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ADHD Coach vs. Therapist


So you want help with your ADHD.

Maybe your struggling with procrastination, time management, larger-than-life emotions, relationship issues, self-care, having confidence, all of the above, or something else entirely. 

Is it better to work with an ADHD coach or a therapist?

Well don’t worry your pretty little head, because that’s exactly what we’re going to be talking about today.

And even though I’m an ADHD coach myself, I’m going to give you my unbiased opinion, as while there are circumstances when an ADHD coach is what you need, there are also times when you’d be better off in therapy.

 So, let’s get into it. Coach vs. therapist? Which one should you choose?

Well let’s look at a few different things. 

Diagnosing ADHD

First of all, getting a diagnosis. If you suspect you have ADHD but do not currently have a diagnosis and you want one, then a coach is not the person for you.

Coaches are not qualified to diagnose ADHD.

So for a diagnosis, you will want a therapist such as a psychologist or psychiatrist.

You can also ask your primary healthcare provider, a.k.a. your regular doctor for a diagnosis.

Now, real talk. And I hate that I have to do the real talk here, but here we go.

A lot of people, and especially a lot of women, fail to be diagnosed with ADHD and are often misdiagnosed with other mental health conditions.

I myself have been misdiagnosed with major depression, anxiety, and bipolar disorder with rapid cycling, and turns out I don’t have any of those nor did I respond at all to any of the medication for those things that I do not have.

And let’s be clear here, it’s 100% possible to have ADHD and depression, anxiety, bipolar and so on, but I have seen it time and again where people are labeled with something that’s really just a byproduct, let’s say, of their ADHD.

And unfortunately, my misdiagnosis story is far from unique.

My friends diagnosed me in the end, but I ignored them, and then I found a book about ADHD in a box on the sidewalk in Brooklyn, New York, believe it or not, and read it, and went, oh . . . shucks. That’s me!

Then I signed up to talk to a therapist about it, and hijinks ensued. You can read all about my adventures in therapy in my blog post called CBT for ADHD? OMG. 

I didn’t get my ADHD diagnosis until I was in my mid 30s.

My advice if you’re seeking a diagnosis, is to look for someone who has ADHD listed as one of their specialties in their profile.

And I don’t mean that they have ADHD and literally every other word in the dictionary in their profile, but that they have ADHD and maybe a handful of other things listed there.

It breaks my heart when I hear stories of people finally getting up the courage and calling upon the gods of organization to help them make that first appointment and then they go in, see someone who doesn’t really have much training in ADHD, and are basically gaslit.

They hear things like, “You got good grades, so I don’t think you have it,” or, “No, it’s just menopause,” or “I doubt it, you make really good eye contact.” That last one is the one that I got, by the way. {Video: Then Your Doctor is Wrong} So if you’re going for a diagnosis, look for someone who knows what’s up, okay? Take it from me.

No Diagnosis? No Problem

Now, what if you want to work with an ADHD coach, and I’ll talk later in this episode about when it’s a good idea to do that, but you don’t have a formal diagnosis. Can you still work with a coach?

The answer is yes. Most of us ADHD coaches have ADHD ourselves, and, therefore, we get it. We know it’s A) sometimes hard to get a diagnosis and B) all of the ADHD coaches that I know don’t really treat it like some secret exclusive club. So even if you simply suspect you have ADHD, most if not all coaches will be happy to work with you and will welcome you with open arms.

Now, I’ve heard that in some countries the waiting list to be seen for a diagnosis is freaking long at the moment. So if that is the case for you, but you would like support now, you can try reaching out to some ADHD coaches and getting started with them in the meantime.

As coaches, we are trained to know when a potential client would be better served by therapy, so if that is the case, the coach will tell you, but if not, you can get started on getting support for your ADHD by working with a coach, and, yes, most of us are pretty busy, but I haven’t heard any of my coach friends say that they are fully booked years into the future. So chances are, you’ll be able to talk to a coach pretty darned quickly.

So, to recap that part, if a diagnosis is what you seek, then a therapist is your best bet here, but an ADHD coach can work with you even if you haven’t been formally diagnosed yet.

What's the Difference between ADHD Coaching and Therapy?

