A Research Paper By Lisa Dorries, ADHD Coach, UNITED STATES
ADHD Coaching (Attention Deficit Hyperactivity Disorder)
This research paper will focus on coaching practices for adults with Attention Deficit Hyperactivity Disorder (ADHD). The ADD Coach Academy (ADDCA) holds accreditation with PAAC, the international organization responsible for establishing and maintaining global standards of excellence for credentialing ADHD coaches and accrediting qualified ADHD coach training schools and programs. ADDCA is the only ADHD coach training program that is fully accredited by the International Coach Federation.
What differentiates ADHD coaching is that it takes the core ADHD challenges into account to help clients get the most benefit from coaching. Practical skills, how to maintain focus, and how to make abstract goals into concrete actions are often objectives. ADHD coaching also helps clients build motivation so they can get unstuck and move toward their goals. By assisting them in understanding how ADHD impedes progress, they can find better solutions and create a new sense of identity as well.
Background Information on ADHD
It is essential to understand the definition of ADHD and the specific symptoms that clients experience. In general, ADHD is considered an impairment that is marked by inattention and hyperactivity-impulsivity. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 2, for diagnosis, the adult needs to exhibit at least five symptoms that fall under one or both categories. A person, being referred to as the client going forward, can have a combined presentation of ADHD (inattention and hyperactivity-impulsivity) or just one present.
Inattention: These symptoms include making careless mistakes, having trouble following through on instructions, being easily distracted, losing essential items, not listening well when spoken to, missing details, and difficulty sustaining attention. It is a matter of not being able to execute due to these symptoms. Clients struggle to break projects into manageable steps, get sidetracked, misplace things, and don’t keep up with work deliverables, homework, or household responsibilities.
Hyperactivity/ Impulsivity: These symptoms include fidgeting, moving around when sitting still is expected, interrupting others, talking too much, and difficulty waiting. Clients may blurt out answers before thinking, shop excessively/buy impulsively, overcommit, or be impatient. Actions sometimes look motorized by constant hand or foot tapping, squirming in the seat, fidgeting with items, and moving without resting.
In addition to exhibiting at least five of the above symptoms, clients need to experience a pattern that interferes with at least two life settings such as home, work, or school. That demonstrates that the struggle is a real pattern, and rules out the possibility that it is not merely a response to the environment. Symptoms can also be either mild, moderate, or severe, and must appear before 12 years old for a diagnosis of ADHD.
The Role of Dopamine
ADHD is complicated, but it is also essential to understand the role of dopamine in the brain. Dopamine is involved in the reward and reinforcement circuit and is referred to as the feel-good neurotransmitter improving motivation and mood. Experts initially believed that ADHD occurred as a result of low levels of dopamine. Still, according to the Gulf Bend Center, people with ADHD have a higher concentration of dopamine transporters that remove it too quickly from the brain, meaning it has less time to work. Symptoms of not having enough are depression, a foggy brain, a slow reaction time, difficulty thinking, poor memory, and a general lack of lust for life.
Less access to dopamine also shows up as a difficulty in creating the momentum to get started and the ability to sustain action. The ADHD brain craves this feel-good neurotransmitter. ADHD coaches help their clients understand how their brains function and the critical role of dopamine in improving motivation and mood.
Key ADHD Coaching Elements
There is a growing consensus among researchers that the executive functions of the ADHD brain do not allow for enough self-regulation and management. These weaknesses show up in many areas of clients’ lives, and coaches can help them avoid frustrations by increasing understanding and offering better approaches.
While ADHD coaching adheres to the ICF Core Competencies for coaching, it also incorporates additional concepts, models, and strategies. Described below are a few key elements.
The Four I’s Model (Interest, Importance, Inspiration, and Internal)
David Giwerc, MCAC, the Founder and President of the ADD Coach Academy (ADDCA), created a coaching model called the Four I’s Model, which explores each area through the use of various exercises, as described below:
Interests:
Because adults with ADHD are easily distracted and have difficulty sustaining focus, finding ways to help clients become engaged and find things that interest them is crucial. Tools the ADHD coach can use are StrengthsFinder, Mind Tools Core-Self Evaluations, and The GIVE Model, to name a few. (For more information about Core Self-Evaluations, visit Core Self-Evaluations – Mind Tools and https://www.mindtools.com/pages/main/newMN_CDV.htm)
Importance:
The motivation for action increases when connected to what is most important to a client. Values clarification exercises help clients discover their top values, and the ADHD coach can assist them in using this knowledge to determine their plans.
Inspiration:
Inspiration is a blessing in that it is the fuel for motivation. An exercise created by David Giwerc, called Magical Moments on the Mountain, helps the client think back to an inspirational, joyful, and fulfilling time in their past. By assisting them in recalling and describing these intensely emotional experiences, the ADHD coach helps clients feel inspired and motivated.
