ADHD coaching is growing. Now we need to understand how it works.  

I am an ADHD coach, and I believe coaching can work. I say that not only because I work in this field, but because I repeatedly see what happens when people stop trying to solve executive-function difficulties with information alone and begin changing the structures, habits and environments around them.

Most of my clients do not come to coaching because nobody has ever told them how to use a calendar, make a list, prioritise a task or establish a routine. Quite the opposite. Many arrive with years of accumulated knowledge about productivity and an impressive collection of abandoned systems. They often know exactly what they are “supposed” to do.

The difficulty is making that knowledge usable in everyday life.

A planner works for two weeks and then disappears from awareness. A carefully constructed morning routine collapses after one bad night. An important email remains unanswered, not because the person does not understand its importance, but because each day of avoidance makes starting it psychologically harder. A large task is postponed until urgency finally provides enough activation to begin, followed by another exhausting sprint to the deadline.

These are patterns I see repeatedly in my coaching work, and they are one reason I find the rapid growth of ADHD coaching so interesting.

A recent peer-reviewed study examining data from the U.S. National Survey on ADHD Coaching provides an unusual picture of a profession that has expanded dramatically since the COVID-19 pandemic. The researchers analysed responses from 465 ADHD coaches and found that the number entering the profession increased substantially after 2019. Newer coaches tended to be younger, were more likely to identify as having ADHD themselves and were less likely to hold professional healthcare licences.

The profession, in other words, is not simply getting bigger. It appears to be changing. For me, that makes the question of what coaching actually does increasingly important.

Coaching is not about knowing what to do

One of the misconceptions about executive-function support is that providing someone with the right strategy should solve the problem. If someone struggles with time management, give them a calendar. If they procrastinate, break the task into smaller steps. If they forget appointments, set reminders.

All of those strategies can be useful. None of them is particularly revolutionary. The difficult part is turning a strategy into behaviour that survives contact with real life.

This is where I believe coaching can make a difference, because changing behaviour rarely happens simply because someone has been given better instructions. Most lasting behavioural change involves repetition, adjustment, feedback and the gradual development of habits that work within the person's actual environment.

In my work, we often begin with something that appears very small. A client may want to check their calendar at a particular point in the morning, create one reliable place for incoming tasks or develop a consistent way of restarting work after an interruption. We try something, observe what happens during the week and then adjust it.

Sometimes the strategy works. Sometimes it works for three days and then disappears. Sometimes what looked like a motivation problem turns out to be an initiation problem, an environment problem, an unrealistic expectation or simply a system containing too many steps.

That process matters. Instead of asking why someone “failed” to follow a perfectly sensible strategy, coaching can ask what prevented the strategy from becoming accessible when it was needed. Over time, repeated behaviours can become less dependent on deliberate executive control. This is hardly an idea unique to ADHD coaching; it is fundamental to behaviour change more broadly. We practise, repeat, modify the environment and gradually make desired actions easier to initiate and maintain.

For people whose executive resources fluctuate, reducing the amount of conscious effort required to perform routine behaviours may be particularly valuable.

What I see in practice

Some of the most meaningful changes I see are not dramatic. A client begins opening their calendar without having to consciously remind themselves. Someone who previously avoided an administrative task for weeks develops a reliable first step that allows them to begin before panic takes over. Another learns that after an interruption, they need to leave themselves a visible cue showing exactly where to restart rather than expecting working memory to hold that information. Individually, these changes can look almost trivial. Collectively, they can change the texture of a person's day.

What is particularly interesting is that progress does not necessarily mean executive-function difficulties disappear. People may still become distracted, underestimate time or struggle to initiate certain tasks. The difference is that they gradually develop systems that anticipate those difficulties rather than relying on willpower to overcome them every time.

I have also seen something else happen. When a strategy repeatedly fails, clients can be extraordinarily quick to interpret that failure as evidence about themselves. They are lazy, inconsistent, incapable of maintaining routines or simply “bad at adulting”.

Coaching creates an opportunity to treat the failed strategy as information instead.

Perhaps the reminder appeared at the wrong time. Perhaps the task was still too large. Perhaps the environment contained too much friction. Perhaps the system depended on remembering to use the system — a particularly unfortunate design for someone struggling with prospective memory.

Once the question changes from “What is wrong with me?” to “What is preventing this from working?”, there is much more room for experimentation. That is one of the reasons I believe coaching can be useful. It is also precisely why I want better research demonstrating when, how and for whom it is useful.

