What Is ADHD Coaching — and How Is It Different From Therapy?

If you’re a professional woman with ADHD who feels capable, intelligent, and driven—yet still struggles to start, finish, or follow through—you’re not alone.

Many of the women I work with are late-diagnosed, high-achieving, and deeply tired. They’ve often done therapy before. They’ve read the books. They’ve tried the planners and productivity systems. And still, they find themselves caught in cycles of pushing hard, burning out, and quietly wondering why things feel harder now than they used to.

At some point, a very reasonable question comes up:

Do I need ADHD therapy, ADHD coaching, or something else entirely?

This post is meant to clarify the differences—ethically and transparently—so you can make an informed decision about what kind of support best fits your needs right now.

What Is ADHD Therapy?

ADHD therapy is a form of psychotherapy provided by a licensed mental health professional. It is designed to assess, diagnose, and treat mental health conditions, including ADHD and commonly co-occurring concerns such as anxiety, depression, trauma, and burnout.

In ADHD-informed therapy, the work often includes:

• Understanding how ADHD affects attention, motivation, emotions, and relationships

• Addressing shame, self-criticism, and long-standing coping patterns

• Supporting emotional regulation and nervous system stability

• Exploring how past experiences, stress, or trauma interact with ADHD

• Helping clients integrate a late diagnosis with self-compassion

• Developing insight and practical tools in a way that supports mental health and safety

Therapy can be present-focused, future-oriented, and skills-based—but it also has the depth and clinical training to address what’s happening underneath the struggle.

This matters, because for many women with ADHD, difficulties with focus and follow-through are not just logistical. They are tied to emotional overload, chronic stress, fear of failure, and years of adapting to a world that wasn’t built for their nervous system.

What Is ADHD Coaching?

ADHD coaching is not therapy and does not involve diagnosing or treating mental health conditions.

According to the International Coaching Federation (ICF), coaching is a collaborative, goal-oriented process that assumes the client is capable and resourceful. ADHD coaching typically focuses on present-day challenges and future goals, with an emphasis on action, accountability, and strategy.

ADHD coaching may support things like:

• Clarifying goals and priorities

• Creating structures for follow-through

• Experimenting with ADHD-friendly systems

• Accountability around tasks or routines

• Identifying obstacles to execution

Coaching can be useful for some people, particularly when mental health is stable and the primary challenge is implementation rather than emotional or psychological distress.

However, coaching does not treat anxiety, depression, trauma, or nervous system dysregulation—and it is not appropriate when those concerns are significant or untreated.

Why the Distinction Matters—Especially for ADHD Women

Many late-diagnosed women are used to being “high functioning.”

They’ve held careers, raised families, met expectations, and looked fine from the outside—often at great internal cost. Over time, this can lead to:

• Chronic over-functioning and burnout

• Emotional exhaustion masked as competence

• Heightened nervous system stress

• Increased ADHD symptoms during perimenopause or other life transitions

• A sense that old strategies no longer work

In these cases, struggles with productivity are often signals, not failures.

This is where ADHD-informed therapy can be especially important.

Rather than asking, “How do I push myself to do more?” therapy often explores:

• What’s driving the resistance or shutdown

• How safety, energy, and emotional load affect capacity

• Why certain strategies stop working over time

• What regulation and support actually look like for this nervous system

For many women, addressing these layers is what makes sustainable change possible.

A Note on Nervous System–Informed ADHD Therapy

In my work as a licensed therapist, I approach ADHD through a nervous system–informed lens.

That means we pay attention not just to tasks and goals, but to:

• How stress and dysregulation impact focus and motivation

• How fear, self-doubt, or pressure quietly interfere with follow-through

• How patterns of pushing, freezing, or shutting down developed for a reason

• How regulation supports clarity, energy, and choice

This is not about “fixing” someone or forcing productivity.

It’s about creating enough internal safety and support that action becomes more accessible—and less costly.

Can Therapy and Coaching Ever Work Together?

Sometimes, yes—when roles are clear and care is appropriate.

Some people engage in therapy to address mental health and emotional regulation, and later choose coaching to support specific goals. Others may work with separate professionals simultaneously, provided boundaries are well-defined and mental health needs are being adequately addressed.

Neither approach is inherently better. The key is matching the level of support to the level of need.

When emotional distress, trauma, or burnout are present, therapy is often the safest and most supportive starting point.

How You Might Know What You Need Right Now

You might benefit from ADHD-informed therapy if you notice:

• Chronic overwhelm, anxiety, or emotional exhaustion

• Shame or harsh self-criticism tied to productivity

• Difficulty regulating emotions or stress

• Burnout, shutdown, or feeling stuck despite “knowing what to do”

• A sense that your nervous system is always on edge

You might consider coaching (with someone else) if:

• Mental health is stable

• You’re primarily looking for structure and accountability

• Emotional regulation is not the main barrier

And it’s okay if you’re not sure yet.

If You’re Still Figuring It Out

If you’re reading this and thinking, “I don’t know exactly what I need,” that’s completely understandable.

Clarity often comes from gentle exploration, not pressure.

You’re allowed to:

• Take time deciding

• Learn more before committing

• Start with education and self-support

• Change course as your needs shift

If you’re not ready for therapy, you’re still welcome to begin building understanding and compassion for how your ADHD works.

You can:

• Join my email community

• Listen to the podcast

• Watch my YouTube channel

• Download the ADHD 5-Step Task Master Plan to begin working with your ADHD in a more supportive way

There is no “wrong” starting point—only the next step that feels possible.