Elias D Graham, Melissa R Dvorsky, Carlos E Yeguez, Jillian K Holbrook, Margaret H Sibley
The COVID-19 pandemic saw an increased demand for ADHD psychosocial treatment, which exceeded capacity of traditional healthcare providers. Online ADHD coaching may have become a source of support for individuals seeking support during this period. This study investigates trends in ADHD coaching between coaches who began pre- versus post-COVID-19 pandemic. We conducted secondary analyses (N = 465) of the U.S. National Survey on ADHD Coaching, which used a purposive electronic survey and snowball sampling to select self-identified ADHD coaches with at least one client in the U.S. in the past year. We compared pre-pandemic (n = 182) and post-pandemic (n = 283) coaches across survey items. Post-pandemic coaches were younger (t = 9.48, p < .001), more likely to self-identify as having ADHD (χ2 = 9.01; p = .003), and more professionally isolated, with lower rates of referring clients to CBT providers (χ2 = 8.63; p = .003) or medication prescribers (χ2 = 27.60, p < .001), and lower rates of healthcare licensure (χ2 = 5.90; p = .015) or professional liability insurance (χ2 = 11.1; p < .001). Post-pandemic coaches were less likely to discuss clinical topics, including medication adherence (χ2 = 18.06; p < .001), substance use or addictions (χ2 = 15.86; p < .001), and suicide, abuse, or harm to self/others (χ2 = 16.11; p < .001). Following the COVID-19 pandemic, pre-pandemic coaches were more likely to see clients virtually (53.85%), have a larger caseload (28.57%), and practice outside of their local region (30.22%). Differences between pre- and post-pandemic ADHD coaches may indicate where the field is headed and should be considered when researching ADHD coaching, designing training standards, and evaluating need for regulatory structures, clinical oversights, and clarified professional boundaries between ADHD coaching and psychotherapy.