Internal:
The last of the four I’s is internalizing. The clients have been building on their interest, importance, and inspiration, and now need to make it all stick. One way to do so is by having them keep a journal as a way to reflect and internalize their thoughts. Internalizing helps them cement the feelings of wholeness and can be a source to turn to for positivity and a renewed motivation for life. Without this, the ADHD client is at grave risk for stagnation.
Integrating the Power of Pausing
A powerful ADHD coaching concept is learning to ‘pause’- the ability to put on the brakes before proceeding. Since ADHD adults struggle with impulsivity and often act before contemplating the best decision, this new behavior is crucial. The coach helps clients understand the negative results associated with impulsivity and works on change. The client identifies what led up to an impulsive act, discovers if there were any warning signs, and learns how to stop and pause before proceeding. A simple example of a strategy is having a prepared response when under pressure, such as, ‘That sounds interesting, but I need to take a day to think about it.’
Another time pausing is useful is to tame hyperactivity during conversations. Some ADHD clients tend to talk too much, overshare, or interrupt. Learning to break to allow a conversation to go back and forth is a useful skill addressed in ADHD coaching. Breaking will enable clients to avoid undesired reactivity and reflect on the best response.
A slight variation of the power of pausing is learning to break away from hyper-focus. Another ADHD tendency is when a person becomes so focused on an activity, a rabbit running down a hole, that he or she blocks out other stimuli not hear others talking, and fails to address essential tasks that must get done to be successful. Some strategies to address hyperfocus include building in outside structures and setting timers to alert the need to return to the focus.
Emotional Regulation
Research by Dr. Russell Ramsay of the University of Pennsylvania has shown that people with ADHD think negatively about themselves, related, in part, to being misunderstood in the past. For example, poor memory is interpreted as not caring, and weak follow-through as laziness. Also, shame may result from repeated negative feedback, as well as low self-esteem.
Most often, by the time someone comes to coaching, they are beaten down by a world that dictates that they need to be successful in all aspects of the job, school, or life. Coaches focus on creating a more realistic view of life and boosting their self-esteem through compassion and reminding them of their strengths.
Coaches help clients learn to gain awareness of signals in their bodies where there may be tightness or discomfort. They are encouraged to name the emotion they are feeling and why. It is a skill that acts as a precursor to preventing downward spiraling from overload and helps with executive function.
Focus on Strengths
ADHD coaches work with their clients to identify their intrinsic interests as it is much easier for them to concentrate when they are interested and engaged in something. Yet, it is also vital to help them focus on their strengths. Clients are encouraged to work with their character strengths vs. their productivity strengths. The objective is to concentrate on core strengths and align these with interests, whenever possible, to direct their energy there. Otherwise, ADHD clients bore, feel frustrated, lose interest, and leave the task incomplete or do a poor job.
When a person with ADHD attempts pursuits that require executive functioning skills that are inherently weak, vs. ones that use their strengths, it is a recipe for failure. It would be like being told to study courses in college regardless of interests or abilities. By pursuing college studies in this manner, it is highly unlikely that they will be successful.
The Importance of Personal Identification
It is of utmost importance for clients to understand their identification with ADHD and the type of approach they need to be successful in life. They also need to know that they have a right to be heard and to voice their needs. Many people with ADHD may have an underlying belief that they do not have the right to require someone to speak and treat them with respect, even if they make a mistake. ADHD coaches help their clients understand the importance of how they can be accountable for their identification in the world, and when they may need to ask for help.
ADHD Coaching Unique Challenges
Having a coach that understands the unique challenges of ADHD can make a significant difference. Just as not asking a blind man to try harder to read when he cannot see, a trained ADHD coach knows to avoid asking a client with ADHD to remember something without suggesting supportive tools and structures.
ADHD coaching transforms lives by helping clients understand their diagnosis and themselves, find their strengths and personal identification, develop tools when stuck, and create sustainable action plans to move forward toward a happy life.
References
What Is an ADHD Coach?
Dsm-5 Criteria for ADHD: Source: American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.
ADHD Support Talk Radio ADHD Coaching David Giwerc & Lynne Edris
Is There a Link Between ADHD and Dopamine? Medically Reviewed by Timothy J. Legg, PH.D., Psyd on June 18, 2019 — Written by Shannon Johnson
How Does Dopamine Affect the Body? Healthline Article, November 5, 2019.
What if We Don’t Have Enough Dopamine?
ADHD Coaches Organization Conference. ADHDCoaching and CBT Coaching and CBT for Adults: Differences, Similarities, and Benefits.
The Give Model Building a Positive Personal Identify