This is the question I get asked most on discovery calls, usually with a slightly apologetic tone, as if it should be obvious. It is not obvious. The two fields overlap, plenty of people need both, and the right answer depends on what you are actually trying to change. So here is the honest version of how I explain ADHD coaching vs therapy when someone asks me directly.
What therapy does well
A psychologist works with your mental health. Diagnosis, trauma, clinical anxiety and depression, and the processing of things that have happened to you. Therapy looks back. If you are in genuine distress, if the past has its hands around the present, or if you suspect you have a condition that has never been assessed, therapy is the right first stop. If you are at the stage of only just suspecting you have ADHD, a free self-assessment covering current symptoms and childhood history will give you something concrete to hand the clinician at that first appointment. In Australia a GP can set you up with a mental health treatment plan, and psychiatrists handle ADHD assessment and medication. None of that is coaching territory, and any coach who suggests otherwise should worry you.
What ADHD coaching does well
ADHD coaching points the other way. It is forward-looking, practical and collaborative. We are less interested in why you became who you are and more interested in how you want to live and work now, and what keeps getting in the road. The material is day to day and concrete: the report you have opened eleven times without starting, the business idea stuck at ninety percent, the temper that flares in meetings, the sense of running flat out and going nowhere.
With an ADHD coach you work on executive function in the real world. Planning, starting, finishing, prioritising, remembering. You build systems shaped for your actual brain rather than the brain productivity books assume you have. In my practice we also work at the body level, because emotional regulation lives in the nervous system rather than in good intentions, and no calendar app fixes a nervous system.
There are moments where this looks a lot like therapy. We do go deep at times, into the emotions sitting under the stuck patterns and the beliefs you formed about yourself somewhere along the way. The difference is the orientation. We go there to move forward, not to dig for its own sake, and we go there from a particular starting assumption: that you are already whole rather than broken, and that the answers are in you rather than in me. My job is to help you reach them, not to hand them down.
ADHD coaching vs therapy in one sentence
Therapy helps you heal and understand. Coaching helps you build and act. That is a simplification, and the borders are softer than any one sentence allows, but as a compass it points the right way.
Plenty of people need both
Some of my clients see a psychologist and see me in the same season of life, working different problems in parallel. The therapy handles the anxiety that rides along with decades of undiagnosed ADHD. The coaching handles the week to week reality of running a team or a business or a household with that brain. The combination is often stronger than either alone, and a decent coach and a decent therapist will happily coexist.
What to expect in ADHD coaching sessions
- A structured conversation with an agenda you set. You bring the real situations. We work them.
- Systems designed around your brain, tested between sessions, and adjusted when reality disagrees with the plan. Reality usually gets a vote.
- Somatic work when the problem lives below the neck. Racing before a hard conversation, shutdown after criticism, the afternoon crash.
- Accountability that feels like backing, never like a disappointed parent. You have had enough of those conversations for one lifetime.
- Direct feedback. You are paying me to be useful, and useful sometimes means saying the thing nobody else will.
How to choose
If you are in crisis, in deep distress, or working through trauma, start with therapy and come back to coaching later. If you are functional but frustrated, if you know what you should be doing and cannot make yourself do it, if you have read the books and bought the planners and nothing sticks, that is coaching work. And if you are unsure, ask. I tell people on discovery calls when I think a psychologist is the better fit. It costs me a client occasionally and it is still the only way I want to run this practice.
I offer ADHD coaching online across Australia and around the world, and I am based in Perth. If you want to figure out whether coaching is your next step, book a free discovery call and we will work it out together, or read more about how I work with professionals.
