I informally coached a good friend who has ADD. The friend could “hyperfocus” on his passion which was catering, but he had problems including the inability to start his own business and his disorganization and failure to attend to details in the rest of his life. I gave his spouse some strategies and ultimately had him report to me about his progress at specified times. He started out organizing his career, but he couldn’t follow through and was very apologetic to me. The issue was that failure to keep on task was not a negative consequence for him, so he couldn’t keep up a high arousal level over time. (He did try stimulants, but they made him more anxious.) After all, I was not charging him for this service, and I would still remain his friend.
In formal coaching, I have learned that adult ADDers who need strong negative consequences have to pay a reasonably high fee for coaching, so that they lose a substantial amount of money if they don’t follow through. As a clinical psychologist, if I treat an adult client for an anxiety disorder in a therapeutic environment, and learn later that he has ADD, I require a private fee for coaching. I take insurance for psychotherapy, but most companies will not pay for the ADD coaching. This is probably good, since a small copay from the client would usually not be a strong enough consequence for him to follow through with a strategic coaching program.
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