Once a niche offering, attention-deficit/hyperactivity disorder (ADHD) coaching has surged in popularity over the past 5 years, emerging as a common add-on to more traditional care for the condition.

Around 15.5 million adults and 7 million children and teenagers in the US have been diagnosed with ADHD, according to the CDC. In 2024, nearly 1 in 5 adults and 1 in 7 children with ADHD received coaching to help them manage the disorder, according to a report by the magazine ADDitude. (ADDitude is published by WebMD, a sister company of Medscape.)

ADHD coaching typically focuses on practical, goal-oriented support, such as improving organization, managing time, or remembering to take prescribed medication. Although the industry operates with little formal oversight, psychologists who work with patients with ADHD told Medscape Medical News that well-trained coaches can provide targeted help for challenges that may fall outside the scope of standard treatments like cognitive behavioral therapy.

Tamara Rosier, PhD, an ADHD coach and founder of the ADHD Center of West Michigan in Grand Rapids, Michigan, said primary care clinicians whose patients inquire about coaching should be mindful of the field’s limited regulation and help patients carefully evaluate a coach’s qualifications.

“We keep making moves forward, and I think in the next few years you will see more of a commitment to certification in this field,” said Rosier, a co-author of a recent study of nearly 500 ADHD coaches working in the US, published in JAMA Network Open.

Not New, Not Regulated

The ADHD coaching practice started in K-12 schools in the 1990s, and many of the first ADHD coaches were former teachers, said Maggie Sibley, PhD, a psychologist and professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle. But the number of people offering these services has grown exponentially in recent years, she added.

“There has been a change in this field, a rapid expansion of it because of the online opportunities and a low barrier to entry,” Sibley said.

In the recent study of ADHD coaches in JAMA Network Open, many — nearly two thirds — reported beginning practicing during or after the COVID pandemic. Most were not employed by an institution or health system, nor did they have a physical office to see patients; more than 90% were self employed, and 86% worked from home.

No formal licensure exists for ADHD coaches and the profession lacks a governing body, as exists for those licensed to practice psychiatry or behavioral health. Several professional organizations do offer certification, including the Professional Association for ADHD Coaches and the ADHD Coaches Organization (ACO), both of which typically require about 60 hours of training in life coaching plus at least 35 class hours on subjects like the basic neurobiology of ADHD and how the condition can make executive function challenging.

But the certifying organizations do not provide training themselves. The International Coach Federation provides accreditation for life coaching training, including for specialized ADHD coaches.

However, “those do not require any type of training in psychology, and there are no licensure requirements or governing bodies such as state agencies,” said Sam Margherio, PhD, an assistant professor of psychology at Virginia Tech in Blacksburg, Virginia.

Still, Margherio said ADHD coaching could be helpful for people struggling with specific skills, such as time management and organization. But she said professional groups need to develop standards for certification.

Who Benefits?

In the JAMA survey, ADHD coaches reported predominantly offering virtual weekly sessions that cost about the same as a weekly session with a psychotherapist, with a median cost of $150. Nearly two thirds reported receiving referrals from health providers.

Cathrin Danielle Green, PhD, LCP, a pediatric psychologist and researcher at the Center for ADHD at Cincinnati Children’s Hospital, Cincinnati, said primary care clinicians can help patients by talking through whether seeing a coach might be helpful.

“If a family is bringing up an ADHD coach, the first thing we can do is validate that desire for more support,” Green said. “And then we have a duty to clarify what coaching can and cannot do. Make it clear that coaching is a supplement.”

Patients with co-occurring mental health conditions, such as depression or anxiety, should be referred to a mental health professional.

“Coaching is not clinical intervention, coaching is support,” Green said. Coaching can be an asset for people, “who are stable and engaged in treatment but just want to work on some practical skills.”

The JAMA survey showed nearly three quarters of coaches had been diagnosed with or suspected they had ADHD, and that their experiences living with ADHD informed the services offered. More than 44% had received ADHD coaching themselves.

Sibley said ADHD coaches might evolve to be similar to now-established peer support specialists who help patients with substance abuse and addiction, which “started as a grassroots movement that became formalized.”

Sibley said a shortage of clinicians trained in teaching skills to people with ADHD.

”If we have folks who really want to help, and people who really need help, we have an opportunity to professionalize it,” she said.

Vetting a Quality Coach

If a primary care clinician determines a patient could be a good fit for ADHD coaching, the next step is helping vet a coach. Look for “red flags such as promising quick fixes or major solutions and vetting for people who have backgrounds in mental health care, education, occupational therapy or social work,” Margherio said.

Rosier recommends clinicians direct their patients to select coaches from the ACO ADHD coach directory, which only includes coaches with training. She said the most important question to ask an ADHD coach is: What ADHD coach training and continuing education do you receive?

“If someone can answer that, your patient will know right away if they are a good coach,” Rosier said.

Patients can also ask how long the person has been an ADHD coach, how their progress will be monitored, and what types of issues they specialize in.

“It’s never really detrimental to have a coach, but for some individuals a coach is not enough,” Green said. “It’s perfectly fine for people to seek this option knowing that it is not the end all be all for ADHD treatment.”

Kaitlin Sullivan is a journalist living in Colorado.