At one time I was a mild skeptic about the benefits of therapy for Adults with Attention Deficit, especially for sufferers of the Inattentive-Type variant of the disorder. I now believe that it can be a valuable and powerful tool.
I still believe that for most sufferers, psychiatry should be the first treatment after a solid diagnosis is made, preferably by a psychologist with special training in evaluation. Whether or not medication makes sense in the long run, experiencing even a short-term reduction in symptoms is enlightening. The light at the end of the tunnel doesn't just give hope, but it lets you know which direction to walk.
Coaching can sometimes be beneficial for many sufferers of Attention Deficit, as long as expectations are kept realistic. More important than general expertise as a coach or therapist, I believe that direct experience with ADD is the most important factor in the success of coaching. What distinguishes "coaching" from "therapy" in the case of Adult Attention Deficit is that coaching aims primarily to improve task performance on identified concrete goals. Coaching should focus on short-term goals, accountability, and concrete + discrete behavior changes. Obviously if coaching is effective and not too stressful, there is nothing wrong with making it a permanent part of treatment. But it's important to also understand that this type of coaching can be extremely stressful, is not a substitute for medication, and can cause some ADD sufferers to feel worse. A coaching failure shouldn't be viewed as a failure or either the coach or the participant. It is a learning experience.
So, why therapy? What is therapy for a person suffering from Attention Deficit Disorder? In a nutshell, therapy is about helping a person cope with being a person with an Attention Deficit in a society where focus is both intentionally fragmented and deeply commodified. If you have an Attention Deficit, you have been judged. That judgement can take many shapes. You may have been called lazy, uncaring, aimless, reckless, unreliable, impractical, stubborn, or selfish. But even more likely, you may have come to believe these things about yourself because of your failure to live up to the myriad social expectations we all face. Maybe some of those messages have buried themselves so deeply in your psyche for so long that you developed defenses. These defenses can look like anger, self-sabotage, dishonesty, or isolation. Therapy is a way of finding your way back to yourself, of accepting yourself, and getting out of your own way. Any therapist who is client-centered, empathetic, non-judgmental, warm, and humanistic can be a good therapist for a person with Attention Deficit. But a therapist with expertise or direct personal experience with Attention Deficit can help bring a greater level of clarity and relief faster, cutting through the communication barriers of language that can impede communication about internal states.
I want to provide therapy to adults suffering from Attention Deficit. Connecting with this population is one of the main reasons I started my private practice and started blogging at wilsontherapy.org.