Reprinted from the NYTimes October 2021 By Christina Caron.
This has been something I have been talking about for years. Wake up OTs!! This is a great niche market others will capture if you don’t. There is no mention of OT in this article.
Managing A.D.H.D. Is Hard.These Coaches Want to Help.
A growing crop of professionals are guiding people with attention deficit disorder toward healthier behaviors, and self-acceptance. Weekday mornings have become “drive-to-school jam out time” for Dan and Melissa Roberts, and their four boys. The couple, who live near Grand Rapids, Mich., let each son take turns picking the music. (Imagine Dragons, Ed Sheeran and Sam Smith are current favorites.) They are not only on time these days, but nobody is complaining. It’s a big departure from the way things used to be: kids who couldn’t seem to get out of their pajamas, backpacks left behind in the rush out the door.
“Transitions are tough,” Ms. Roberts said. “If it’s not interesting then we can’t focus on it — it’s not really a choice.”Both she and her husband have attention deficit hyperactivity disorder, or A.D.H.D., a neurodevelopmental condition that can make it difficult to manage both time and emotions. Their two oldest boys, 9 and 7, were also diagnosed with A.D.H.D. (The youngest ones, 4 and 2, haven’t been tested yet.)Ms. Roberts attributes their smoother morning routine to the A.D.H.D. coach Tamara Rosier, who has been teaching the whole family how to stay on track. Sometimes that means getting everyone on board for a family singalong to make an ordinarily humdrum event more interesting and start the day on a positive note.
“We have a fun-seeking brain,” said Dr. Rosier, who — like many A.D.H.D. coaches — also has the disorder. Tasks like laundry, paying bills and getting ready for school can seem boring, so “we’re going to try to gamify everything.”Many of her clients “can do brilliant things,” she added, “but not go to bed on time.”A.D.H.D. coaching is considered an emerging field, although the profession is becoming more widely known. Interviews with coaches and clients, and a number of studies assessing college students, suggest that it can help manage A.D.H.D. symptoms like inattention, hyperactivity and impulsivity, while improving executive functioning skills and self-esteem.Unlike a therapist or an executive coach, the A.D.H.D. coach educates their clients about A.D.H.D. and works collaboratively with them to develop stronger emotional regulation, meet goals, find self-acceptance and create practical solutions that help them stay focused — such as checklists, timers and calendars. Sessions are not covered by insurance.
“Over the years there has really been a growing interest and a demand for this kind of supportive service,” said Lisa Joy Tuttle, the director of coaching and group programs at the Penn Adult A.D.H.D. Treatment and Research Program at the Perelman School of Medicine at the University of Pennsylvania. Ms. Tuttle gets hundreds of inquiries a year for coaching sessions. Coaches can often help their clients anticipate and address the roadblocks that have been holding them back for years, she added.“We’re really trying to help people develop their own insights and solutions,” Ms. Tuttle said.
‘They’re not broken.’
The concept of using a coach to help manage A.D.H.D. is often traced back to the ’90s, when the popular book “Driven to Distraction” discussed coaching as a “structuring force” in the life of someone with A.D.H.D., a process distinct from psychotherapy. Since then, coaches have formed a nonprofit, the A.D.H.D. Coaches Organization, to establish professional standards, provide ongoing training and create a community. In addition, private companies like JST Coaching and Training and the A.D.D. Coach Academy are educating the next generation of coaches. For those seeking a coach, their websites also include provider directories. Because coaches are not licensed by their state, they can (and do) work with people anywhere in the United States and in other countries, too, via phone or video. Although some coaches counsel teenagers or the parents of younger kids with A.D.H.D., most of them guide college students or adults who want extra help with planning, time management, goal setting, organization and problem solving. During individual coaching, the client sets goals and establishes their ideal pace for making changes, whereas group coaching may follow a curriculum and has a set pace, Ms. Tuttle said. Both types of coaching aim to help people with A.D.H.D. identify and utilize their strengths.“We have to help them understand that they’re not broken,” said David Giwerc, president of the A.D.D. Coach Academy, which trains A.D.H.D. coaches in the United States and abroad.
Managing big feelings.
