The ADDA Guiding Principles for Coaching Individuals with Attention Deficit Disorder

Presented by:
The ADDA Subcommittee on AD/HD Coaching
Edited by:
Nancy A. Ratey, Ed.M, ABDA, MCC
Peter Jaksa, PhD, Clinical Psychologist

Introduction

Over the past two decades there has been an explosion of diagnosis, treatment and research regarding Attention Deficit Hyperactivity Disorder (AD/HD), also referred to as Attention Deficit Disorder (ADD). As a pervasive neurobehavioral condition, AD/HD can profoundly compromise functioning in multiple areas of living. Research and clinical experience suggests that AD/HD related difficulties can lead to significant educational, occupational, and family dysfunction and contribute to a variety of health, social and economic problems.

As researchers and clinicians have increased our understanding of AD/HD, it has become clear that for some individuals traditional methods of treatment, such as medication, behavioral or psychological therapies, and education or workplace accommodations, are not sufficiently effective. For these individuals different intervention approaches and services are needed.

Within the scope of new services and treatments, a field has emerged called AD/HD coaching. AD/HD coaching is practiced by coaches who work one-on-one with people with AD/HD. ADDA supports AD/HD coaching as an adjunct or additional intervention within the range of available methods of treatment.

ADDA believes that one of the most critical steps in advancing AD/HD coaching services is to establish a standard of care for people seeking coaching. As in any newly formulating field, consistent and accurate information is needed. Over the past decade, coaches with extensive experience have begun to identify certain principles regarding what constitutes effective coaching for people with AD/HD. It is the combined efforts of these coaches, working within the ADDA Subcommittee on AD/HD Coaching, which helped create these Guiding Principles.

The ADDA Guiding Principles for Coaching Individuals with Attention Deficit Hyperactivity Disorder represent an attempt to improve the overall care of individuals and their families who are affected by AD/HD. These Guiding Principles should not be viewed as a coaching cookbook or intervention manual. Rather, they seek to define the essential elements of AD/HD coaching, in order to help consumers increase their understanding of AD/HD coaching and its benefits.

As a consumer advocacy organization, ADDA’s goal is to have these Guiding Principles serve as a step towards identifying the core components of AD/HD coaching. This document should be reviewed not as a final product, but rather as an ongoing work to be added to and updated as theories and practices are refined and built upon. We hope that these principles will improve the quality of life for everyone affected by AD/HD.

What is AD/HD Coaching?

AD/HD coaching is an ongoing partnership that helps clients live more effective and satisfying lives by deepening their learning, improving their performance, and enhancing their quality of life.

Clients with AD/HD have the same human needs as any coaching client, and also face unique challenges related to AD/HD , which can interfere with their quality of life. These challenges might include hyperactivity, impulsivity, and/or inattention, as well as the belief that they can’t reach their goals because they have AD/HD.

AD/HD Coaches support their clients in developing a comprehensive understanding of both the nature of AD/HD and the impact of AD/HD on their client’s quality of life. In addition, AD/HD coaches work with clients to create structures, support, skills and strategies. Coaching assists clients with AD/HD to stay focused on their goals, face obstacles, address core ADD-related issues like time management, organization, and self-esteem, gain clarity and function more effectively. AD/HD coaches work with their clients to develop strategies to move forward towards their goals, to deepen their self-awareness and to continue moving toward fuller and more satisfying lives. The client is seen by the AD/HD coach as resourceful and thus, with increasing self-awareness, as fully capable of discovering his or her own answers.

AD/HD coaching also helps clients to:

• Understand that the source of many of their challenges is AD/HD , not personal shortcomings.
• Safely examine areas of failure and areas where they want to be held accountable.
• Heighten self-awareness and self-observation skills, and use those heightened skills to improve decision-making and performance.
• Change perspective when “stuck”, for example, learning new ways to work with procrastination, perfectionism, staying on task, or being more consistent.
• Become aware of their own learning styles, processing styles and learning preferences so they can enhance their ability to learn and comprehend information and situations.

The Benefits of AD/HD Coaching

AD/HD Coaching can be an important part of a comprehensive program for individuals with AD/HD. The coaching process initiates and encourages taking ownership and self-responsibility. Coaching is individualized and action-focused, so the client is working to build productive habits and systems that lead to a fulfilling life.

