Thriving as a Therapist with ADHD
By Kristen Dammer
Do you have ADHD and are a provisionally licensed counselor or social worker? Or maybe you are a therapist newly diagnosed with ADHD? If so, do you ever wonder how ADHD might be affecting your clients sessions or if it even matters? As a therapist living with ADHD who also supervises clinicians with ADHD, I love learning all I can about ADHD to help others and myself feel less self-critical and more functional.
In my research, I noticed that there is very little information on how being a therapist with ADHD can impact your one-on-one counseling sessions. This blog attempts to explore two possible areas of executive functioning challenges that I have noticed come up for me in my own clinical work with clients, as well as supervision sessions with my supervisees.
Basic Executive Functioning Tasks for Therapists in the Workplace
First, I want to discuss the basic, or “no brainers”, executive functioning challenges that arise in the workplace. We can assume that these workplace tasks that occur outside of your clinical sessions are difficult and well-known to people living with ADHD:
- Scheduling clinical sessions
- Completing paperwork on time
- Starting and ending sessions on time
- Tracking hours for supervision
- Paying attention in meetings
- Learning new interventions
- Remembering what is important to talk about in supervision
- Completing “extra” tasks such as marketing videos, updating bios, etc.
- Responding to emails in a timely and appropriate manner
- Returning phone calls
- Needing time and space to transition between clients
- Not scheduling too many clients in a row
- Procrastinating on a project that is due tomorrow
- Being afraid to ask for help because you “should” already know
Everyone most likely struggles with these workplace functions, but to those with ADHD, even more so. I’m calling these executive functioning tasks “no brainers” because “DUH!” (and yes I grew up in the 80s); the list above are the tasks of executive functioning that are often discussed and understood by employers.
Interventions to Use as an ADHD Therapist
Beyond the “no brainers” listed above are the subtle, and sometimes not so subtle, aspects of ADHD that are more difficult to talk about. They are difficult to talk about because they are not as understood and possibly hold more shame for therapists with ADHD.
Working Memory: “Working memory is a limited capacity store for retaining information for a brief period while performing mental operations on that information” (Simply Psychology). Basically, the brain holds short-term member information on deck to return to later. Working memory can be challenging for a therapist with ADHD, especially when working with a client who has ADHD, who processes outwardly.
An example of this is working with a client who talks for long periods during the session, which is a “normal” experience in therapy. Clients could be outward, or external, processors or circumstantial thought processors. This means that they answer and explain their experiences with details that aren’t always the “meaty” pieces. This leads to the therapist gaining understanding of how the client conceptualizes their place in the world.
Sometimes a therapist with ADHD might find it difficult to hold all the “golden nuggets” or important parts in their mind to “pin” as a place to return to, where we can ask questions to expand the therapist’s understanding of client challenges, or go back to and explore further because that is the working memory piece.
It is difficult to hold that spot in your mind when you are also listening to more important details that are moving fast in the conversation. Oftentimes, I see this showing up where a client shares 15 minutes of very important information entwined with unimportant details and then stops and looks at me, waiting for me to respond. I can imagine that at times I have a blank look as my brain is uploading all the information the client shared while trying to address the places in the conversation to explore in order for the client to process and gain insights.
As a therapist with ADHD, I find it much easier to be able to “interject” or for clients to pause and wait for my responses, as my working memory is not as taxed. If this happens, I’m not trying to hold on to important aspects because I can add them throughout the conversation vs holding them to the end. Sometimes I might not hear all the details because I’m trying to write down the pieces to return to or I become overwhelmed and go blank.
Now, I’ve learned how to interject appropriately. I sometimes disrupt using my curiosity or excitement stating, “oh this sounds really important can we stop here and explore.” As a beginner therapist, I would sometimes interrupt and then I would get understandably frustrated looks from the client because I am cutting them off and most likely disrupting their own working memory.
What Works For You?
As I learn more about ADHD, I understand that talking about working memory, outward processing, and circumstantial thinking in sessions with my clients is helpful. The educational piece can help clients understand the conversational dynamics, and ease any tension. Hopefully, adding grace with ourselves as neurodiverse humans who do not need to be perfect.
Sometimes I might ask, “how would you like me to add important insights or ask exploratory questions so as to not disrupt your thought process?” Whatever solutions you find, have grace with yourself, because some days are better than others and that’s okay. I find this incredibly helpful to understand the dynamics showing up in sessions with clients who have ADHD.
Another situation that can present itself in therapy sessions is oversharing, especially when you are unprepared for the question or the situation. I can teach myself to build pauses before I speak over and over, but I must understand that sometimes my brain is not going to catch up to my mouth.
Recently and unexpectedly a client asked me a question that can come up in sessions, “Can you tell me something about yourself as a person?” I was caught off guard because I hadn’t shared about myself for a while, so I “naturally” just began at the beginning. I started with where I grew up and when I moved to Colorado and before I slowed down my mouth, I was into my midlife. The more I learn about ADHD, the more grace and humor I can have as I make my daily way in the world.
Putting It All Together
Building in pauses, remembering to breathe, and feeling my body are all helpful coping skills with living with ADHD as a therapist. Understanding is not about perfection. Understanding is an explanation. Understanding the conceptual framework of good strategies based in theory to help ADHD is so helpful. The goal is for more consistency with the parts I can change and acceptance in the parts I can’t. (Ari Tuckman, Psyd). I love being a therapist. I can accept ADHD. Understanding how ADHD can impact sessions allows me to stay connected to my passion.
How we can help
If you are a therapist who has ADHD and are seeking clinical supervision or consultation, reach out today to see if our skilled clinical supervisors can support you in your journey!
Author Bio
Kristen Dammer is a clinical supervisor, therapist, and blogger with Firelight Supervision and Catalyss Counseling. Kristen specializes in trauma, ADHD, and perinatal counseling with adults and is trained in EMDR. Kristen enjoys providing clinical supervision and consultation to beginning to advanced clinicians in private practice, hospital, and agency settings.
Great article! I found the topic engaging, but I’d love to see more detailed examples or case studies in future posts. Overall, it’s a solid read!https://finestpedia.com/