Thursday, October 22, 2009

What is AD/HD Coaching and How is it different from therapy?

With "coaching" still being a relatively new phenomenon, many of you may be confused about what exactly AD/HD Coaching is, and how it is different from therapy. This answer can vary widely, depending on who your coach is and what credentials he or she has.

In the DC area alone I know coaches who range from Ph.D.'s to professional MOM's. Furthermore, their approaches range from one like my own, which has a lot in common with Cognitive Behavioral Therapy, and one's that rank closer to that of a personal organizer. Coaching is held in the office, in the client's home, or even over the phone with hundreds of miles between the coach and client. Like the word "therapist", the word "coach" has very little meaning in and of itself. Anyone can call themselves a coach and hang their shingle for business--a little scary.

In fact, I've had clients decide NOT to pursue services because they had previously been to a "coach" and came out worse for it. This saddens and angers me. On the other hand, I can say the same for some people who have been to bad therapists...which can sometimes even be those with a prestigious Ph.D. after their name. In no way do I believe that having a particular set of credentials necessarily makes you good at what you do, but it does mean you have gone through the training necessary to know what you should do. More importantly, the word "licensed" as in "Licensed Clinical Psychologist" means there is an entity monitoring that person, making sure he or she is behaving in an ethical way toward their clients and keeping their skills current by requiring continuing education.
Coaching is not there yet, although there are people and organizations working hard to create standards and requirements for the coaching community.

Another important issue is that, to date, there is very little research on AD/HD coaching and its effectiveness. As a psychologist, I believe strongly in the idea of empirically validated interventions, meaning that any activity I engage my client in has been backed up by research, not just anecdotal evidence. This is why the particular coaching intervention used by myself and my coaches at Psych Ed Coaches has been researched in multiple independent studies. One of these was my own, which I presented at the 2009 International CHADD Convention. I am now in the midst of turning this study into a book with Dr. Frances Prevatt of Florida State University, one of the leading AD/HD Coaching research sites. There are a few other helpful studies; however, while they all investigate "AD/HD Coaching", as I said before, this does not mean they are investigating the same intervention across studies. For example, one recent study looks at AD/HD Coaching from a workshop perspective, and another lumps it in with many other types of coaching.

My personal approach to AD/HD Coaching is, as I said, a lot like Cognitive Behavioral Therapy...with an emphasis on the behavioral. The client and I meet once a week for 50 minutes in my office. There, using the Psych Ed Coaches "Coaching Handbook" we record the clients' goals in a measurable, objective way. Weekly sessions are used to explore and create small steps the client can take toward meeting their goals, which can be anything from effectively using a planner, to managing finances, to eating more healthfully. The cognitive and emotive part comes into play when a client becomes stuck or has trouble progressing and the reasons why need to be explored. We then link these feelings and thoughts to the client's behavior so that they become congruent and the client can move forward. Is it coaching, therapy, or does it even matter what you call it? I've seen it work and I have the research to back it up.

Some things to be aware of...coaches who do not have a mental health background should NOT be exploring this "why". They do not have the training to do so, and this is probably the number one reason people can have a negative experience with coaching. Likewise, a therapist should not be calling a session coaching and then spend 45 minutes exploring a client's deep seeded pathology. It is a delicate balance and a good coach, regardless of which side of the coin they lie on, should know their boundaries.

Overall, coaching can be a great choice for those looking to improve their executive functioning behavior deficits. Like shopping for a dentist or a dress, just remember...buyer beware.

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