    *   Do I prefer to be coached by a man or a woman?
    *   In addition to the coach's knowledge of ADIHD, would I benefit from a coach who has a
        background in business, academia, or gender issues?
    *   Am I looking for someone who has expertise in an area such as organization or family issues?
    *   Do I want someone who has a lot of energy, or someone who takes a more subtle approach?
    *   Is a sense of humor important? Would a more serious person make a better match?

Step Two. Compile a list of potential coaches with training in ADIHD coaching and interview them,
using the following types of questions:

        How long have you been a coach?
        What is your approach to coaching adults with ADIHD?
        How many clients with ADIHD have you coached?
        Have you received formal training in coaching? Did this include certification or credentialing of
        any kind?
        What coach training courses or conferences have you attended? Were they ADIHD-specific?
        Are you involved in any local professional coaching groups? Are they ADIHD-related?
        In what ways are you contributing to the development of the field of ADIHD coaching?
        What is your confidentiality/privacy policy?

Step Three. Take notes on each coach's answers to these questions as well as your own overall reaction
to the personality and style of each coach.

Step Four. Review all of the information and select the coach that best meets your needs.

Coaching Is Not Therapy

Coaches deal with problems in everyday living such as organization, time management, memory, follow-
through, and motivation. Coaches focus on what, when andvhow - never why. They are not trained to
address psychiatric, emotional and interpersonal problems, which should be addressed by mental health
professionals. Through formal educational programs, mental health professionals (e.g. psychiatrists,
psychologists, clinical social workers, psychiatric nurse practitioners, marriage and family therapists) are
trained to diagnose and treat mental health issues such as depression, anxiety, personality disorders, and
interpersonal difficulties. They also must have a license to practice. Therapists work primarily through
face-to-face contacts while many coaches also work by telephone or e-mail.

Depending on an individual's diagnosis, the mental health professional may employ a number of
psychotherapeutic approaches such as cognitive-behaviortherapy and behavior modification. The goal of
therapy is generally to help clients address the symptoms and problems that brought them to therapy in
the f i s t place. Often, mental health professionals take a "problem-centered" approach to therapy rather
than a "client-centered" approach; treatment lasts until the specific problem is no longer causing
significant impairment and disruption to the client.

If an adult with ADIHD needs assistance primarily in dealing with the practical challenges in daily life, a
coach may be a good person to help. If the adult needs assistance with emotional, psychiatric, or
interpersonal problems, then a therapist should be consulted. If an adult with ADmD needs both types of
assistance, it may be helpful to select a coach and a therapist, and ask them to work with each other.

Summary

Although the field of coaclung is still developing and does not yet have a research base that demonstrates
its effectiveness as an intervention for adults with ADIHD, many adults find that having a coach who is
familiar with ADIHD can be helpful in facing the challenges of daily life. Individuals who need more
information about coaching should consult the resources listed below. Because there is a great need for
research evaluating the effectiveness of AI)/HD coaching, coaches and other professionals are strongly
encouraged to pursue research on this emerging form of support for those dealing with ADIHD-related
challenges.

References

1. Hallowell, E.M., & Ratey, J.J. (1994). Driven to distraction. New York: Pantheon Books.
2. ADDA Subcommittee on ADD Coaching. (2002). The ADDA Guiding Principles+fovCoaching
   individuals with Attention Deficit Disorder. Hyde Park, IL.: Nancy Ratey & Peter Jaksa (Eds.).

Suggested Web sites

International Coach Federation, www.coachfederation.org
CHADD Directory of Professionals, Products & Services (coming in February 2004)
ADDitude Magazine ADIHD Coach Directory, www.additudemag.corn
ADDA Yellow Pages, www.add.org

Suggested Reading

Quinn, P.O., Ratey, N.A., & Maitland, T.L. (2000). Coaching college students with AD/HD. Silver
Spring, MD: Advantage Books.

Quinn, P. & Ratey, N. (Eds.). (In press). AD/HD throughout the lifespan: Research, diamosis and
treatment. South Easton, M A : S.C. Publishing, Inc.

Ratey, N. (2002). Life coaching for adult ADIHD. In Goldstein, S. & Ellison, A.T. (Eds.). Clinician's
guide to adult ADHD: Assessment and Intervention. London: Academic Press.
This information & resource sheet was developed for the National Resource Center on AD/HD under
CDC grant R04/CCR321831-01-1 by the Attention Deficit Disorder Association. It was approved by
CHADD's Professional Advisory Board in December 2003. Permission is hereby granted to reproduce
this document in its entirety as long as the NRC name, contact information, and logo are included.



                For further information about AD/HD or CHADD, please contact:

                              National Resource Center on ADED
                Children and Adults with Attention-Deficit/Hyperactivity Disorder
                               8181 Professional Place, Suite 150
                                     Landover, MD 20785




                     Please also visit the CHADD Web site at www.chadd.org.

