Why Do Adults With ADHD Choose Strength-Based Coaching Over Public Mental Health Care? A Qualitative Case Study From the Netherlands

Abstract

For this qualitative case study, 23 semistructured interviews were conducted with clients of a private coaching center in the Netherlands. We explored why adults with attention deficit/hyperactivity disorder (ADHD) prefer coaching, which is financed out-of-pocket, over public mental health care and what the perceived added value is for them. The participants highly valued the optimistic strength-based and solution-focused approach, which was contrasted with what they have experienced as a deficit and symptom-centered approach in public mental health care. Coaching was perceived as a joint venture, resulting in a more thorough understanding of how one approaches life and can be better equipped to deal with future problems. This study identified a group of adults with ADHD who feel that their needs are currently unsatisfactorily addressed in public mental health care. Future research should further explore whether this is a specific group of adults or whether these experiences are more common.

The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review

“…These models focus on the characterisation of ADHD as deficits in executive function relating to goal-directed behaviour, disorganisation and planning, motivation, and ultimately self-regulation. Citations for characterisation in ADHD Coaching models include one referencing DSM IV [ 211 ], three reference DSM-IV-TR [ 191 , 202 , 214 ], one reference to Brown’s Executive Function Model [ 195 ], and twenty-eight reference Barkley specifically [ 118 , 128 , 143 , 186 , 188 , 189 , 191 – 194 , 196 – 201 , 203 – 207 , 209 , 212 , 214 – 218 ].…”

Silver linings of ADHD: a thematic analysis of adults’ positive experiences with living with ADHD

“…There is a consensus within psychotherapy that treatment should not only focus on the absence of symptoms but also on recovery, coping, well-being and growth 46. However, adults with ADHD still report current treatment options to be too deficit oriented 19. By putting an emphasis on the full range of experiences related to ADHD, both good and bad, one might be able to offer treatment interventions more in line with the needs of adults with ADHD, which may be favourable for treatment engagement and clinical outcomes.…”

“…This particular intervention was found to improve the participants’ knowledge about ADHD and life satisfaction, giving support for incorporation of a strength-based approach in psychological treatment for adults with ADHD 17. Findings from qualitative research further indicate that public mental healthcare is perceived as too deficit centred and symptom centred by adults with ADHD, leading some to seek alternative treatments that are perceived as more strength-based, even if not reimbursed by healthcare insurances 19. The willingness to pay out-of-pocket for these treatments could suggest that the current treatment options do not fully meet the needs of adults with ADHD 19…”

“…17 Findings from qualitative research further indicate that public mental healthcare is perceived as too deficit centred and symptom centred by adults with ADHD, leading some to seek alternative treatments that are perceived as more strength-based, even if not reimbursed by healthcare insurances. 19 The willingness to pay out-of-pocket for these treatments could suggest that the current treatment options do not fully meet the needs of adults with ADHD. 19 Taken together, the scientific literature on the strengths associated with ADHD is still scarce.…”

ADHD College Coaching: Potential Adverse Events

“…Studies using cognitive behavioral therapy with ADHD coaching techniques (Prevatt et al, 2017;Prevatt & Yelland, 2013) demonstrated significant improvement in students who participated in a modified coaching program. Qualitative studies with college students and other adults (Rich-man et al, 2014;Schrevel, Dedding & Broerse, 2016) also found that coaching increased clients' self-determination, executive functioning skills, and academic skills and was perceived as an optimistic, strengths-based, and relationally focused experience. In a recent study of 1,782 undergraduates with ADHD and/ or LD, DuPaul and colleagues (2017) investigated the relationship between targeted services (i.e., coaching, tutoring, academic advising) and students' GPA over a period of five years.…”