Psychologist and coach Alan Graham, PhD, has created a specialty coaching practice that seeks to bring order and goal attainment to some of the people who struggle with it most: clients with attention-deficit disorder. The challenges these clients face include difficulty with executive functioning, the “administrative secretary” of the brain that keeps things organized and tells you what to do next.

“Some people with ADD have lived their lives with things not working out for them, and as a consequence, feel that they’re no good,” says Graham. “Coaching helps them realize they can be something else.” Graham helped one client, a young man with ADD who had failed at one college, succeed academically and return to his institution. Chief among the strategies they developed together was a weekly schedule the client was accountable for — a kind of external “executive function.” Now, “he’s on top of everything,” says Graham.

Graham helped another client, a man in his 40s, accept the reality of his condition and make changes accordingly. Like many people with ADD, the client’s spouse had “great executive functioning,” took over that role for him, and often chastised him for his lack of organization and impulsivity.

Graham and his client worked together to distinguish which of his behaviors were caused by ADD, and which weren’t. Being chronically late, for instance, turned out not to be a function of laziness or inconsideration, but rather his difficulty keeping track of time. Conversely, balking at a chore was sometimes just laziness. In both cases, Graham worked with the man to accept responsibility for his actions and come up with ways to live more effectively.

The work can result in an unfamiliar but welcome realization for people with ADD: They are in charge of their lives.

“They learn to accept themselves in a whole new light,” says Graham.

—T. DeAngelis