ADHD Coaching or therapy: how to decide what you need

If you’re considering what support you need after an ADHD diagnosis, you might be unsure about whether to try therapy or coaching. Or maybe you’ve tried therapy in the past and are wondering how ADHD coaching is different and if it really helps.

Online comparisons often flatten the difference. Therapy is described as dealing with ‘the past’. Coaching is framed as ‘the future’. Therapists are reduced to a one note approach. Coaches are presented as purely action focused.

The reality is more nuanced.

It’s not about the ‘best’ option but about understanding what each offers and deciding what might be most useful for you right now.

Where therapy and ADHD Coaching overlap

Both therapy and coaching can help you:

• understand patterns in your thinking and behaviour

• improve emotional regulation

• increase self-awareness

• shift self-beliefs

• improve day-to-day functioning.

Therapy involves many approaches and techniques. Those which are most useful for ADHD include CBT (Cognitive Behavioural Therapy), ACT (Acceptance and Commitment Therapy), DBT (Dialectical Behaviour Therapy) and IFS (Internal Family Systems).

ADHD Coaching grew out of the CBT approach and ACT lends itself well to a coaching context with a focus on valued action.

DBT is a therapy designed to help with emotional regulation by teaching a range of skills that are helpful across the balance of change and acceptance needed for healthy emotional regulation.

Find out more about how learning DBT skills can help adults with ADHD develop a practical 'manual' for emotional regulation - with or without therapy or coaching.

IFS is a treatment for healing trauma which fits clearly within therapy but an understanding of parts is starting to be integrated in coaching.

So the difference isn’t whether insight happens. This is part of both. The difference lies in what the work is oriented toward.

The main difference: now what?

Therapy is often geared towards uncovering the insights. It can be the end point.

In coaching, insight is not enough.

Coaching is built around translating awareness into change. It asks not only what is underneath the behaviour or pattern, but what this awareness will be used to do differently and creating experiments to put this into practice.

ADHD Coaching focuses on:

• translating emotional insight into practical growth

• designing systems that work with your nervous system

• breaking big goals into experiment-sized actions

• creating sustainable change in real life.

Past vs present is an oversimplification

It’s common to hear therapy works with the past and coaching works with the present.

This is based in truth but too simple.

Many therapy models are present-focused. And coaching may briefly explore earlier experiences when they help clarify current patterns.

It’s primarily about purpose rather than time:

• therapy works to process and integrate

• coaching works to apply and implement.

The past is not ‘off limits’ in ADHD Coaching if understanding it is used to shape current behaviour. The emphasis simply remains on the future.

ADHD and trauma

Trauma is common among adults with ADHD. Sometimes this relates to significant life events or childhood trauma. But it can also be cumulative. For many adults, it has been less a single catastrophic event and more what feels like a thousand paper cuts over time: years of criticism, misunderstanding, repeated struggle, and internalised shame from not knowing why things felt so hard.

Because of this, ADHD Coaching needs to be trauma-informed.

However, healing from trauma belongs clearly in therapy.

Coaching can help identify when past experiences are shaping current functioning. It can create stability and structure. But if it becomes clear in the coaching process that deeper trauma work is needed, referring clients to therapy is ethical and appropriate.

The aim is not to pathologise everything. It is to recognise when healing work is required, and when forward-focused support is sufficient.

Where do you start?

You might start with therapy if:	You might prefer ADHD Coaching if:
trauma is interfering with daily life	you understand your patterns but struggle to translate insight into action
depression or anxiety are preventing progress	life feels chaotic and your systems aren’t working
you’re in active addiction	you want practical scaffolding designed for ADHD
emotional regulation feels unsafe or overwhelming.	you’re ready to experiment and take goal-directed action.

Some people move between therapy and coaching at different stages. Some work with both simultaneously, with clear communication between professionals. There is no one right order.

If cost is a significant factor, you may want to weigh up the benefits of a Mental Health Care Plan for psychologists and funding options through JobAccess for ADHD Coaching.

When to seek support

After diagnosis, the first decision isn’t always ‘therapy or coaching’. Sometimes the question is whether to begin structured support at all.

Professional support becomes more important when:

• mental health symptoms feel destabilising

• emotional intensity is interfering with daily functioning

• you feel stuck in patterns you cannot interrupt alone

• you are struggling to translate intentions into action.

In these cases, structured support can create stability and forward movement.

Letting it sink in first

For many adults, diagnosis brings a period of reflection before action.

Processing your diagnosis might look like:

• understanding more about ADHD

• reading and reflecting

• journaling about the feelings your diagnosis has brought up

• reinterpreting past experiences now you know

• allowing relief and grief to settle.

Particularly after late diagnosis, there may be years of self-blame to unpick. That process doesn’t happen instantly. Many people begin this process themselves before being ready to discuss it in coaching or therapy.

Professional support makes sense when you’re ready to move from understanding into structured change or when emotional intensity makes support necessary.

There is no rule about how quickly that transition needs to happen and sometimes it is better to resist the ADHD urge to treat it urgently and ‘fix’ everything right away.

If you’re still unsure

The question isn’t ‘which is better’.

It’s ‘what would help most right now’.

If therapy feels stalled because insight isn’t translating into action, ADHD Coaching may be the missing piece.

If coaching feels overwhelming because emotional intensity is too high, therapy may need to come first.

Both have a role.The order depends on you.