ADHD Therapies

Life Coach or Therapist: Who Should You See First?

An ADHD life coach can help you better manage your time and finances, but that won’t solve any big, underlying problems if you struggle with difficult emotions or the role your diagnosis plays in your life. In that case, you might be better off with an understanding therapist.

Two doors representing the ADHD coach and the therapist.

Many adults recently diagnosed with attention deficit hyperactivity disorder (ADHD or ADD) opt to see an ADHD coach to help them work through core issues of the condition — like planning and time management — that can sometimes make daily life and realizing other goals difficult.

But what if the answer, at least right away, isn’t a life coach, but a therapist? How does one know which expert to see?

Beth Main and Sandy Maynard, certified ADHD coaches, explain:

ADHD Coach vs. Therapist

Main: In general, a therapist facilitate healing, while an ADHD coach facilitate action.

A therapist spends more time on the emotional aspects of having ADHD and can treat co-existing conditions such as mood disorders and anxiety. Coaches help clients develop skills and strategies to overcome executive function deficits such as planning, organizing, and time management.

Coaches can — and often do — work on emotional challenges to some extent, and therapists also work on life skills. The difference is the degree to which each need is present.N

If the primary challenge is managing or understanding emotions, particularly those that have been present for years, a therapist would likely be the appropriate option.

Likewise, if the primary goals are getting organized, managing time, and creating healthy routines, coaching might be the better approach. It is not uncommon for a person to be working with a therapist and a coach at the same time.

[Click to Read: Coaching Through the ADHD Life Cycle]

Maynard: Untreated co-occurring conditions — mood disorder, anxiety, substance abuse, and/or obsessive-compulsive disorder — should be treated with medication and/or therapy before coaching can be effective. Not being able to control our emotions is another reason to set up time with a therapist. A client has to be ready, willing, and able to be coached for the process to work.

Main: In terms of certification, psychologists must be licensed by their state in order to practice, but certification is optional for coaches. A credential is a good indication that the coach has the appropriate level of training and experience to be effective.

Besides certification, you should always interview a prospective coach and make your own decision. Ask questions about their experience and training, and always make sure you feel comfortable with them.

Distracted—or Avoidant Behavior?

Maynard: Sometimes the need for therapy is not apparent. My client, Fred, came to me ready to begin coaching. Fred’s plans were to leave the family business and start his own business on the West Coast, where he had established some contacts and resources. Together Fred and I defined the steps to accomplish this, and developed structures and strategies to achieve his goals. Every week Fred left with a list of things to get done and plans to accomplish them, and every week he returned with nothing crossed off the list.

When I asked what he spent his time on, the list of things he managed to do was long. We assessed what was wrong. It was not that he was distracted, since we had identified and worked on eliminating typical sources of distraction. Fred had also implemented visual reminder systems to keep him on track with his goals. It seemed like avoidance behavior to me.

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I suggested that, since coaching wasn’t working, something else might be preventing him from moving forward. We put coaching on hold until he talked with his therapist.

Three months later Fred returned with a list of goals, thanking me for suggesting he see his therapist. Emotional blocks were indeed preventing him from moving forward.

Fred told me, “Sandy, you were wrong about coaching not working at all. It’s been three whole months, and I haven’t lost my list!” We both laughed and reviewed his list and the strategies we had discussed. Fred reported the following week that nearly all the items on his list were completed, and his desk was starting to look like a workspace instead of a recycling bin.

Poor Organization? Or Emotional Blocks?

Maynard: Another client of mine, Gwen, was sure that coaching would help her develop better time management and organization systems to help her find a new job after her divorce.

We talked about her resume and a template for a cover letter that she could customize for each application. We looked at her schedule and prioritized her responsibilities, carving out time for job-hunting by eliminating non-essential tasks.

Gwen often returned with no progress made. The common denominator was “The Ex.” Even though the divorce was final, there were clear signs of co-dependency and blame.

Gwen had not accepted her divorced status or processed her resentment. Her emotional state kept her in constant turmoil and distracted her from the simplest tasks she set out to do.

I suggested that it might be too soon to move forward with her goals, and that she may need time to heal. I recommended a therapist who does brief cognitive behavioral therapy (CBT), and emphasized that a full understanding of the emotional factors holding her back could let her move forward.

Three months later, I got a call from Gwen’s therapist, saying that she was ready to resume working with me, and our first coaching session confirmed that. Gwen seemed calmer, happier, and more self-assured. Early on Gwen struggled to be consistent, but she took responsibility for her actions, and, with practice, was able to make less impulsive choices.

Many of my clients still see their therapists, and rely on therapy to work on their feelings of fear and anger. Coaching is a rewarding and beneficial experience when we are ready to be coached, but working with a therapist is often needed to make that happen.

[Click to Download: Your Free Guide to ADHD Coping Mechanisms]