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Finding the Right AD/HD Coach

  • 1. Resource A Program sf CHADD Coaching and AD/HD in Adults Coaching is a relatively new field that has become more prominent in recent years. In general, coaches help individuals reach their fullest potential in life. As a specialty within the broader field of coaching, ADIHD coaching has emerged among the many approaches, services and treatments for ADIHD. This inforrnation and resource sheet will: 0 describe ADIHD coaching and how it may help discuss who may benefit from AD/I-ID coaching describe the credentialing process available to AD/HD coaches provide practical suggestions for selecting a coach Coaching in General Coaching is an emerging field that seeks to help individuals accomplish their life goals. The coaching relationship is intended to help people achieve better results in their lives: academically, professionally, socially, or in any area of life they want to improve. Through individualized assistance and support, coaches help people concentrate on where they are now, where they want to be, and how they can get there. Currently, there is no published research evaluating the effectiveness of coaching as an intervention for individuals with ADIHD. There is anecdotal evidence (reports based on individual cases rather than a research study) suggesting that coaching may be a helpful supplement to other interventions for which there is a more established evidence base. This inforrnation and resource sheet and the suggestions it offers are based upon the emerging standards of coaching practice and the principles of behavior change, not on scientific literature. What is ADIHD Coaching? Although the concepts of professional and personal coaching have been around for several decades, the concept of ADIHD coaching was first addressed in the 1994 book, Driven to Distraction,' by Edward M. Hallowell, M.D., and John J. Ratey, M.D. ADIHD coaching seeks to address the daily challenges of living with ADIHD. A coach helps people with AD/HD carry out the practical activities of daily life in an organized, goal- oriented, and timely fashion. Through a close partnership, an ADIHD coach helps the client learn practical skills and initiate change in his or her daily life. A coach may help an adult with ADIHD: e Maintain focus to achieve identified goals e Translate abstract goals into concrete actions e Build motivation and learn to use rewards effectively I Through regular interactions, coaches learn how the symptoms of ADIHD play out in the daily lives of their clients and then provide encouragement, recomendations, feedback, and
  • 2. practical techniques to address specific challenges. They may offer reminders, raise questions, or suggest time management methods (see the related information and resource sheets on time management and organizing the home and office). Coaches ask questions to help the client come up with strategies and act on them. Examples of such questions are: What can you do about it? e How can you motivate yourself to take action towards this goal? 0 When must this action be completed? What steps have you taken already, and when will you take the remaining steps? Regular meetings and check-ins are an essential part of the coaching process. These sessions can be conducted in person, by phone, or by e-mail, depending on the client's preference. However, before the coaching process begins, the client and the coach should have an initial session that addresses issues such as client needs, expectations of the client and of the coach, and fees and payments (coaching services are often not covered by traditional health insurance). The first coaching session is typically an in-depth, 1-2 hour meeting to develop a step-by-step plan for identifying and achieving the client's goals. Who Benefits From ADIHD Coaching? ADIHD coaching may be beneficial particularly for adults with ADIHD. It is important that clients are ready for coaching before they commit to the process. Clients are ready for coaching when they are able to admit that they have a problem, can spend the time necessary to create strategies for improving their behavior, and can adhere to those strategies to the best of their ability. Obstacles to Effective Coaching There are several issues that can complicate the coaching process and often require a referral to a medical or mental health professional: * The client can not use simple self-management or organizational strategies to achieve goals, despite the coach's resources and reminders. e The client has a co-existing psychiatric condition such as depression, bipolar disorder, anxiety disorder, substance abuse, or personality disorder. * The client has stressful life circumstances such as marital problems, divorce, or death of a loved one. e The client has a serious physical illness or other chronic medical condition. Under such circumstances, the coach should work collaboratively with the medical or mental health professionals involved in the client's care. In such cases, the client may benefit from the addition of traditional treatments such as medication and psychological therapy. ADfHD Coaching Credentials There is currently no specialized schooling or licensing required to become a coach or a coach who specializes in ADIHD. ADIHD coaches often have different educational and professional backgrounds and diverse knowledge about AD/HD. Many coaches, including those who work with individuals with ADIHD, seek credentialing through the International Coach Federation (ICF), an international association of personal and business coaching that is evolving as the principal governing body for this field. General requirements and more information on guidelines and accredited coach training programs can be found on the ICF Web site (www.coachfederation.org). The ICF recognizes ADIHD coaching as a special area of expertise. Because coaching is a very broad field with many areas of subspecialty, adults with ADIHD
