More people with attention-deficit/hyperactivity disorder (ADHD) are turning to coaches for guidance. Those coaches, who often have ADHD themselves, offer similar services to psychologists but don't think of their work as clinical, according to a study to be published (Jan. 15) in JAMA Network Open.
It's the first major survey of this rapidly growing field and a prerequisite to studying how safe and effective it is, the authors suggested.
"This is the most systematic information anyone's ever gotten on ADHD coaching," said Maggie Sibley, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine and the paper's lead author.
During the COVID-19 pandemic, there were shortages of both ADHD medications and office hours among psychologists who treat ADHD. In parallel, more people began to offer ADHD coaching services, and patient testimonials went viral on social media. Healthcare providers recommend ADHD coaching to their patients, and that service became part of ADHD treatment guidelines .
People with ADHD shifted to the services that were available and trending — despite the lack of evidence about the safety or effectiveness of the practice.
Sibley and Tamara Rosier, then president of the ADHD Coaches Organization , were discussing these trends and began to wonder, "How do we start a conversation about this without any systemically collected information about who coaches really are and what they do?" Sibley recalled.
They developed a survey to formally gather that information.
Notable among the findings: Most people who offer ADHD coaching have ADHD themselves. This connection can provide unique benefits to patients, Sibley said.
"The emotional validation of connecting with a person who has walked in your shoes is powerful," she said.
The field was inspired by people who market themselves as "life skills" instructors. ADHD coaches offer similar services to psychologists, including clinical care, and have similar fees. The survey found that the median per hour rate for ADHD coaching is $150. But they don't think of their work as clinical, and their fees are not covered by insurance.
"They're squarely placing themselves outside of healthcare structures and systems," said Sibley.
Unlike psychologists who need to complete a bachelor's degree, doctoral degree, internship, and certification exams, there is no formal training or licensure to be an ADHD coach. Therealso are no formal standards, oversight or professional liability insurance for the field, Sibley said, all of which can help set business boundaries and protect coaches and patients if a patient has a mental health crisis or anything else goes awry. In the absence of these features, both groups are at risk, she cautioned.
"ADHD coaches are really at a juncture where they have to decide which direction they as a profession want to head," said Sibley. Coaches could stay outside of the healthcare field and clarify their clinical limits, or they could develop formal training and licensure certifications — following the leads of workforces such as physician assistants and peer substance-use counselors. Both fields emerged from grassroots traditions and are now formalized.
Sibley thinks of coaching as an opportunity to get people with ADHD the care they need.
"This workforce is highly interested in helping other people, and they're not going away," she said.
