Efficacy of ADHD Coaching for Adults With ADHD
Joyce A. Kubik Bridge To Success Skills Training, LLC
Journal of Attention Disorders Volume 13 Number 5 March 2010 442-453 © 2010 Sage Publications 10.1177/1087054708329960 http://jad.sagepub.com hosted at http://online.sagepub.com
Objective
This is perhaps the first outcome study on the efficacy of ADHD coaching for adults with ADHD and its longterm effect.
Method
Forty-five adults (30 women, 15 men) rated 22 areas of concern before and after the coaching experience. Factor analysis of the 22 areas of concern revealed five factors. Descriptive statistics and intercorrelations were analyzed on the five factors.
Conclusions
ADHD coaching had a positive impact on the lives of people with ADHD.
(J. of Att. Dis. 2010; 13(5) 442-453) Keywords: ADHD; Coaching; Kubik; Adults)
Longitudinal studies indicate that 55% of childhood ADHD continues to meet criteria into adulthood according to Knouse, Bagwell, Barkley, and Murphy (2005). Barkley, Murphy, and Fischer (2008) developed 91 items “that might have some potential for being associated with and predictive of ADHD at the adult stage of its development” (pp. 195-197).
Several items addressed behavioral and cognitive inhibitions as well as items that adults with ADHD voiced as problematic. Traditional treatment options are pharmacotherapy (medication), psychotherapy (therapy), or a combination thereof. The American Academy of Child and Adolescent Psychiatry (1997) reported that the effectiveness of medication has been well established for children with ADHD. However, less than 50% of adults with ADHD are effectively treated with medication alone (Wilens, Spencer, & Biederman, 2000).
According to Sherman (2005), traditional therapy focuses on “emotions and mines the past to find causes of current problems” (pp. 36-38). In seeking a diagnosis, adults with ADHD often describe the outcomes of living with ADHD in terms that are more identifiable with depression and anxiety. Ramsay and Rostain (2007) referred to issues such as depression as the “unidentified effect of secondary, subclinical ADHD symptoms” that can interfere with treatment progress. Jaksa and Ratey (1999) found that after therapists guided clients through behavioral and emotional concerns to increase productivity, they were “perplexed that the therapeutic goals are simply not being implemented on any consistent basis.” Therapists interpreted the client’s inability to follow through as resistance to treatment.
One form of therapy, cognitive behavioral therapy (CBT), focuses on problematic thoughts and negative beliefs to create change in emotions and behaviors. Growing up with untreated ADHD leads to many negative beliefs. Rostain and Ramsay (2006) found CBT, when combined with medication, to be effective in treating adults with ADHD. ADHD coaching is an intervention that complements treatment plans that include medication, therapy, or both. It focuses on behavioral, emotional, and cognitive outcomes and builds life skills to change negative outcomes and beliefs.
The Institute for the Advancement of AD/HD Coaching (IAAC) developed core competencies “to identify the behavioral coaching proficiencies required” to become a certified ADHD coach (IAAC, 2007). The approach used in this study can be likened to psychoeducation used in psychosocial treatment.
Psychoeducation provides “basic information about the neurobiology of Journal of Attention Disorders Volume 13 Number 5 March 2010 442-453 © 2010 Sage Publications 10.1177/1087054708329960
http://jad.sagepub.com hosted at http://online.sagepub.com
Author’s Note: Address correspondence to Joyce A. Kubik; e-mail: Kubikja@bridgetosuccess.com.
Current Perspectives Kubik / Efficacy of ADHD Coaching for Adults 443 ADHD and how it translates into some of the common functional problems faced by adults with ADHD” (Ramsay & Rostain, 2007, p. 344).
ADHD coaching educates adults with ADHD on the outcomes of living with ADHD over a lifetime, making a logical connection to their current cognitive, emotional, and behavioral responses. This knowledge is integrated throughout the coaching program as structures and strategies are developed. ADHD coaches do not treat comorbid depression or anxiety that often becomes barriers in the coaching process. Collaboration of ADHD coaching with therapy or medication addresses psychological barriers that are beyond the scope of ADHD coaching.
The therapist’s insight to these disorders helps the adult with ADHD address any barriers. Once understood, patients can return to coaching with increased ability to cope and implement new strategies and structures. There are no scientific studies demonstrating that coaching of any type is an effective intervention in the treatment of adults with ADHD. Goldstein (2005) expressed his concern that “professionals from diverse mental health, business, and educational backgrounds” promote coaching as a service they offer without the support of scientific studies. There is an emerging interest in ADHD coaching. Anecdotal accounts provided by experts view this as a promising intervention. Jaksa and Ratey (1999) are the first to make the distinctions that “ADD coaching is a specialty area within the broader field of personal and professional coaching.”
Hartman (2005) referred to coaching as “one of the most powerful and effective ways for people with ADHD to achieve success.” The ADHD Coaches Organization (n.d.) “supports the value of coach-specific training, as well as education in the field of ADHD and Coaching, as critical to the effective practice of Coaching.” Quinn (2007) noted that coaching gets to the “nitty, gritty stuff that medication does not address,” such as getting organized or getting a better job. Moreover, Ratey (2008) said, “coaching can be the difference between minimal functioning and true, full living” (p. 13).
In summary, the primary purpose of this current study was to evaluate the effect that coaching has on adults with ADHD and to report the observations made during the coaching process. Our hypothesis was that ADHD coaching in combination with medication or therapy has a significant positive effect on adults with ADHD. More specifically, it was predicted that adults with ADHD completing an ADHD coaching program designed to address their coping difficulties will demonstrate significant improvements on measures of various domains of coping. Furthermore, there would be a greater significant effect when ADHD coaching is combined with medication or therapy.