AD/HD coaching also:

• Provides support from an understanding coach who is knowledgeable about AD/HD.
• Helps clients identify their positive AD/HD characteristics and to appreciate their strengths.
• Improve client’s understanding of AD/HD related to their learning styles and personal challenges.
• Nurtures personal awareness and responsibility, and encourages the client to look for options that lead to progress and success.
• Guides the client into actions that (re)build self-esteem, self-awareness, and self-regulation.
• Focuses on the client’s executive functioning skills (i.e., planning, prioritizing, and analyzing) to create customized systems that will improve the client’s consistency and effectiveness.
• Offers a safe environment for clients who need to let go of their isolation and helps them form a nurturing connection with another person.
• Provides consistent accountability and encourages the client to move beyond thinking into appropriate action.
• Helps clients learn to advocate and speak out for their own needs, questions, and boundaries.
• AD/HD coaching builds hope by educating clients about AD/HD. It is instrumental in developing systems and strategies that they can use in effectively managing their specific AD/HD challenges, which can dramatically improve their quality of life.

How AD/HD Coaching Works

This section is excerpted from: “ Life Coaching for Adult AD/HD” by Nancy Ratey, Ed.M., ABDA, MCC in Clinical Interventions for Adult ADHD: A Comprehensive Approach, edited by Sam Goldstein, PhD and Phyllis Ann Teeter, Academic Press, 2002

Neuropsychological research tells us that the brain is flexible in its ability to learn continuously. Physical and chemical changes occur in the brain when it is challenged or when new learning takes place. Rehearsing actions helps forge new neural pathways in the brain, allowing it to develop new competencies in areas that have been deficient. This is how new habits are learned. Coaching paves the pathway for this learning to occur.

Coaching intervention can make a real difference in how people with AD/HD negotiate their own particular deficits and cope with life on a daily basis. There are five major deficit areas that can be seen playing out in the lives of persons with AD/HD. The following is a discussion of these areas, and how the coaching relationship can offer successful compensatory strategies.

1. Coaching maintains mental arousal and focus on completing goals.

If attention is under-aroused, chances are motivation will lag also, and vice versa. For instance, people with AD/HD often have a hard time pursuing abstract goals. Coaches seek to bring the more abstract goals to the forefront of their clients’ minds, keeping attention aroused to work on the goal and stay focused until it’s completed.

The coaching partnership provides a “shared awareness”, or mutual consciousness, of goals and their associated challenges so as to sustain the AD/HD client’s vigilance towards an identified goal. The coach works with the client to create deadlines, schedules, meetings and regular phone check-ins around reaching goals. This induces a certain level of “good stress” on clients, keeping their brain aroused, vigilant, and on track to reach stated goals.

2. Coaching helps modulate emotions.

Shame, guilt and fear are demons plaguing many people with AD/HD. Years of being labeled “stupid”, “ditzy” or “irresponsible” create an emotional burden that can derail their actions, throw them off course or even paralyze them. A coach helps clients learn how to identify bad feelings and their triggers, and explores effective ways to modulate emotional responses. Instead of blaming themselves when AD/HD gets in their way, clients can think: “Wait a minute! I know this is my AD/HD at work, and I know I have ways to get around it now.” By isolating the behavior from the emotion, the behavior can be broken down into parts to take the mystery out of it, giving clients an opportunity to think up strategies to contain and change the behavior.

3. Coaching maintains motivation and sustains the feeling of reward .

Motivation is often questioned in people with AD/HD. Although clients may have developed the tools to sustain attention to tasks, they may still lack motivation. By reminding clients of their top priorities and of all the gains they have made, the coach provides encouragement. Self-confidence is bolstered.

The client may under-function in certain situations, especially when it comes to prioritizing, planning, attending to details and following through with projects. In other instances, the client may become overwhelmed with a project, and not knowing where to start, may avoid the task. By breaking large projects down into smaller, more manageable tasks, coaches keep clients more focused on their goals. Other clients might need help in discovering a system of tangent rewards so as to sustain motivation and progress forward.

4. Coaching acts as the “Executive Secretary of Attention. “

Clients with AD/HD are challenged in their ability to “gross prioritize”, to gather and focus their attention in a more global way. By keeping the big picture in mind, the coach helps the client to sustain their attention on their primary goals, pointing out distractions and helping to create strategies when distractions do arise.

