Kevin’s Story
The story of “Kevin,” a young adult male in his early twenties, is a case study in the effectiveness of combining coaching with psychopharmacology and psychology in treating clients with ADHD. Kevin was enrolled in a well-known university in Washington, D.C. Kevin reported back to his family in New York City that all was going smoothly his first year away at school. He reported that his classes were interesting and “doable.” He was doing well socially and academically and was having a successful freshman year. During school breaks, Kevin would return home to New York City and accompany his family on vacations to destinations including Israel, Switzerland and the Hamptons. All seemed normal. During the summer months, Kevin’s father inquired about Kevin’s grades before paying the upcoming year’s tuition. At this point, his father discovered that Kevin had neither attended his classes, nor did any course work or took any exams. Needless to say, Kevin received no credit for his freshman year from the university. His parents told him that before he could return to that school, he needed to register for two classes at a local university and work in tandem with a coach to ensure success. If these requirements were not met, he would not be going back to the university in the fall.
Kevin was immediately sent to a New York psychologist, Dr. Stephen Josephson, who diagnosed Kevin with ADHD. He sent Kevin to a psycho-pharmacologist, who prescribed medication to help lower his distractibility, and to a life coach specializing in clients with ADHD. The “triad” was in place. The life coach portion of the “triad” helped Kevin implement the necessary tools to enhance his executive functioning abilities, encourage him to keep on task, and realize that his goals were attainable. With Kevin’s medication in place, he met weekly with his psychologist to discuss shame, resistance, blame and entitlement. Kevin also began meeting weekly with his coach. Together they planned out detailed routines, created working strategies, broke down tasks into organized steps and set realistic goals. The weekly meetings were supported by two or three additional weekly “flash session” meetings, conducted by phone. The flash sessions were set up to ensure Kevin’s accountability and to determine if he were meeting his goals. What tools could be used to accomplish his goals? What was contributing to his distraction?
If Kevin had a difficult time starting and completing his homework, his coach used a timer to keep him on task. Set for just 30 minutes, the timer required Kevin to stay immersed in his work. When he became frustrated, his coach would encourage him and together they would set smaller goals. When those were accomplished, bigger goals were added until they were met without anxiety and failure. The continued impact of positive encouragement, implementation of tools, routine, breaking down tasks, creating strategies, organizing steps and rewards were all part of the coach’s work with the client.
After an initial period of success, Kevin again fell behind and it became difficult for him to keep up with his work. The coach increased the number of flash sessions and offered encouragement until Kevin was back into the rhythm and routine that had proven successful before. After one-and-one-half years of coaching, Kevin was able to manage the process on his own. He is now a college graduate and owner of a successful business. The guidance and encouragement of coaching, coupled with the tools he needed, led to Kevin’s success.
Conclusion
The “missing link” in treatment of ADHD has been coaching, which is now being integrated as part of the “triad” of support for clients. Coaching starts a client on the path of accomplishment that previously was unattainable without stress and anxiety. Working with a coach teaches the client how to organize and approach tasks and time, and how to allocate resources and use tools effectively. The ability to consistently apply strategies and programs taught by a coach will result in a client’s success throughout his career and personal relationships.
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Appendix: Josephson Interview 2010
- How long have you been in practice?
- What is your speciality?
- Do you treat both adults and children?
- What percentage of your patients are ADD/ADHD?
- Are most of your patients who are ADD/ADHD on medication?
- Are you ADD/ADHD?
- Please describe ADD/ADHD and their differences?
- What are their strengths? What are their weaknesses?
- Can people who are ADD/ADHD learn to cope with their weaknesses?
- Do you treat both children and adults with ADD/ADHD?
- What is your method of treating your patients with ADD/ADHD?
- What is CBT therapy? What is ACT therapy?
- What is the most difficult thing to get across to your patients?
- Have you been successful treating these patients?
- What do you wish for these patients?
- Do you use coaches in your practice to help support the work you are doing with your patients?
- How has it been beneficial to your patients?
- How can coaches help support your patients?
- Do you think that coaching ADD/ADHD id the “missing link” in helping them reach their full potential?