The Double-Edged Sword: How ADHD Influences Counselling Service Delivery

Abstract: Attention deficit-hyperactivity disorder (ADHD) is a neurodevelopmental condition that impacts individuals across the lifespan, regardless of gender, race, socioeconomic status and culture. Many challenges can be perceived in the workplace setting for individuals with ADHD, challenges that influence a person’s ability to perform in certain instances if not provided with the right support and environment. That said, ADHD individuals also present a unique set of strengths that can significantly influence the delivery of any service in the workspace. For many decades, individuals with ADHD have been told that they are not capable of pursuing certain careers due to their difficulties in organising and following through on various tasks, their impulsivity, challenges with self-regulation and self-awareness. Being a therapist means being able to hold space for someone else’s thoughts, feelings and experiences, to remain present and focused for almost an hour, multiple times a day, listening and attending to another person.
While there has been greater interest in supporting clients with ADHD in the counselling room and providing guidance for neurotypical counsellors working across neurotypes, little attention has been paid to the neurodivergent counsellor and the manner ADHD impacts the therapeutic alliance. This article aims to shed light on the lived experience of counsellors with ADHD as they navigate professional practice through an existential/ interpretive phenomenological lens.
Data was collected using semi-structured interviews, conducted online from December 2023 till May 2024. Purposive sampling was used to recruit counsellors with a diagnosis of ADHD (n=12) working across different settings throughout Australia. Data analysis yielded two major themes: challenges and strengths of counsellors with ADHD for effective service delivery. Challenges related to the inherent characteristics of ADHD symptomology, psychological difficulties, masking, limited self-care practices, pharmacotherapy and non-inclusive workspaces. These limitations, however, were offset by attributes that facilitated counselling practice, such as enhanced rapport building, resilience, attracting neurodiverse clients, a counsellor finding their own tribe and celebrating qualities unique to a counsellor with ADHD.