People with A.D.H.D. may also need help with emotions like anxiety, anger and shame. Studies have linked A.D.H.D. symptoms to specific regions in the prefrontal cortex, especially in parts of the brain that regulate behavior and attention, and also help us plan, make decisions and manage our impulses. Emotional regulation is one of the most vital skills that clients must learn, said Dr. Rosier, president of the A.D.H.D. Coaches Organization and author of “Your Brain’s Not Broken,” a new book about how to navigate the powerful emotions that can accompany A.D.H.D.“In other words, how do I not flip out all the time in my head,” she added. “From there, I introduce cognitive flexibility,” or, “knowing I have different choices in the moment.”She taught the Roberts children how to label emotions using toy monkeys that have names like Irritable Ian or Whine-y Winnie. When they want to flop on the floor and not do their homework, they can ask themselves, “Who’s in control right now? What’s happening? Oh, I’ve got an A.D.H.D. monkey going on,” Ms. Roberts said.
Scott Lyman, 35, an artist and writer in Scottsville, Va., has been in therapy and also used medication, he said, but it was telephone sessions with his coach that helped him figure out how to focus on smaller, more manageable goals and taught him mindfulness techniques, like “pause and notice,” to help regulate his emotions.
“It may seem simple, but when my brain is flooded and I get overwhelmed, the act of taking a moment to step back and notice what’s happening allows me to disconnect from the minutiae and look at the big picture,” Mr. Lyman said.Otherwise, he added, “one negative or anxious thought can just set you off. It starts to snowball.” René Brooks, an A.D.H.D. coach and creator of the website Black Girl Lost Keys, said an effective coach will understand that many clients have the best of intentions but still have difficulty meeting their goals.“It’s not a matter of trying harder, it’s a matter of trying differently,” Ms. Brooks said.
What does the research say?
The latest peer-reviewed research on coaching appears promising. Even so, most of it is has focused on college students and, to a lesser extent, group coaching for adults, so there is still much more to learn about how individual adults fare.Among college students, A.D.H.D. coaching may lead to improvements in grade point average, well-being and the mental processes that help students plan, focus and remember instructions.Elena Schmitt, 24, who graduated earlier this year from the University of Michigan, credited A.D.H.D. coaching with raising her grades and helping her earn her degree.She had done well in school until her first year of college, when her grades started to fall. By junior year she was on academic probation. Her parents, who are both clinical psychologists, helped her get an evaluation that would eventually lead to a diagnosis.
“I went 21 years of my life not knowing that I had A.D.H.D. and dyslexia,” she said.She has been working with her coach, Dr. Rosier, for nearly three years. In the past, Ms. Schmitt said she had often judged herself harshly if she didn’t meet a deadline or lost focus, but through coaching she has learned to treat herself with compassion, and received the “skills and guidance to live comfortably in my brain.”
Transitioning to college can be much more difficult for people with A.D.H.D., in part because they are entering a less structured environment with bigger challenges that require more executive functioning skills. That makes it an ideal time for coaching, said Jodi Sleeper-Triplett, a pioneer in youth A.D.H.D. coaching and the founder and chief executive of JST Coaching and Training, which trains people to become A.D.H.D. student coaches.For kids with A.D.H.D., it’s not helpful for parents to tell them to “just do it,” she said. “If they knew how to do it — if they had the skills — they would do it. Kids don’t want to fail.”Parents who are facing an A.D.H.D. diagnosis in the family can find information and coaching resources at the nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder, or CHADD.
Putting coaching into action.
For the Roberts family, there’s less blame and more brainstorming now that they’ve been working with Dr. Rosier.Punishments aren’t the answer, Mr. Roberts said. Instead, their sons need parent-approved external rewards that the boys get to choose — like taking a hike, extra swim time in the family’s pool, going out for ice cream or downloading a new game. The rewards provide extra incentive because the boys don’t typically get internal gratification from completing a task, he explained.Before, when a task wouldn’t get done for the 75th time, “we would ask, ‘Why?’” Mr. Roberts said. “Now we know why.”And if their oldest son is having trouble staying seated for dinner, “it’s not because he’s just being a bad kid or he’s trying to get attention,” Ms. Roberts said.