Okay so what’s the difference between ADHD coaching and therapy for ADHD? While there is quite a lot of overlap between the two, they also have some characteristics that are different. It’s important to mention that both coaching and therapy have been studied a lot and both show clear, statistically significant benefits for people with ADHD.

First, the Similarities

Psychoeducation - Why You Might Be Doing What You're Doing

One thing that both ADHD coaching and therapy for ADHD have in common is what’s called psychoeducation.

That’s basically helping you understand what ADHD is and making sure you’re familiar with the symptoms, even the less common ones.

Therapists are supposed to do this with their clients.

I have had both ADHD therapy and ADHD coaching, am in fact am in ADHD coaching at the moment because it helps me so much with prioritization and if I get stuck on something my coach is really great at helping me examine my own thoughts and behavior and getting unstuck.

In my personal experience, my therapist did not provide me with any education on ADHD, whereas my coach does.

Even though my coach knows I know what’s up, like I know all the symptoms, she knows that sometimes I still need it pointed out to me that what I’m doing is an ADHD thing, even though I’m an expert on the subject.

It’s another story when it’s your own life, isn’t it?

But anyways, in theory, both therapists and coaches should be providing you with ADHD education. It’s so important for us to understand what’s going on with us.

And it doesn’t have to be a 45-minute lecture every time you meet, but rather just that the coach might point something out that comes up naturally during the course of a session like, for example, that we often can get stuck on conflicts and ruminate on them.

And simply knowing that that’s a “thing” can help a lot. I have found that one of the most valuable parts of ADHD coaching for my clients is that they learn that they’re not alone in this.

So receiving education about ADHD whether during the course of your coaching sessions or through material provided to you to work through between sessions, is a big part of the process and a very important one on your path to managing your ADHD and becoming even more awesome than you already are.

ADHD-Specific Treatment

Another similarity between ADHD coaching and therapy for ADHD is that both should be designed with an ADHD brain in mind.

Duh, right?


But it’s important to point out, because there are things that we need to do a bit differently sometimes, and if that’s not taken into account by our practitioner, whether that’s a coach or therapist, it can set us up for failure and that lovely feeling we all know very well as ADHD peeps: shame.

What do I mean by this?

For example, in the CBT therapy I went through, the therapist didn’t know that I had ADHD, and I explain why in the other post {CBT for ADHD - OMG}.

It’s a pretty messed up story which is hilarious to me now, but wasn’t so much at the time.

So, she gave me a suggestion of a way to overcome one of my problems and it absolutely 100% did not work, and actually wound up making me feel worse because not only did I still have the problem, but I had failed at implementing a solution that a professional brain person had suggested, so then I felt extra bad.

This same problem, presented to an ADHD coach will be met with very different tactics as well as an understanding that the client will likely have to do a bit of experimentation to find out what’s best for them, thus the coach or the therapist, if they’re good at what they do, will come to the sessions with a level of monk-like patience, knowing that these are usually lifelong problems that this person has, and they’re not going to be solved with a five-minute pep talk.

This unconditional, unwavering patience, and wholehearted belief in the client and their abilities is really, in my opinion, the magic of coaching and therapy too.

A lot of times, when my clients first come to me, I am literally the only person on the planet who believes in them.

Eventually, they start to believe in themselves too.

And then, some of the people around them start to believe in them as well. Some of them don’t, but we work on not listening to those people so much because what do they know?

So summarizing that, both coaching and therapy for ADHD can and should have the ADHD brain in mind. The general stuff, like general life coaching and general therapy can help with some things, for sure, but ADHD is really its own animal and needs some specific treatment as well.

Now, the Differences

More Focused on Taking Action

Now, moving on to some of the differences between ADHD coaching and therapy, very generally speaking, ADHD coaching is going to be quite focused on taking action and working towards goals.

And so an important part of the process is going to include goal work.

And a goal can be all sorts of things.

It can be something very tangible like opening a business. That’s pretty black or white. You either opened it or you didn’t.

Or it can be something that’s maybe a little more abstract like, wanting to feel more confident in social situations.

You will see some variation among coaches when it comes to goal setting, but pretty much all of us are going to tell you that it’s important to have an idea of where you want to go so that we can start working on how to get you there.

With my clients I like to do what’s called “rough draft goals,” which is where we talk a bit about what they want to accomplish but also why, knowing that, sometimes goals can change and that that’s perfectly okay.

