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Published on: June 12, 2020
Demographics, Services, and Practices in Attention-Deficit/Hyperactivity Disorder Coaching in the US
Margaret H Sibley1,2, Elias D Graham3, Jillian K Holbrook3
1Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
Importance:
Individuals with ADHD face great challenges accessing formal psychosocial treatment. ADHD coaching has rapidly emerged online as a popular and accessible form of grassroots psychosocial support; however, there is a paucity of documentation about this workforce or the safety and effectiveness of its services.
Objective:
To document patterns in the ADHD coaching workforce, including workforce entry dates, services, and coach characteristics.
Design, Setting, And Participants:
The US National Survey on ADHD Coaching was conducted from October 1, 2024, to April 3, 2025, using a purposive electronic survey and snowball sampling. The survey was distributed online and in person to ADHD community hubs, professional listservs, and direct outreach to self-identified ADHD coaches providing care to at least 1 client in the US during the past year.
Main Outcomes And Measures:
The ADHD coaching workforce's characteristics and practices were assessed using descriptive statistics.
Results:
The survey was completed by 481 ADHD coaches. Among 464 coaches who provided age data, the mean (SD) age was 51.3 (11.5) years. Among 467 coaches who provided gender data, 381 (81.6%) identified as women. Most of the ADHD coaching workforce (283 of 465 [60.9%]) began practicing during or after the COVID-19 pandemic, actively received referrals from health care professionals (312 of 481 [64.9%]), and served clients across state lines (389 of 481 [80.9%]). Many practiced internationally (194 [40.3%]). Most participants self-identified as either having or suspecting they have ADHD (338 of 465 [72.7%]), used lived experience with ADHD to inform their services (460 of 465 [98.9%]), and previously received ADHD coaching (207 of 465 [44.5%]). Coaches were typically self-employed (440 of 481 [91.5%]), worked from home (417 of 480 [86.9%]), had no professional license (396 of 466 [85.0%]), and operated without formal clinical supports (420 of 464 [90.5%]). ADHD coaches predominantly offered virtual 1:1 weekly sessions with self-pay fees similar to those of psychotherapists, advertising via social media or other online platforms. While 417 of 467 (89.3%) reported no professional background in mental health, 292 of 467 (62.5%) completed an ADHD coach-led curriculum prior to workforce entry. Most ADHD coaches reported using executive function skills training, cognitive restructuring, and motivational interviewing. They discussed clinical topics such as mental health crises, substance use, trauma, and medication adherence.
Conclusions And Relevance:
The findings of this survey study suggest that there was a spike in ADHD coaching workforce entry at the outset of the COVID-19 pandemic that continues presently. Randomized clinical trials are essential to establish the safety and effectiveness of ADHD coaching. Conditional on positive findings of these trials, the health care and ADHD coaching communities might collaborate to develop standardized educational, credentialing and/or licensing, and clinical oversight.
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