  • 3. should ask potential coaches about their experience with ADIHD and coach-specific training in ADIHD as well as their credential status. Because the coaching field is still in its infancy, much remains to be done to establish practice standards and ethics. In 2002, a task force of coaches organized by the Attention Deficit Disorder Association (ADDA) wrote "The Guiding Principles for Coaching Individuals with Attention Deficit is order."^ This document proposes the essential elements of ADIHD coaching, establishes standards, and outlines ethical principles to help people better understand ADIHD coaching and field standards. Finding and Choosing an ADlHD Coach Step One. Coaching is a collaborative process so it is important to find the right match in a coach. First, ask yourself the following questions before contacting prospective coaches: e Is it important that my coaching sessions be face-to-face? (If so, look for a coach who is geographically close and offers this as part of a service package. Many coaches conduct the initial session in person, and then do weekly check-ins by phone and/or e-mail.) * Do I prefer to be coached by a man or a woman? * In addition to the coach's knowledge of ADIHD, would I benefit from a coach who has a background in business, academia, or gender issues? * Am I looking for someone who has expertise in an area such as organization or family issues? * Do I want someone who has a lot of energy, or someone who takes a more subtle approach? * Is a sense of humor important? Would a more serious person make a better match? Step Two. Compile a list of potential coaches with training in ADIHD coaching and interview them, using the following types of questions: How long have you been a coach? What is your approach to coaching adults with ADIHD? How many clients with ADIHD have you coached? Have you received formal training in coaching? Did this include certification or credentialing of any kind? What coach training courses or conferences have you attended? Were they ADIHD-specific? Are you involved in any local professional coaching groups? Are they ADIHD-related? In what ways are you contributing to the development of the field of ADIHD coaching? What is your confidentiality/privacy policy? Step Three. Take notes on each coach's answers to these questions as well as your own overall reaction to the personality and style of each coach. Step Four. Review all of the information and select the coach that best meets your needs. Coaching Is Not Therapy Coaches deal with problems in everyday living such as organization, time management, memory, follow- through, and motivation. Coaches focus on what, when andvhow - never why. They are not trained to address psychiatric, emotional and interpersonal problems, which should be addressed by mental health professionals. Through formal educational programs, mental health professionals (e.g. psychiatrists, psychologists, clinical social workers, psychiatric nurse practitioners, marriage and family therapists) are trained to diagnose and treat mental health issues such as depression, anxiety, personality disorders, and
  • 4. interpersonal difficulties. They also must have a license to practice. Therapists work primarily through face-to-face contacts while many coaches also work by telephone or e-mail. Depending on an individual's diagnosis, the mental health professional may employ a number of psychotherapeutic approaches such as cognitive-behaviortherapy and behavior modification. The goal of therapy is generally to help clients address the symptoms and problems that brought them to therapy in the f i s t place. Often, mental health professionals take a "problem-centered" approach to therapy rather than a "client-centered" approach; treatment lasts until the specific problem is no longer causing significant impairment and disruption to the client. If an adult with ADIHD needs assistance primarily in dealing with the practical challenges in daily life, a coach may be a good person to help. If the adult needs assistance with emotional, psychiatric, or interpersonal problems, then a therapist should be consulted. If an adult with ADmD needs both types of assistance, it may be helpful to select a coach and a therapist, and ask them to work with each other. Summary Although the field of coaclung is still developing and does not yet have a research base that demonstrates its effectiveness as an intervention for adults with ADIHD, many adults find that having a coach who is familiar with ADIHD can be helpful in facing the challenges of daily life. Individuals who need more information about coaching should consult the resources listed below. Because there is a great need for research evaluating the effectiveness of AI)/HD coaching, coaches and other professionals are strongly encouraged to pursue research on this emerging form of support for those dealing with ADIHD-related challenges. References 1. Hallowell, E.M., & Ratey, J.J. (1994). Driven to distraction. New York: Pantheon Books. 2. ADDA Subcommittee on ADD Coaching. (2002). The ADDA Guiding Principles+fovCoaching individuals with Attention Deficit Disorder. Hyde Park, IL.: Nancy Ratey & Peter Jaksa (Eds.). Suggested Web sites International Coach Federation, www.coachfederation.org CHADD Directory of Professionals, Products & Services (coming in February 2004) ADDitude Magazine ADIHD Coach Directory, www.additudemag.corn ADDA Yellow Pages, www.add.org Suggested Reading Quinn, P.O., Ratey, N.A., & Maitland, T.L. (2000). Coaching college students with AD/HD. Silver Spring, MD: Advantage Books. Quinn, P. & Ratey, N. (Eds.). (In press). AD/HD throughout the lifespan: Research, diamosis and treatment. South Easton, M A : S.C. Publishing, Inc. Ratey, N. (2002). Life coaching for adult ADIHD. In Goldstein, S. & Ellison, A.T. (Eds.). Clinician's guide to adult ADHD: Assessment and Intervention. London: Academic Press.
  • 5. This information & resource sheet was developed for the National Resource Center on AD/HD under CDC grant R04/CCR321831-01-1 by the Attention Deficit Disorder Association. It was approved by CHADD's Professional Advisory Board in December 2003. Permission is hereby granted to reproduce this document in its entirety as long as the NRC name, contact information, and logo are included. For further information about AD/HD or CHADD, please contact: National Resource Center on ADED Children and Adults with Attention-Deficit/Hyperactivity Disorder 8181 Professional Place, Suite 150 Landover, MD 20785 Please also visit the CHADD Web site at www.chadd.org.