The Insight Model of Coaching

Now that said, it’s not just about doing a bunch of stuff.

I personally coach my clients using something called the insight model. The insight model has roots going all the way back to Socrates.

If I had to put it into my own words, I would describe it as, uncovering the limited beliefs that are holding us back.

For example, let’s say that you are trying to get more movement and exercise into your day, but it’s just not happening, like, at all.

Now, when you say this to someone, that’s when you tend to hear all this advice like, “sleep in your workout clothes,” or “just take the stairs,” or “you need to buy this app that will send you a notification.”

And that’s all decent advice, but what if there’s something going on under the hood, so to speak, that’s keeping you stuck?

By uncovering this limiting belief, or what some other people call a thought error, your coach can help you break through those mental blocks that are holding you back.

So maybe you talk to your coach, and together, through a series of questions, you uncover that you have a belief that exercise means putting on special clothes, going to the gym, and working out super hard for at least an hour, otherwise, it’s not really exercise.

In other words, kind of being a bit black and white about it, or maybe even a bit perfectionistic about it.

And when you uncover this belief, it might make you realize why it’s so hard for you to exercise and why you’re not doing anything at all.

You’re making it too hard from the get-go and giving yourself icky feelings about it because it just seems so hard.

So by working with your coach you will come up with a new way of thinking about exercise.

Maybe you will decide that for you, for now, going for a walk in whatever clothing happens to be on your body at lunchtime is a-ok. And later maybe you’ll revisit the idea of going to the gym, but for now, you’re just going to get started on something simpler.

Strengths-Based Coaching for ADHD: I'm Not Really a Fan

Many ADHD coaches also work a lot with what’s called “strengths-based coaching.”

The theory behind this is that a coach should help their clients recognize their strengths and then build off of them.

I’m going to ruffle some feathers here by throwing in my own opinion and experience, but I really don’t see how this plays out session by session.

What I mean by that is, let’s say that you identify one of your strengths as creativity. Cool. And this week, you decide that what you need the most support with in your session is your relationship with your boss.

I’m having trouble seeing how, in a practical setting, during the course of a coaching conversation, you will be able to find a way to lean on your creativity to help you with this problem, but maybe I’m just not creative enough. (Side note, I am.)

So, I do think it’s great to talk about strengths when beginning coaching, but not necessarily to help with taking action so much as to remind the client of their positive qualities as our work often involves improving self-esteem. And that’s just me, and if you disagree with my philosophy, you go on and work with a strengths-based coach, and we’ll still be friends, no problem.

My All-Time Favorite Coaching Question: What's Going Well?

Now, that said, something that I do do, and that nearly all coaches across the board will do, although it’s not something I’ve ever come across personally in therapy, is giving some attention to the wins.

So, while I don’t spend much time focusing on a person’s character strengths after the initial meeting, you’d better believe in every session, we’re going to spend at least a little time talking about what’s going well.

Why? Usually I work with my one-on-one clients on a weekly basis. And they know that setting the agenda for the session is up to them. I always bring 2-3 themes to each session just in case the client doesn’t have a particular issue they want to work on that week, but I also don’t want my clients to only be thinking of the negative and the problems in between sessions.

I also want them to be looking out for the positive.

This is something you might not have heard before, but did you know that those of us with ADHD tend to have a proclivity for negativity?

Yup, it’s extra easy for us to focus on the negative and focus on it for a freaking long time. So we usually need a little nudge to remind us that there are some things that are actually going well.

And instead of only talking about problems, which is super important and needs to be done, it’s important to discuss successes and to examine why they happened. So, while I don’t devote so much energy to talking about a person’s good character, I devote energy to talking about a person’s good actions (as what is character anyway but a series of repeated actions).

Deep Work on Feelings in Therapy

Now, how does this all compare to therapy?

Well, in general, therapy will be a little less focused on taking action and more focused on dealing with feelings. In therapy you can work a bit more deeply on emotions, especially those stemming from trauma.

You’ll be looking more deeply at past patterns than you will in coaching, and working more on healing. Of course, this can help you achieve your goals, but in general, therapy tends to be a little less focused on your week-to-week goals and more focused on overall recuperation of your mental health.

