Dr. Daniel Amen on the Power of ADHD Coaching

If you’ve tried medication, counseling, and every other alternative therapy out there, ADHD coaching might be the next step in your treatment plan.

By Daniel Amen, M.D. Verified Updated on December 27, 2019

Coaching is a powerful treatment for many people with ADHD. Knowing what you want your future to look like is an important part of coaching. The most common question ADHD coaches ask is “What do you want?” The answers to this question will let you develop a “metaview,” a big-picture perspective. People with ADHD tend to struggle with this.

I use garden metaphors to help clients see the big picture. I ask them what they would like the landscape of their life to look like, the type of “flowers” they want to plant, and the care the garden is going to require. Clients often find that they spend too much time nurturing a flower they don’t like while neglecting another more important part of their garden.

Reaching a goal that you didn’t think you could reach brings a great feeling. Most people come to coaching fearing that they will never be organized or successful in a job because of their ADHD. A significant moment for people with ADHD is when they are asked: “OK, you have ADHD. How do you want to be with it? How do you want to show up in life, given that you have attention deficit? You have some choices here. What do you want?

With the help of a coach, clients learn to take a 360-view of what it will take to achieve their goal:

What will I have when the goal is accomplished?
What am I saying “yes” to by working toward my goal?
What do I need to say “no” to in working toward my goal?
What resources do I need to obtain or develop?
What habits do I need to have in place?
What has gotten in the way of realizing my goal in the past?
What three things can I do differently from what I have tried in the past?
By when do I want to accomplish my goal?

When you hire an ADHD coach, he or she will likely ask you about your values. Your values are a thumbprint of who you are. They are the things you hold sacred, that you can’t live without — love, family, honor, joy, honesty, and spirituality. They can be turned to when making decisions, trying to understand interpersonal relationships, and overcoming procrastination. Discovering your values is a starting point that gives you a sense of direction and ownership of your goals.

[Click to Read: Coach or Therapist — Who Should You See First?]

Overcome Roadblocks

Coaching encourages the client to confront the roadblocks in the way toward achieving her goal and to look at them from different perspectives to see what she can learn about them. Some of the common roadblocks people with ADHD face are fear of failure, fear of success and responsibility, loneliness, rejection, sadness, emptiness, and fear of commitment.

Good coaching invites people to be challenged in a way that holds them in a soft, friendly light. The coach creates an environment in which risk-taking is safe. When a client takes a risk, it shows that she is taking action and moving in the direction of her goal. People with ADHD who have had a long list of failures are relieved. By breaking through a roadblock, they develop more confidence. This, in turn, gives them momentum to move toward their goals. People with ADHD have a strong drive for stimulation, so once they set a goal that is important, they are hard to stop.

Here are some comments from my clients who have used ADHD coaching to achieve their goal:

“I feel like I lost weight in a whole different way!”
“I am living a life of intention.”
“This is more powerful than any therapy I’ve ever done.”
“When someone else starts to believe in you, you start to believe in yourself.”
“I feel more focused and aware of the choices I make.”
“The belief that I was very disorganized disappeared.”

How to Get Started

Although professionals conduct ADHD coaching in various ways, the format at the Amen Clinics looks like this. The client attends an initial one-on-one meeting that usually runs for two to three hours. The meeting can be done over the phone, if distance is a factor.

At the initial meeting, clients identify several areas that they want to focus on with the coach. They assess where they are and start to identify actions and habits that will move them toward their goals.

Some areas of focus might be:

to create and follow a regular schedule for routines, personally and professionally
to break rigid thought patterns
to better follow through on commitments
to create and follow a consistent exercise program.

The coach’s role is to hold the focus for the clients in pursuing goals. A client with ADHD sometimes forgets why he came to coaching or why he wanted to make changes in his life. A coach keeps him pointed toward his goals and reminds him, especially when the going gets tough, of what he is trying to achieve.

