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Do I Need Parent Training or Coaching?



Training versus coaching for ADHD—what’s the difference, and how do they help?

Behavioral Parent Training
Behavioral parent training programs follow a therapeutic model supported by many years of research; they are conducted by credentialed behavioral therapists. In these programs, parents learn more about ADHD and how it affects their child, actively learn new parenting skills and techniques that uniquely address their child’s ADHD symptoms and challenges, and learn how to guide and manage their child’s behaviors. In such training, parents may work individually or in small groups with the therapist to learn these new skills. 

Parent Coaching
In contrast, parent coaching originated in the coaching field. Although to date there has not been science-based research that provides substantive levels of evidence regarding outcomes, it has proved to be an invaluable goal-focused tool that has helped countless parents succeed in helping their child with ADHD. Coaching typically assumes the client already has knowledge about ADHD and the basic skills to accomplish a goal, but needs support to reach those goals. Coaching has developed as a complementary approach to help parents of children with ADHD implement and stick with the goals and techniques learned in behavioral parent training. It also serves to support the parent when new situations arise that threaten to challenge the goals and skills they’ve established in training. Among the goals coaching often targets techniques involving planning, time management, goal setting, and organizing. 
Parent Training
(Also known as Behavior Management Training for Parents or Parent Behavior Therapy)
Parent ADHD Coaching
  • Evidence-based
  • Coaching model-based
  • Recommended as treatment
  • Complementary Approach
  • Science-based education on ADHD and how it affects their child
  • Basic knowledge on ADHD is assumed
  • Training over a course of weeks based on a set curriculum
  • Coaching has an indefinite timeframe, based on the client’s desire to continue working with the coach
  • Learn new skills and strategies to help the child improve behavior
  • Goal-center approach to parenting that can include practicing new skills
  • Work individually or in a small group with a behavioral therapist
  • Work individually with a coach
  • Parents learn by watching live or recorded parenting situations and discussing with the therapist the parenting skill modeled
  • Define parenting goals and help parents to develop a strategy to reach those goals
  • Homework, either in a workbook or in a parenting assignment, is done between sessions with the behavioral therapist
  • Provide accountability and feedback for clients based on how successful the client was in working towards a goal
  • Learn skills to improve communication with the child and in the family
  • May roleplay with the client a parenting situation to help the client decide how to handle the situation
  • Learn how to create structure and provide consistent discipline
  • Gives suggestions on how to adjust a plan or an approach if the original one was unsuccessful
  • How to reinforce desired behaviors and decrease unwanted behaviors
 
When to seek Parent Training for ADHD

Behavioral parent training is appropriate in two stages of their child’s development. First as a stand-alone technique when their child is too young to begin medication treatment, and/or as an enhancement to the effectiveness of medication treatment when the child is old enough to begin taking ADHD medication. Parents should consider behavioral parent training when:
  • Their child is newly diagnosed with ADHD
  • Their child is between 3 and 6 years old
  • They want to begin behavioral management approaches before adding medication management
  • Their child is struggling with negative behaviors
  • They want to enhance the success of their older child who is taking medication

The goal of parent training is to help parents know how and when to intervene in their children’s behaviors, to support productive behaviors, and to decrease or eliminate maladaptive behaviors.

Parents should expect to participate in a training program for eight or more weeks, depending on the program. Classes may be weekly and will include meeting with the behavior therapist or parent trainer, discussion on the new skill or information, and watching as the new skills are modeled, with some practice in the clinical setting. Between classes, parents will complete homework based on the lesson completed. The therapist will review the family’s progress and provide support to the parents and may adjust strategies as needed to ensure improvement.

For very young children
For children aged 3-6, the American Academy of Pediatrics Clinical Practice Guideline for preschool children affected by ADHD recommends behavioral therapy and parent training as the first approach to treatment, before medication.

“There is clear evidence based on a plethora of controlled studies that behavioral parent training should be the first choice for treating ADHD in young children,” says George DuPaul, PhD, a former CHADD Professional Advisory Board member and professor of school psychology at Lehigh University, commenting on recent reports regarding parent training. “When behavioral parent training is implemented consistently, it can lead to greater parent understanding of behavioral principles, increased use of positive parenting strategies, enhanced parent-child relationships, improvement in child behavior, and possibly delayed initiation of pharmacotherapy.”