Coaching Requires the Client to be Functioning at a Certain Level

And here is another important distinction between the two. In coaching, we work with individuals who are functioning.

What do I mean by this? You’re able to take care of yourself, even if it’s not perfect.

So, for example, oops, you woke up a bit late today and you had to rush to the office without showering and you arrived a half hour late.

Okay, you’ll hopefully do better tomorrow.

On the other hand, if you haven’t showered in a month, and you haven’t been able to get to the office at all for weeks because you just can’t get out of bed, that’s a different story.

A therapist can work with both of these cases, but a coach can only work with the first one.

As coaches, we are not equipped to deal with these extreme levels of distress and we will advise you to seek help from a therapist.

Don't Freak Out . . . Your Coach Might Give You Homework

Another difference between coaching and therapy for ADHD is that coaches will often have self-study material that goes along with their programs.

In my case, my signature program includes weekly workbooks about holistic health including work on nutrition, sleep, stress management, relationships, confidence, your life’s purpose, and much more, and I have woven in ADHD-specific information to my program.

My background is in wellness and I know it’s critical to base all of your mental health work on a strong physical foundation as, in the words of the brilliant Dr. Georgia Ede, “Studies have shown conclusively that the head is part of the body.” So that’s my style, always focusing on the whole picture, as sometimes the answer is as simple as something like drinking less coffee in the afternoon, but if we only focus on our thoughts and feelings, we can miss something as simple as that and wind up really spinning our wheels.

In my experience, therapy, on the other hand, does not in general come with any self-study material, although in my post CBT for ADHD? OMG” I talk about a homework assignment that my therapist gave me that was pretty eye-opening, so make sure you check out that blog post after this one.

Location, Location, Location

Yet another difference between coaching and therapy is that coaches can work with clients anywhere in the world, whereas therapists do have some restrictions based on licensing laws, so they are limited to people living in the same country as them and sometimes the same state or province. So that’s something to keep in mind when searching for support.

Let's Talk About Money, Honey

And hey, what about costs and insurance? So, costs vary but I would say in general, ADHD coaching is priced a bit lower than therapy, again it depends.

Is ADHD Coaching Covered by Health Insurance? What about Therapy?

In terms of insurance, most of the time, ADHD coaching will not be covered by insurance, however, I am starting to see ADHD health coaching being offered by some insurance companies and, if you’re in the U.S., you can most likely use your HSA or FSA account to pay for coaching if you have one.

In the U.K., ADHD coaching may be covered under the Access to Work program. Apart from that, your employer may have a program to help pay for coaching as well, as part of their professional development benefits. And if you are self-employed, you may be able to claim a tax deduction.

Therapy, on the other hand, is more likely to be covered by health insurance plans, although you’ll need to check with yours to see. Not all therapists take insurance. For those of you in the U.K., therapy is covered on the NHS, however I have seen that in some places, it can take a really long time to be seen. For example, I read on the BBC that in Sussex there’s currently a five-year wait to be seen for an ADHD assessment. Five years!

Can I Work With an ADHD Coach and Therapist at the Same Time?

Now what about working with a coach and a therapist at the same time? That is totally doable and many people do that. I give it a thumbs up.


So, to summarize, ADHD coaching and therapy for ADHD have some overlap but also some things that are particular to each one.

Both are tailored to the ADHD brain, when done right, and both include an educational component about the disorder. ADHD coaching will be more geared toward taking action and uncovering the strategies that work for you in the here and now, whereas therapy will be more geared toward emotional healing.

Coaching is designed for people who are currently able to take care of themselves on a basic level, even if not perfectly, whereas therapy can work with those who are both able and currently unable to take care of their basic needs.

You’re more likely to receive supplementary self-study models when working with a coach than a therapist.

Coaches cannot diagnose you with ADHD.

It’s sometimes hard to get an appointment with a therapist without a long wait time, whereas this may be easier with a coach, and therapy is more likely to be covered by insurance than coaching, although many options exist when looking into how to pay for either.

Last but not least, if you want both and therapist and coach, that’s definitely doable too.

All right! I hope this information has been helpful for you! If you’re curious about my experience with therapy, which also includes information about whether or not CBT is helpful for ADHD, check out this other blog post about CBT for ADHD. 

Thanks so much for being here. As always, I’m rooting for you. Have a happy and healthy day.