Believing in an intervention is not the same as proving it

My experience as a coach gives me considerable reason to believe that this process can improve people's everyday functioning. My training as a researcher also makes me cautious about what I can conclude from that experience.

The clients I see are not a randomised controlled trial. People who choose coaching may be particularly motivated to make changes. Improvements may reflect many things happening simultaneously, including medication, therapy, changes at work, increasing understanding of ADHD or simply the passage of time. I also see the people who continue attending coaching; research needs to account for those who stop.

Professional experience can generate hypotheses and reveal outcomes that researchers may not have thought to measure, but it cannot establish efficacy by itself. That distinction is important because ADHD coaching is growing considerably faster than the evidence base supporting it.

There have been promising studies, particularly among university students and young adults, but compared with medication and established psychological therapies, contemporary ADHD coaching remains poorly studied. We still lack robust answers to some surprisingly basic questions about which elements of coaching produce change, who benefits most, how long improvements last and how much training is required to deliver it effectively.

A changing profession needs clear boundaries

The U.S. survey also raises questions about where coaching sits within the wider ADHD-care system. Newer coaches were less likely than those who entered the profession before the pandemic to report referring clients to medication prescribers or CBT providers. At the same time, they were less likely to engage with clearly clinical issues such as medication adherence, substance use, suicide, abuse or self-harm.

I find that combination particularly interesting because coaching does not need to become psychotherapy in order to justify its role. In fact, I think maintaining that distinction is essential. Many of the issues I work on with clients concern implementation: translating intentions into action, creating external structures, establishing routines, reducing friction, managing competing demands and developing ways to recover when a system inevitably breaks.

That is different from treating depression, trauma, substance-use disorders or other mental health conditions. Yet ADHD rarely exists in a vacuum. A person may arrive wanting help with procrastination when severe anxiety is driving the avoidance. Someone may describe difficulty getting out of bed as an executive-function problem when depression also needs to be considered.

A competent coach needs to recognise the boundary. Knowing when something belongs outside our scope and another professional should become involved is not a limitation of coaching. It is part of practising responsibly.

Perhaps we are measuring the wrong things

There is another reason I think ADHD coaching deserves better research. The outcomes my clients care about are often surprisingly ordinary. They want to leave home without returning three times for forgotten belongings. They want to start work before a deadline becomes an emergency. They want to stop losing an hour every time they are interrupted. They want to manage email without feeling permanently behind, keep track of appointments, maintain routines and finish the tasks they intended to finish.

Traditional ADHD symptom scales do not necessarily capture these changes very well. A person's core symptoms may remain measurable while their life becomes considerably easier to manage. If coaching is primarily trying to improve everyday functioning, research should measure everyday functioning. We need to know whether people initiate tasks more reliably, recover from disruption more quickly, maintain useful habits for longer and achieve the same outcomes with less compensatory effort.

We also need longer follow-up periods. I am less interested in whether someone can use a new strategy while meeting with a coach every week than whether that strategy is still part of their life six months after coaching ends. That is where the habit question becomes particularly important. The aim should not be to make someone permanently dependent on a coach who reminds them what to do. Good coaching should gradually make the coach less necessary by helping the person develop structures, habits and ways of problem-solving that can continue without us.

The evidence needs to catch up with the practice

I believe ADHD coaching can work because I see people change behaviours that had been causing difficulties for years. I see small adjustments become routines, routines reduce cognitive load and successful experiences begin to replace long histories of frustration and self-criticism.

But I also believe strongly that a profession should not rely on practitioners saying, “I see it working.” We need rigorous research capable of testing those observations. We need trials that describe what coaches actually do rather than treating “ADHD coaching” as though it were one uniform intervention. We need meaningful comparison groups, longer follow-up, measures of real-world functioning and studies examining which clients benefit and which do not. We also need to understand whether the mechanisms we assume are important — accountability, environmental modification, repetition, habit formation, externalisation of executive functions or something else entirely — are actually responsible for change.

For me, those two positions are not contradictory. I can believe in the value of the work I do while also wanting stronger evidence for it. In fact, because I believe it can be valuable, I think we should hold it to a higher scientific standard rather than a lower one.

ADHD coaching has grown rapidly enough that asking whether it “works” is becoming too crude a question. What we now need to understand is what works, for whom, why it works, how long the changes last and whether those changes make everyday life meaningfully easier.

Those are questions worth answering.

Research reference

ADHD coaching since the COVID-19 pandemic: Is there a new wave of ADHD coaches? (2026). Frontiers in Psychiatry.

https://doi.org/10.3389/fpsyt.2026.1841020