Coaching sessions after the initial meeting take place over the phone for 30 minutes a week. Some clients prefer meeting in the office for an hour once a week, or twice a week for 15 or 30 minutes. Some coaches include a daily check-in period via phone, e-mail, or text to help with accountability.

Coaching involves teaching the client skills that he can use on his own to meet his goals. The two most important parts of developing a skill are practice and commitment. During the early stages of coaching, the client goes through ups and downs, tests the waters, retreats after a failure, moves forward with fear, and makes a commitment to succeed. Here are several skills that coaches help their clients acquire:

1. Awareness. One of the biggest pieces of building any skill is the awareness of when and where to use it. Building awareness is a challenge for most people with ADHD. “Feeling fuzzy” is how one of my clients describes what gets in the way of his ability to make decisions and follow routines. Another client calls it his “deer in the headlights” feeling. He can’t seem to act. A third person refers to it as “the twirls.” “I go from room to room, not sure why I went there.”

Being aware is imperative to success. The coach helps his client develop internal awareness by teaching him to ask himself : “How do I know when I am fully present?” “What am I choosing right now?” “Where is my awareness?” The answers help a client decide whether he is on or off track. Coaches set up systems — such as visual or auditory reminders — to prompt clients to ask such questions several times a day.

2. Habits. Many believe that their habits are impossible to change. Yet many people who decide to work with a coach want to change and eliminate the struggles they experience. A good coach — one who is there to pick you up when you fall and cheer you at the finish line — believes that you can change your habits.

Coaching works when the client also believes that his habits can be changed. Coaches use several techniques to strengthen a client’s commitment to change. One is “stepping over the line.” The client literally steps over a threshold to indicate that she is leaving behind what she does not want and “stepping into” what she does want. We also use a “yes/no” board — a poster board with “Yes” on the left side and “No” on the right. Clients write down things that they are saying no and yes to in order to achieve their goals. Saying “yes” to taking a continuing education class might mean saying “no” to a regular night out with friends. This tool helps them visualize what they must give up in order to gain something else.

3. Perspective and choice. What makes coaching successful is the client’s ability to choose what will work for her. The power of choice gives a client a sense of power and fulfillment. You don’t feel like a victim but an owner, as described by Steve Chandler in his book Reinventing Yourself. “Owners create and victims react. Taking ownership is the highest form of focus. When you are intentional in your choices, your life has clarity and fullness. You are living on purpose, not by accident.”

One client thought she would never be able to pass the medical board exam. She had failed it several times. After a couple of coaching sessions, the client realized that her failures made her think she was a loser. The coach helped her see that her belief wasn’t accurate. The client realized that she hadn’t done her best to prepare for the test — by working with a study partner or creating a review schedule. Once she realized that it was her attitude that was holding her back, not her abilities, she moved forward.

Put the “Gremlins” in Jail

“Gremlins” are the voices within us that hold us back from achieving our goal. They prevent us from growing and keep us from taking action. Thomas, a client I worked with, was making significant strides during the first several weeks of coaching. He started to hit roadblocks when he tackled bigger challenges, such as organizing his desk, sticking to a routine, and exercising. He was stuck in the belief that he was incapable of doing these things because of his past performance, his ADHD, and his procrastination in making commitments.

Thomas developed an imaginary jail to send his gremlin to when he acted up. Once the gremlin was out of the way, Thomas was instructed to ask himself: “I’ve noticed that my gremlin was making judgments I don’t agree with. What are my choices in this situation?” This gave control back to Thomas to make his own decisions and not let his gremlin decide for him. We tied his values to his decision-making, choosing actions that involved integrity, spirituality, and family. It didn’t take long for Thomas’s self-esteem to take off.

Keeping Up the Relationship

My clients are asked to make at least a three-month commitment, primarily to acknowledge that long-term change takes time. Six months is the minimum for most of them. Many people with ADHD choose to work with a coach over many years, talking once or twice a year on the phone or in person. If a client moves away, the relationship does not have to end. It’s calming for clients to know that there is always a person out there who accepts, and doesn’t judge them, and who celebrates their achievements.

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