Parents who have children newly diagnosed with ADHD, especially if their children are in their preschool years, should discuss parent training with their child’s healthcare provider. Examples of evidence-based parent training programs that have been shown to be effective are:

What to look for in Behavioral Parent Training Programs
  • A behavior therapist who focuses on training the parents
  • A program that teaches positive ways to interact and communicate with their children
  • Homework for parents to practice with their children
  • Can re-evaluate and adjust strategies as needed

As a medical treatment, parent training is usually covered by health insurance. Parents may need to seek out a parent training program offered by a behavioral therapist or in a university or hospital clinic setting.

ADHD Coaching for Parents

Coaches work with parents of children affected by ADHD in a supportive role. Coaches support clients by providing encouragement, feedback, and practical suggestions to address specific challenges, as well as supporting them and holding them accountable for following through on their goals. Coaching is not a treatment for ADHD. It is similar to solution-focused intervention approaches and provides tools and techniques for parents to help their child to improve life skills; coaching also helps parents consistently and adaptively attain goals they defined during their Behavioral Parent Training. 

Parents might consider ADHD coaching when:
  • life circumstances have changed
  • they are looking for personal support that is not therapy
  • their child has been diagnosed for some time and may be going through puberty or facing new social pressures or challenges in his/her life
  • as adults who have ADHD, the parent is also coping with ADHD symptoms
  • they have completed a parent training program and are looking for ongoing support to continue skills they have learned

The goal of ADHD parent coaching is lifestyle management as the client copes with the effect of ADHD symptoms on the family, helping family life be more fulfilling. The coach serves as an ally, providing encouragement and support when the parent must face and manage difficult situations.

Elaine Taylor-Klaus, CPCC, PCC, is a coach and a co-founder of ImpactADHD, in addition to being a member of the CHADD Board of Directors. Ms. Taylor-Klaus coaches both adults and parents; she often works with parents to help them implement the parent training they’ve received.

“It’s a great vehicle for supporting parents as they put into practice what they understand about ADHD,” Ms. Taylor-Klaus says. She refers to coaching as a “change management system” that helps raise awareness and understanding in a situation to help the individual or the family move forward in a more positive way. 

“Systems” for managing behaviors

Coaches also help their clients create systems to help manage the day-to-day challenges in their lives caused by ADHD. Once the systems are set up, coaches help clients decide if those systems are working for them and how they can be adjusted to work better. Because people with ADHD tend to crave novelty, very often clients find themselves growing bored with a system and can benefit from a coach’s help in rethinking how to make it interesting. 

“The systems are a means to an end,” Ms. Taylor-Klaus says. “It’s based on looking at what works, at the successes. If we can understand what works in one place we can apply it to others.”

Coaching is often not covered by health insurance plans. However, there are other ways to take advantage of coaching techniques. 

“There’s a lot out there that is inexpensive,” Ms. Taylor-Klaus says. Most coaches provide a lot of free information and resources, available on the Internet. Take advantage of those free resources, she says, to get a sense of a coach’s approach and style to “find the coach you resonate with. I encourage people to find one or two coaches and ‘follow’ them.”

Websites, blogs, and newsletters by your favorite coach may contain tips and ideas you can implement on your own, she says. Many coaches have written books, which you can borrow from your local library, that focus on a specific area of your life, including parenting skills. Ms. Taylor-Klaus says not to be shy in asking for what you need; sometimes explaining your interest in working with the coach can lead to a scholarship or grant program to help pay for coaching.

What to look for in an ADHD coach:
  • Formal training in coaching. This includes certification or credentialing from a national coaching organization.
  • Is the coach also a licensed mental health provider who has expertise in associated mental health issues, such as anxiety and depression? Some people prefer to work with a mental health specialist who incorporates coaching techniques as part of her practice.
  • Specialist training on coaching for people affected by ADHD.
  • Prior experience coaching parents and willing to put you in contact with prior former clients to discuss their experience with that coach.

Have you attended parent training for ADHD? Have you worked with an ADHD coach? Share your experiences with our community.


This article appeared in ADHD Weekly on February 16, 2017.
     


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