5. Coaching supports the client’s ability to self-direct actions and to change behavior

In order to function autonomously, individuals must be able to screen out distractions, sustain their attention and use feedback appropriately. Attentional arousal is a double-edged sword for people with AD/HD. While it is usually the case that their attention needs to be aroused in order to attack certain tasks, it is also true that if their attention is too aroused they can find themselves becoming “over-focused” and getting stuck in a particular activity or step of a task at the cost of everything else. Just as they can be sidetracked by pleasurable feedback, clients can also be sidetracked by negative feedback such as those “voices in the head” that continually remind one of one’s inadequacies. Clients with AD/HD are also very adept at self-deception and forgetting the pain of past procrastination and other self- defeating behaviors.

The coach compensates for these deficits by providing daily reminders and helping the client sequence out the details of needed actions. By pressing clients to process and evaluate outcomes and consequences, the coach allows clients to develop the ability to make more proactive choices and be less reactive to the environment. Coaches also help clients develop the ability to estimate the time it takes to complete tasks by having on-going discussions, reviewing plans for timelines and processing out the details and sequences of tasks. The coach helps clients to, in effect, observe themselves in action, by processing out events, asking questions and providing feedback.

What to Look For in an AD/HD Coach

The relationship between coach and client is that of a partnership. A good fit between coach and client is vital. Below are questions that can be asked of a prospective AD/HD coach in determining the specifics of how the partnership will work. In asking these questions one might also be listening for the less tangible, but equally important characteristics such as style, energy and tone of the prospective coach being interviewed.

• What can I expect from a coach and from coaching?
• Can the coach clearly explain what I will get from coaching?
• What would this partnership look like?
• How exactly would we work together to accomplish what I need to accomplish?
• What would an individual session look like?
• How, where and when would we meet – face-to-face meetings, telephone, or electronic mail?
• What happens if I miss a session?
• How much will it cost?
• What is the method of payment (check, credit card)?
• Can I access my health insurance to pay for coaching?
• Does the coach have a sliding fee scale?
• Are my records and information kept confidential?
• Are there ever times when information about me would be shared with other professionals?
• Under what arrangement?
• How long has the coach practiced?
• What is their experience in the coaching profession?
• By whom and when were they trained?
• Is this coach certified?
• Do they have a specialty: executive coaching, spiritual coaching, career coaching, life style coaching, etc.?
• Do they associate with other coaches belonging to coaching organizations?
• Does this coach have specific AD/HD coach training?
• Do they have knowledge of medications, other professionals who diagnose and treat, and relevant resources?
• Does the experience of this coach match my needs?
• What else would I like to know about this coach and their work in order to discern that we might work well together?
• Does this coach’s philosophy, style and/or approach fit with how I believe I function best?

In choosing an AD/HD coach one must be as clear as possible in stating specific needs, challenges and desired goals. The coach’s ability to listen, summarize and help in expressing this information may be a further indication of how well you might work together in partnership. It is important to choose a coach who can answer your important questions, help you clarify what you want from coaching, and be a total support and advocate.

AD/HD Coaching Competencies

There are certain unique skills, abilities and knowledge all AD/HD coaches must possess that are the hallmarks of our profession and help distinguish us from other helping professionals. Even though there is currently no standard training, licensure, or certification of AD/HD coaches, the savvy consumer knows that AD/HD coaches must possess this core set of standard AD/HD coaching competencies.
The following are core AD/HD coaching competencies:

• The ability to use a structured goal-setting and goal-achievement orientation as the primary method of working with clients The ability to use a conceptual coaching framework within which the day-to-day coaching work takes place The skill to create a partnership with clients for the purpose of realizing their goals and hopes Training and facility in AD/HD coaching skills including active listening, questioning, strategizing, planning & goal setting, designing actions, monitoring progress, and creating accountability
• Knowledge about AD/HD , including a thorough understanding of the neurobiological nature of AD/HD and co-morbid conditions, and the impact these conditions have on the client’s quality of life
• Familiarity with current literature and research about AD/HD and AD/HD coaching
• Commitment to stay abreast of rapidly expanding information on AD/HD and AD/HD coaching, demonstrated by ongoing professional reading and regular attendance at professional conferences, workshops and trainings
• A fund of AD/HD coaching tools, strategies and interventions and the skill to use them appropriately to assist clients in areas like daily living, time management, organizational skills, and work and/or school issues. (The term “daily living” refers to areas like sleep, eating, exercise, medication management, and social skills)
• The ability to help clients move back and forth between the big picture and the details
• Skill in helping clients self-advocate
• The ability to collaborate with psychiatrists, psychologists, psychotherapists, educators, employers, etc. on the client’s behalf
• Consistently demonstrating professional ethics
• Knowledge needed to give appropriate professional referrals
• Skill to explain coaching logistics – frequency of contact, fee structure and coaching format

Consumers will benefit by using this information in conjunction with the questions in “What to Look for in a Coach” to determine whether prospective coaches have the competencies the consumer requires.

