NEW ENGLAND CENTER FOR PSYCHIATRIC TREATMENT AND EDUCATION

SIMON EPSTEIN, M.D.
91 STRAWBERRY HILL AVE. #140
STAMFORD, CT 06902
203-348-8579

Monthly NewsNotes

Monthly NewsNote

March 2006

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When to Use a Coach

Recently a mother was discussing her ADD son. "He's a teenager now" she said. "Soon he'll be in college. I won't be able to sit with him while he does his homework. Who will help him organize his life?" I suggested a coach for her son. Coaching can help both children and adults and is an important subject. Therefore, I’m going to share some of my thoughts in this edition of the Monthly NewsNote. I should note that I believe medication is an important part of the process, but I will not go into this further at this time.

Let me first discuss children and then move to adults. A coach is not a tutor. He or she is not primarily involved in teaching a subject. The role of the coach is to help the student learn to deal with aspects of
ADD, primarily those relating to organizational skills. These include but are not limited to failing to get the homework assignment, forgetting the necessary books, losing homework, and procrastination. Of course, the techniques used by a coach vary with the needs of the child, but the goals are improved functioning.

Take Richard as an example. Richard, an 11 year old, always had difficulty getting things done, but he got by. But in 6th grade his organizational skills could not meet his needs and his grades fell sharply. He was highly distractible, failed to get the assignments, left books at school and lost his papers. His time management was also very poor.

Enter Tom the coach. Tom was able to establish a good relationship with Richard. He also made contact with the teachers to find out how he was doing and where they felt help was needed. From that point he was able to help Richard understand his problem and develop skills to improve schoolwork.

Charles, an 8th grader, added another layer of problems. He was having the same type of difficulty but had started to lie to cover his failures. He would say, “There was no homework” or “I did it at school” or "I don’t need you to check my homework.” This attitude was beginning to have serious negative effects on his learning. A coach was helpful in defining the problem areas and teaching helpful techniques.

How often should a coach come? This is an individual decision, but I think twice a week is good for a start. When there is some improvement, weekly visits are probably enough. A coach may be needed for a few months, or longer if the difficulties are not under good control.

A major problem can be the cost of the coach. While it is a worthwhile expense, it is not covered by insurance, and the cost is out of range of many parents. If this is so, look to other resources. These could include a school resource program, a cooperative teacher who might spend a little extra time, or an adult friend who understands the problem.

Moving to adults, I can certainly say that adults often need and are helped by coaches. I remember Ed who came in with pictures of his desk. Of course, I only knew there was a desk in the picture because he told me. Though a professional man, he had no organizational skills. He functioned with the help of his support staff, but when they left he was in significant trouble. I was able to help him with medication, but organization, procrastination, and time management were major problems. While I made suggestions, they were of little help.

So I turned to a coach who works with me and does short term work. His coaching style is to visit the workplace (or home) once or twice to get a feeling for the problem and the patient. He then writes a plan of
action for the patient to work with to deal with the identified problems. Several follow-up sessions follow, after which the patient should have a plan, an approach, and someone to call if the problems are not under control.

With Ed, the coaching helped bring the major problems under good control. This included training the staff, introducing new software and working out a time schedule. It was a good result.

This time-limited technique has worked for home visits for ADD patients having great trouble keeping the house organized, piles under control, and time used effectively. Coming to the house and seeing the problem, and then expecting the adult to learn to deal
with the disorganization gives the adult a responsibility and uses his or her motivation to help with learning and ongoing performance.

There are many coaching styles, and some even do it by phone. But someone who steps in, teaches organization, supports the person with ADD and improves day-to-day living is a valuable resource. Coaches can be a great help.

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