What Is ADHD Coaching and How Does It Differ From Therapy?

In the months after the diagnosis something odd happened to me: I now knew what I needed to do and I still could not do it.

Every source I read said the same things. Keep a single list. Write it in the calendar. Break the task into pieces. All of it was right, I had understood all of it, and none of it was entering my life.

There is a gap between knowledge and practice, and in ADHD that gap is exactly our weakest spot. And what is called coaching works right there.

What coaching does

Coaching is structured work focused on everyday functioning. Typically it includes the following:

• Breaking the goal into steps. Bringing a big and vague goal down to concrete steps that can be done this week. Not "advance the thesis" but "two hours of source searching on Wednesday morning."
• Building systems. Designing infrastructure such as the calendar, lists, reminders and file organization to suit the person. The key word here is "to suit the person"; ready-made systems often do not hold.
• Regular follow-up. Weekly meetings. The real factor here is often the regularity itself: follow-up from outside is what is most missing in ADHD.
• Solving obstacles. When a system does not hold, finding the reason and adapting it. This is the hardest part to do on your own, because when a system does not hold, a person blames themselves first.

Where the evidence stands

I need to be honest here, because the coaching field sometimes describes itself as stronger than it is.

Small-scale studies report positive results. Kubik's (2010) study and the evaluation by Prevatt and Yelland (2015) with university students report improvement in self-regulation and academic functioning in participants who received coaching.

But this evidence base is not as broad as that for medication treatment or cognitive behavioral therapy. The samples are small, the number of studies is low and the comparison groups are limited.

Approaching it knowing this is, I think, the most correct way: coaching is a support worth trying, but anything marketed as a "proven treatment" needs to be approached with caution.

Coaching does not give new information. It makes sure what is already known gets applied, and in ADHD that is exactly the link that breaks.

How it differs from therapy

It is important to make this distinction clear, because when they are mixed up, people get support from the wrong place and, when they get no results, give up on both.

Therapy works with emotions, thought patterns, the past and relationships. Topics such as shame, avoidance, self-criticism and anxiety are the domain of therapy. Cognitive behavioral therapy is the most researched psychotherapy approach in adult ADHD.

Coaching works with how today runs. What you will do and when, how the system will be built, how the week will be planned.

Medication treatment reduces the severity of symptoms. Its effect on attention, impulsivity and restlessness has been measured.

The three do not replace one another. The European consensus statement (Kooij et al., 2019) recommends a multi-component approach in adult ADHD: psychoeducation, medication and psychological support together.

A practical distinguishing question is this: at the place where you get stuck, do you say "I do not know what to do," or "I know but I cannot approach it"? The first is the domain of coaching. Under the second there is usually an emotional load, and that is the domain of therapy.

Coaching does not diagnose. A coach cannot diagnose ADHD, cannot recommend medication and cannot give guidance about the dose of medication. If you come across someone who does these things, that is a warning sign and it is best not to work with that person.

When choosing a coach

In Turkey there is no standard professional regulation for coaching and no mandatory qualification certificate. This does not mean the field is entirely unreliable; it means the whole burden of choosing is on you.

Questions to ask:

• What is your training? Have they had training specific to ADHD, or do they hold a general coaching certificate?
• Who do you work with? Are they someone with experience in adult ADHD?
• How do you work? Frequency and length of sessions, is there contact in between?
• What are your limits? What do they do when a therapeutic issue comes up? Can they refer you on?
• How is the fee set? Is a package required, can a single session be tried?

There is also something you need to observe: is the coach listening to you, or applying a ready-made system? If you are handed a template in the first meeting, be careful.

Warning signs: promising guaranteed results, imposing long non-refundable packages, commenting on medication, questioning the diagnosis, speaking in the tone of "you are just undisciplined."

What a coaching session looks like

For those who are curious, the typical flow is described like this.

In the first meeting the current situation is talked through: what is holding, what is not, which area is the most urgent. Then one or two goals are chosen; taking them all on at once is the most common mistake in this work.

In the weekly meetings three things happen: what happened last week is looked at, the reason for what did not hold is sought, and a very small and very concrete step is set for the coming week.

The critical detail is this: when the step is not small, the system collapses, and when it collapses, a person quits coaching. A good coach is the person who puts the brakes on your wish to be ambitious.

Who it suits more

Coaching does not suit everyone to the same degree. The situations in which it works more:

• The diagnosis is new and a system needs to be built
• The symptoms have eased with treatment but the everyday routine has still not settled
• There is a specific project: a thesis, setting up a business, a move, an exam period
• As someone who works alone, no structure comes from outside at all

Situations in which it suits less: marked low mood, intense anxiety or a period in which functioning is seriously impaired. If you are in such a period, a clinical assessment comes first.

Cost and access

In most places coaching is a service paid for out of pocket, and because it requires regular meetings the total cost can be high.

I am writing this openly, because presenting an inaccessible solution as the only option helps nobody. There are ways, free of charge, that take on some of the same function.

Things that can take the place of coaching

• An accountability partner. A friend you talk to once a week. It works even better if you both set up the same routine. The glossary has an entry on the accountability partner.
• Body doubling. Working in the same environment, quietly, side by side. The details are in the article on body doubling.
• A weekly review. A structured review done by yourself. This is what I have managed to keep up for the longest; I described it in detail in the article on the weekly review.
• Support groups. Regular contact with people living the same picture. The benefit here comes less from information than from being seen.

My own thinking

The part of coaching that I believe would work for me is this: regular contact from outside.

Every system I have built for myself shares the same fate: it fizzles out in the third week. Not because the system is bad, but because nothing reminds me of it. Reporting to someone once a week carries that reminder outside.

Coaching is not a treatment and nobody should present it as one. It does not replace therapy or medication treatment; it works on the practical gap they leave. If that gap is where you get stuck most, it is worth trying.