Choosing an ADHD Therapist
If you’re an adult with ADHD, creating a fulsome approach to your overall wellbeing can set you up for success. Medications may be a powerful tool to help you manage day to day tasks and responsibilities, while finding the right coach can help with motivation and accountability. The right form of exercise can also play a big part in managing symptoms.
There is another facet of holistic care that can make an enormous difference: counselling and therapy.
But googling “therapists near me” can yield a confusing array of service providers that may not have the training and experience to work with adult ADHD’ers.
For neurodivergent folks with specific challenges and possible co-existing conditions, a well-intentioned but under trained therapist could create more confusion.
We spoke with two counsellors that work with ADHD clients and asked for their insights.
If you are in crisis, help is available at the BC Crisis Centre.
In Vancouver, hart caplan is co-director of Nightingale Counselling. In addition to years of academic training and research, he has lived experience of ADHD after recently being diagnosed himself. He says it’s important for people with ADHD to drop the “should” around their challenges and let go of comparisons with normative behaviors.
“This is one of the things that I see my ADHD clients struggling with pretty regularly, which is: I should be able to keep a lid on my emotions,” he explains how difficult this can be for ADHD clients.
“I should be able to, even though I know I have this thing called auditory sensitivity or auditory processing disorder, I should be able to go into a busy restaurant. When you use the should now you're in a tension with yourself, because you've taken a kind of a normative understanding of what people should be able to do, and you can't do it.”
He says the pressure of trying to conform can be depleting.
“You then have to cast around and figure out why you can't do it. But that's kind of needless work, right? The reason that you can’t do it is because, you know, your neurology exists in a certain way that makes those things really super tough for you.”
He practices existential therapy which is described in his bio as a being towards authenticity rather than a curative or prescriptive approach. For clients with ADHD, it can be a relief to experience themselves as unique rather than flawed.
“My guess is people who are neurodiverse, who don't respond to classical, psychodynamic, or CBT, or these sorts of things, because they're not ultimately psychological problems but neurological problems. They're the ways that we are in the world. And some of that stuff is amenable to therapy. And lots of it isn't.”
“What I often say to people when they first come and we talk about ADHD, I say the two least interesting things with ADHD are attention and hyperactivity. It's not to say that they're not important, but to me, they're these downstream effects. They're just behaviors, right? You look at a kid or an adult who's hyperactive right and that's the end of the line, right? Like there's a whole causal chain of things that happen”
Lisa Willow is the director of West Coast Adult ADHD. She discovered that she had ADHD when her son was assessed in 2010 and she remembers it took quite some time to process the discovery and to arrive at a place of acceptance.
As a registered social worker and counsellor, she takes a strengths-based approach and a variety of treatment modalities, including CBT (Cognitive Behavioral Therapy) Dialectical Behavioral Therapy (DBT), and Acceptance and Commitment Therapy (ACT). She has specialized training as an ADHD Certified Clinical Services Provider (ADHD-CCSP) and is an ADHD Coach. She is also a long-time mindfulness meditator and certified yoga teacher. She finds that her daily practice helps manage ADHD symptoms while bringing clarity, insight, and peace of mind.
Growing awareness of ADHD
“Adult ADHD is in the mainstream culture now,” she says. “It is becoming more recognized that ADHD is not a childhood disorder that a person outgrows. It is a life-long chronic neurological condition and often requires treatment and support. Most people with ADHD struggle their entire lives, feeling alone, without a diagnosis and treatment, and without support. I think that's the thing that's being recognized right now.”
Lisa also notes that people need support in the form of specialized ADHD therapy, coaching and to connect with other folks with ADHD. She says healing happens in community and urges people to find a therapist and join a support group. Lisa adds that people with ADHD may live with a sense of shame and feel like they don’t measure up.
There is a lot of masking that happens to try and fit into a neurotypical world. At the same time, it is possible to thrive with ADHD and for many people this means learning new skills, tools, and strategies, while also doing some deeper inner work with a therapist to tap back into and to reclaim the authentic self.
Ask questions and trust yourself
Lisa recommends a consult before committing to a counsellor. She also suggests asking about credentials. Some therapists have earned a Master’s degree that comes with years of rigorous training, while others may have more condensed training in a niche area. Both may be effective, depending on your circumstances and goals.
“There are coaches out there without university degrees and I personally recommend going with someone who has been through university level counselling training along with coaching experience and training.
But the most important thing she says is to check in with your whole self before proceeding.
“What happens in your stomach? Do you feel comfortable with this person?
And number one is: do you feel safe?”
She says working with a therapist is an intimate process requiring trust so having a sense of safety is crucial.
With so many therapy options, taking some time to ask for a consultation, trusting your gut, and reflecting on what goals you have for working with a counsellor are important. Working with a counsellor can also be expensive. Depending on where you live, there may be some coverage through your provincial health plan or you may be eligible for a tax credit to offset the cost.
Robbie McDonald was diagnosed with ADHD in mid-life and writes about mental health from her home in the beautiful Pacific Northwest.