Adult ADHD: Diagnostic Assessment and Treatment by J. J. Sandra Kooij

Author:J. J. Sandra Kooij
Language: eng
Format: mobi
ISBN: 9781447141372
Publisher: Springer
Published: 2012-12-10T22:00:00+00:00

Chapter 5

Treatment: Coaching Adults with ADHD

5.1

Introduction: What Is Coaching?

This chapter is based on the literature about coaching and cognitive behavioral ther-

apy for adults with ADHD and on experiences from clinical practice. The aim of

this chapter is to provide a guide for mental health-care professionals regarding the

coaching of adults with ADHD.

The literature regularly draws a distinction between the concept of coaching for

ADHD and psychotherapy (especially cognitive behavioral therapy) (Ramsay and

Rostain 2008 ) . Coaching provides the patient with support in achieving their practical goals, for example, in work or education. Psychotherapy focuses more on the

overall functioning of the patient, and diagnostic assessment is an important part of

the treatment. Coaching does not include any explicit cognitive behavioral interven-

tions, although these can be part of it.

The various models for cognitive behavioral therapy for adults with ADHD dis-

tinguish between different focuses for the treatment. With Ramsay and Rostain, for

example, there is relatively more attention focused on the cognitive component,

whereas Safren devotes more attention to the acquisition of practical skills (Ramsay

and Rostain 2008 ; Safren 2006 ) .

The term coaching is used loosely in this chapter. It may be more formal cogni-

tive behavioral therapy, for example, with patients with a persistent negative self-

image as the result of experiences of failure. Or with other patients, the focus may

be more on teaching practical skills and supporting the achievement of goals , pos-

sibly with practical support in the domestic situation. With a lot of patients, coach-

ing will include both elements. The focus of the treatment will thus depend on the

patients’ problems. With all patients, diagnostic assessment, including that of

comorbid disorders, is an important condition for the start of the treatment. In prac-

tice the treatment will, as discussed in more detail, be more in keeping with the

methods of cognitive behavioral therapy than those of coaching in the narrower

sense. In this chapter the terms “coach” and “mental health-care professional” will

be used interchangeably.

J.J.S. Kooij, Adult ADHD,

169

DOI 10.1007/978-1-4471-4138-9_5, © Springer-Verlag London 2013

170

5 Treatment: Coaching Adults with ADHD

5.2

Cognitive Behavioral Therapy for ADHD

and for Other Disorders: Similarities and Differences

What exactly is the difference between cognitive behavioral therapy for ADHD and

cognitive behavioral therapy for other disorders , such as depression or anxiety

disorders?

Similarities

• The treatment is transparent; explanation is given about what will be done and

what the reasons for this are.

• The treatment is structured and speci fi c.

• The treatment is aimed at the here and now and at the past only if this is relevant

to the here and now.

Differences

• Coaching uses more limited homework assignments to prevent patients failing.

• For the above reason, assignments are discussed in greater detail during the

consultation.

• Because of patients’ forgetfulness, it is important that things discussed earlier are

repeated.

• Coaching is more practical in the sense that learning practical skills in the fi eld

of planning and structure is an important part.

• The equality of mental health-care professionals and patients is more important

with coaching in order to prevent patients dropping out or resisting the

treatment.

5.3

Rationale of the Treatment

ADHD in adults is a relatively recent diagnosis. As a result of this, there are

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