16. ADHD: Coaching vs. Psychotherapy

I'm in the midst of a recertification program for high-performance coaching so it seemed like a good time to look at the difference between psychotherapy and coaching, especially for ADHD people. I've been a psychotherapist for over 40 years. I've been a certified high performance coach for over 10 years. There is a big difference between coaching and psychotherapy.

Psychotherapy is based on a pathology model and tends to look at history and past traumas of all kinds with the notion of taking a person who is operating at a lower level to bring him or her up to the "normal" level of functioning. Coaching comes out of the human potential movement,and positive psychology movements and is focused on helping a person achieve to the highest possible level.

If you're not familiar with human potential movement or positive psychology movements, they all come from looking at psychotherapy and saying, "well we can get people operating at the normal level, but let's see how far we can push it and get them to operate at their absolute best level.” This is an optimistic and hopeful approach to human performance.

Coaching has an action-oriented approach. It focuses on setting and achieving specific goals and is highly action-oriented. This can be particularly helpful for ADHDers who need clearly structured plans. Psychotherapy spends more time focusing on understanding underlying issues and developing coping mechanisms. This is less direct and is slower to show results.

Coaching provides clients with practical strategies and tools for managing time, organizing tasks and improving productivity. These are immediately implemented. Psychotherapy focuses more on diagnosing and treating deficits or psychological problems.

Coaching focuses on strengths and potential. Coaching spends more time identifying individual strengths and potential and then tries to maximize them. Psychotherapy again focuses more on diagnosing and treating deficits.

Coaching is flexible and customizable, allowing for specific tailored approaches that fit the client’s unique lifestyle and needs. Psychotherapy tends to be more standardized, which sometimes makes it less adaptable.

Coaches work with the client to set clear goals and hold them accountable. Psychotherapists tend to focus more on the therapeutic process than specific outcome goals

Coaching is short term and solution-focused, helping clients make immediate changes and see quick improvements in their daily lives. Psychotherapy can be a longer-term process and may not align best with an ADHD client's need for structure and immediate results.

Coaching tends to be focused on changing behaviors and developing new habits. This is ideal for ADHD symptoms. Psychotherapy focuses more on emotional aspects, which may not address the immediate behavior challenges faced by those with ADHD.

Coaching tends to be a collaborative peer-like relationship that can feel less formal and less clinical. Therapeutic relationships are more structured, with the therapist being the one in charge and the patient being the one taking direction..

Coaching is characterized by continuous motivation and encouragement, which helps with engagement and motivation. Psychotherapy tends not to focus as much on motivation, which makes it harder for individuals with ADHD to stay committed to the process.

Coaching sessions are typically accessible and convenient. They are most often presented virtually, which makes them more flexible and a better fit for the unpredictability of those with ADHD. Psychotherapy typically is more rigid and usually is presented in an office setting. The COVID-19 epidemic changed this of course, with telepsychology becoming the new normal way of presenting psychotherapy services. Telepsychology just means that psychotherapists were allowed by the insurance companies to provide therapy online or by phone. It is unclear if telepsychology will continue to be allowed. Before COVID-19, insurance companies did not reimburse for telepsychology except in rural areas.

Clearly, there are a lot of significant differences between psychotherapy and coaching. Coaching has the advantages of being faster, more immediate and in a lot of ways more personal than psychotherapy. The client is also more empowered by the process of coaching and has more to say about the direction of treatment. Coaching is a more immediate, practical and strength-based approach that fits the needs of ADHDers very well. Psychotherapy and coaching can complement each other and the best approach may be to integrate both methods, particularly considering the many ADHDers have multiple psychological diagnoses.

Thanks for reading and let's make the world safe for ADHD!

Visit my website at terrygingrasphd.com to learn more about Dr. G and my ADHD coaching services. 

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DrG