You got the diagnosis (or you're pretty sure you have it). You've read the books. You've followed the right people on Instagram. You know about working memory, time blindness, dopamine and rejection sensitivity. And now you're sitting at your kitchen table on a Tuesday afternoon trying to figure out what to actually DO with all this information.
You Google "ADHD help Vancouver" and you get two main results: ADHD therapy and ADHD coaching. They sound similar. They are not the same thing. Picking the wrong one will waste your time, your money, and your patience — three things ADHD brains do not have a surplus of.
Let me explain the difference, because I do both, and I have very strong opinions about when each is the right tool.
THE SHORT ANSWER
ADHD therapy is for healing. ADHD coaching is for systems.
ADHD therapy treats the emotional, relational, and identity layers — the years of being told you're lazy, the shame around messy houses, the rejection sensitivity, the trauma of growing up in a body that worked differently than the system expected. It's reflective, slower, and goes deep.
ADHD coaching treats the practical layer — the calendar, the laundry, the inbox, the spiralling project, the executive function gap between what you want to do and what you actually do. It's action-oriented, structured, and externally-paced.
If you only have a hammer, every problem looks like a nail. So let's talk about what each one actually IS.
WHAT ADHD THERAPY LOOKS LIKE
In ADHD therapy, we're often working on:
- The shame story. Most adults with ADHD grew up being told some version of "you're so smart, you just don't apply yourself." That message lands in the body and lives there for decades. We unpack it.
- Rejection sensitivity. Why a passing comment from your boss puts you in a spiral for three days. Why your partner's "I'm tired" hits you like "I don't love you." We work with that.
- Anxiety, depression, and burnout. ADHD rarely shows up alone. The chronic effort of compensating for an ADHD brain in a neurotypical world is exhausting, and it often manifests as anxiety, depression, or full-on burnout.
- Identity. Especially for late-diagnosed folks (and especially women, AFAB folks, and people of colour who are systematically under-diagnosed) — figuring out who you actually are vs. who you became to survive.
- Relationships. How ADHD shows up between you and the people you love. The patterns. The repair.
ADHD therapy is a relationship between you and a therapist where, over time, things shift internally. It's not about Getting Stuff Done. It's about being a different shape of person on the inside.
You probably need ADHD therapy if: you're carrying shame, anxiety, depression, burnout, relationship issues, identity questions, or trauma related to being neurodivergent in a world that wasn't built for you.
WHAT ADHD COACHING LOOKS LIKE
ADHD coaching is more like a personal trainer for your prefrontal cortex.
In ADHD coaching, we're working on:
- Building external structure. Calendars, lists, alarms, accountability, body doubling, environmental tweaks. Hard skills.
- Time management. Not in the cute "use a planner" way — in the real way. Estimating tasks, building in buffers, understanding why "I'll do it tomorrow" keeps stretching into next week.
- Project follow-through. Helping you actually finish the thing you started, instead of starting four new things.
- Executive function scaffolding. The mechanical stuff your brain doesn't do automatically — initiation, sustained attention, transitions, task-switching.
- Habit and routine design. Not generic productivity advice. Stuff that actually works for an ADHD brain (spoiler: it usually involves more variety, more dopamine, and more flexibility than typical advice allows for).
Coaching is more frequent, more practical, and tends to be shorter-term and goal-focused. We pick a thing. We build the system. We test it. We iterate.
You probably need ADHD coaching if: your emotional life is reasonably okay but you cannot, for the love of everything, stay on top of the day-to-day logistics of being an adult.
THE OVERLAP (AND WHY IT'S CONFUSING)
Here's where it gets messy: a lot of the things that look like "ADHD problems" are actually emotional things wearing executive function masks.
Examples:
- You can't start your taxes. Is it executive function (initiation difficulty)? Or is it emotional (you have shame about money and the avoidance is a trauma response)?
- You forget your partner's birthday. Is it working memory? Or is it that you're avoiding the relationship because it's making you anxious?
- You can't stick to a morning routine. Is it habit-formation? Or is it a depressive episode disguising itself as ADHD?
This is why some people need therapy AND coaching. The therapy goes after the root. The coaching builds the scaffolding while the root is being addressed. Together, they get you somewhere neither one could get you alone.
HOW WE DECIDE TOGETHER
In a free consult, I usually ask three questions:
- What's the thing that brought you here today? (This tells me if it's a system problem or a story problem.)
- How emotionally regulated do you feel most days? (Low regulation = often therapy first.)
- Have you tried building structure before, and what happened? (If your previous attempts collapsed under the weight of shame or burnout, we probably need therapy alongside.)
Sometimes I'll start someone with coaching. Sometimes therapy. Sometimes I refer them out — because if what you actually need is medication, my best advice is to talk to a doctor or psychiatrist (and yes, I can help you find a good one).
A GENTLE BS-CALLOUT
If anyone tells you "all you need is mindset" or "ADHD coaching can replace therapy" — they're either selling something or they don't understand the difference. Coaching is a real, useful, distinct discipline. So is therapy. Neither is better. They do different things.
The right answer for you depends on what you're carrying. And we can figure that out together.
WORKING WITH CINNAMON COUNSELLING
I offer ADHD therapy and ADHD coaching for adults across Vancouver, Burnaby, Richmond, and North Van — in person and online. I'm a Registered Clinical Counsellor (RCC) trained in Emotionally Focused Therapy (EFT) and the Gottman Method, with specific experience in adult ADHD and AuDHD presentations.