Professional Guidelines and Standards for Coaching

The following standards represent a framework for ethical AD/HD coaching practices:
AD/HD coaches:

• Provide access to AD/HD coaching for all appropriate clients regardless of age, gender, race, religion, or sexual orientation.
• Respect and hold in confidence all client information, obtaining permission to discuss or disclose client information only when a formal release form, specifying the terms of release, has been signed.
• Clearly and accurately represent their level of competency, expertise, training and credentials.
• Explain in detail the terms of the coaching contract, including administrative details and financial arrangements.
• Define the coach/client relationship and under no circumstances take advantage of a client personally, socially, sexually, or financially.
• Avoid all possible conflicts of interest by disclosing to the client any personal gain the coach might receive by referring the client to another professional or advising the client to take some specific action.
• Continue learning about coaching and AD/HD specifically, attending and participating in professional conferences and organizations.
• Build strong and ethical professional relationships with colleagues to enhance and promote communication and collaboration for the benefit of the AD/HD client.
• Maintain full compliance with any institutional or governmental regulations and laws that may apply regarding research.

All ethical guidelines and standards for practice are directed toward maintaining and promoting quality assurance in the field of AD/HD coaching. All AD/HD coaches have a responsibility to uphold and advance the values, ethics, and knowledge of the profession.

Professional Collaboration in AD/HD Coaching

Collaboration in coaching is the joint effort of two or more people working for the best interests of the client. The AD/HD client does not live, play, work or socialize in a vacuum, therefore, collaboration among key people in the client’s life can be not only helpful, but also essential. In addition there are co-morbid challenges associated with AD/HD , such as learning disabilities, anxiety, sleep disorders and depression. This means that AD/HD clients frequently work with an expanded network of professionals. Those who collaborate with an AD/HD coach might be one or more of the following: physician, psychologist, therapist, social worker, school teacher and/or administrator, employer, family member or significant other.

Collaboration may simply mean communication among two or three individuals involved with a particular client, or it may involve a larger team with clearly defined roles and established communication process from the very beginning. Many AD/HD clients are on medication, an important example of one kind of collaboration that involves physician, the client and the coach.

If the physician has knowledge of the coaching client’s medication goals, for example, to sustain attention, achieve alertness, increase productivity, or alleviate anxiety, the physician and patient can more clearly identify the deficits and direct the choice of medication. The job of the coach and client would then be to plan a system for implementing and maintaining the prescribed medication routine, monitor effects, and strategize ways to address symptoms and behaviors not addressed by the medication. This information can in turn be helpful to the physician in further prescribing and fine-tuning medication.

The primary work of an AD/HD coach is to empower clients to speak, negotiate and better manage for themselves. Toward that end, there will be many occasions where, in helping the client achieve success, information would best be conveyed and strategies planned in cooperation with other individuals living and working with the client. In adult coaching, professional collaborations occur with the express written permission of the client. These collaborations are for the purpose of providing first-hand communication of details, information, assessments or observations, as well as, for establishing or fine-tuning goals, strategies and resources.

List of Contributors

Edited by:
Nancy A. Ratey, Ed.M, ABDA, MCC
Peter Jaksa, PhD, Clinical Psychologist

Contributors:

Committee Chair:
Nancy A. Ratey, Ed.M., ABDA, MCC

Subcommittee Chairs:
Linda Anderson
David Giwerc, MCC
Mary Jane Johnson, PCC, ACT
Hope Langner, MS, CPCC
Sandy Maynard
Susan Sussman, M.Ed, ABDA, MCC

Subcommittee Members:
Victoria Ball, M.Ed., MCC
Ed Barniskis, M.Ed.
Linda Barniskis, M.Ed
Sue Coleman, MCC
Barbara Luther, ACT, MCC, CMC
Theresa Maitland, PhD
Jane Massengill, LCSW, CPCC
Harold Meyer, MBA
Cynthia Runberg
Linda Sepe
Terrence Sole, BSC, MSC, Dip.Ed.

© November 2002 Attention Deficit Disorder Association. All rights reserved.