Schrevel, S. J. C., Dedding, C., & Broerse, J. E. W. (2016). Why do adults with ADHD choose strength-based coaching over public mental health care? A qualitative case study from the Netherlands. Sage Open, July-September, 1-8. doi: 10.1177/2158244016662498
Overview and Recommendations by David Giwerc, MCAC, MCC
The coaching profession has had a relative scarcity of research documenting the benefits of ADHD Coaching for adults. However, a recently published study conducted in the Netherlands asked adults with ADHD about their experiences with different treatment modalities, including ADHD Coaching. The findings indicated that participants reported that they benefit from strength-based ADHD coaching and cited their dissatisfaction with the other current public mental health care options.
The study was conducted through 23 semi-structured interviews with ADHD clients, all older than 25 years-old, who were recruited from a private coaching center. All but one of the interviewees had an official diagnosis of ADHD, and all but one had experiences with mental health care prior to coaching. Most of them had established, years-long treatment histories and frequently described a series of negative experiences in the mental health care system. Five of the participants were taking prescribed stimulant medications.
The study asked why adults with ADHD prefer to pay out-of-pocket for coaching services rather than receive reimbursed public mental health care that is available to them.
All but one of the study participants cited the high value placed on the “optimistic strength-based and solution-focused approach” of ADHD coaching, which was cited as being different from their experiences in the “symptom-centered approach” of public mental health care. Coaching was perceived as a “joint venture” fostering hope and healing by reinforcing personal strengths and competencies, person-centeredness, and the belief that everyone is capable of overcoming mental illness to live a meaningful life.
Rather than becoming fixated on their problems, many of the participants found that coaching facilitated a simpler approach which encouraged them to search for solutions when confronted with problems. By participating in the coaching process, some participants described a greater sense of control over their pervasive problems by learning coping strategies that what worked for them.
The outcome form ADHD Coaching that was most frequently described by participants was increased insight. Participants noted that community-based therapy enabled them to understand themselves, what they are doing, and how and why they are doing it. In contrast, respondents reported that Coaching "lets you discover who you are, and what you are allowed to be. . . how your internal communication works, how you treat other people. They [coaches] teach you how to enjoy life, something very simple actually."
This study highlights two important findings. First, some ADHD adults feel their needs are inadequately addressed by the mental health system, and second, these adults appeared to benefit from strength-based, specialized ADHD coaching.
Using a similar methodology, the research can be expanded to other countries in order to identify the perceptions and benefits of strength-based coaching for adults with ADHD.
Of course, the study is limited by the fact that the participants were recruited from a sample of individuals participating in an ADHD Coaching program, thus there is a self-selection bias, as individuals seeking Coaching may have done so because they were dissatisfied by community care. It is also unclear of the nature of community services available to participants in terms of targeting adult ADHD. Future studies may include a representative sample of individuals receiving a range of treatments for adult ADHD. Lastly, the training of the coaching process, specific models, competencies and strategies employed by ADHD Coaches are varied and studies specifying training standards and approaches used by ADHD Coaches will help the generalization of findings from future studies.