TCPR: How did you get into ADHD coaching?
Dr. Giordano: It’s been my primary focus since 2020. Before that, I had been a college professor. As much as I enjoy classroom work, I found that advising students in one-on-one interactions was more transformative, so I transitioned to holistic educational consulting and coaching.

TCPR: A lot of people with ADHD want coaching. How can we help them find a reliable coach?
Dr. Giordano: A good place to start is to consult a psychologist who treats ADHD. They often collaborate with or refer clients to ADHD coaches. There is also a large network of coaches, but it’s a good idea to get a word-of-mouth referral from someone who has worked with a particular coach.

TCPR: What conditions are most appropriate for coaching? 
Dr. Giordano: I often work with people with education or career difficulties. Coaching is about where you want to go rather than where you’ve been. So, while I work with clients on effective strategies for handling ADHD, I also help them reframe their thinking about ADHD: from that of an affliction to that of a powerful way of being in the world. Rather than a “deficit of attention,” it is often an abundance of attention and creative possibility that comes with a mind on overdrive.

TCPR: How do you apply coaching with ADHD? 
Dr. Giordano: The first part is attitudinal. It’s about helping a client recognize that there are gifts, such as innovative thinking and adaptation, that come with ADHD—traits that can serve them well when cultivated. The world is designed for compliant people who favor order over impulse. Life isn’t necessarily geared for a brain with ADHD, but certain kinds of on-the-go jobs (such as sales) or being a creative component on a team can provide ADHD people with real satisfaction. Another part is helping them learn adaptation strategies. For example, they can break tasks into manageable chunks and connect the time it takes to do such tasks with the scope of the task. A well-known technique is the Pomodoro method, which involves working for 20 really committed minutes and then taking a 5- or 10-minute break.

TCPR: How do they spend the break?
Dr. Giordano: A stretch break, a food break. Step outside, move around. Music. Something rewarding, but best not to go down YouTube rabbit holes that they won’t come out of for an hour. People with ADHD do well when they are physically on the move. I use this in sessions. If we are talking for an hour and I notice they are restless, I’ll say, “Do you need to get up and move for a few minutes?”

TCPR: Is it always “20 minutes work, then a 5- or 10-minute break,” or do you personalize it? 
Dr. Giordano: That’s a good estimate, but yes, it’s different for each person. Some can do 30 or 40 minutes of work. Rarely an hour. I personalize it, and some do better by inserting breaks when they are at a logical stopping point. One disadvantage of the Pomodoro technique is that it can interrupt flow if they do get into the work (Smits EJC et al, Behav Sci (Basel) 2025;15(7):861). I also focus on the kind of break they take. Things that are addictive, or soothing rituals—like lying in bed or scrolling on the phone—are not helpful. They’re going to make it harder to get back into the momentum of work. If that’s a problem, and it often is, I’ll suggest setting an alarm for the 10 minutes.

TCPR: How do you work with procrastination?
Dr. Giordano: In coaching, we’re often using the analytical mind, which can help with procrastination. We take a close look at what is going on around procrastination. What is the person experiencing as they delay getting started? Usually, the first couple of minutes are brutal, but after 5–15 minutes they are into the work. Once they understand the patterns behind procrastination, they can often develop new habits.

TCPR: How so?
Dr. Giordano: I encourage them to think about what makes them finally start. Often, it’s that a deadline is close. I’ll ask about what it feels like in the 15, 10, and 5 minutes prior to starting, and then discuss what they experience in the 5, 10, and 15 minutes after they get started. They start to realize that they can cut out the agony of delaying—and the panic of taking it all the way to the last minute—if they just jump right into it and get to that sweet spot. We also get into the sense of obligation to complete tasks: the duty to themselves, to getting the work done, to others who are relying on them.

TCPR: So the core values that motivate them. 
Dr. Giordano: Yes. When they feel a sense of duty toward something, they are more likely to get it done. When the work is connected to their values, it goes better, but that’s not an easy shift to make.

TCPR: Do you encourage calendars or to-do lists? 
Dr. Giordano: Yes. Clients can use paper calendars/planners if they prefer, but often an electronic calendar is the default option. Many college students are already using Canvas or Blackboard, which have those features built in and integrate with their Outlook, Apple, or Google calendar. I help them recognize that college is a 35- to 45-hour/week job. Generally, you’re supposed to do two hours of work outside of class for every hour spent in class, so we start there. If they are taking 5 classes, that’s a 45-hour/week job: 15 in the classroom and 30 outside the classroom. We create a calendar with time blocks for in-class time and study time. As a coach, I meet with them one or two times a week, which provides accountability. If time management is a big issue, I’ll have them set an alarm for every hour of the day. They write a brief reflection on what they were doing each hour and share it with me in our session. They learn quite a bit about how they use their time through this documentation.

TCPR: How do you reduce distraction?
Dr. Giordano: Setting up the environment is important. We banish unnecessary electronics from work areas. We identify a quiet place on campus, which doesn’t have to be the dorm or library. One client used a music practice room. We also work on physical organization, so they know where to find the things they need to complete their work (Forster S and Lavie N, J Exp Psychol Appl 2008;14(1):73–83).

TCPR: How do you improve focus?
Dr. Giordano: Distraction is part of ADHD, but so is hyperfocus, so I’ll ask them if there is anything they hyperfocus on. Often, it is video games. We’ll look at the qualities that inspire that hyperfocus and strategize if we can transfer any of that to another activity, something where the distraction seeps in. If we’re drawing from video games, we’ll try to gamify it.

TCPR: How do you do that? 
Dr. Giordano: Some clients use productivity apps that gamify and reward focus. We also look at play styles, an idea I’ve borrowed from Mihály Csíkszentmihályi, who is best known for his work on flow. He identified different styles of play in the development of flow. There are competitive games, games of chance, and social games, as well as play that involves exploration, storytelling, or altering states of consciousness (Editor’s note: See table “Styles of Play Adapted From Mihály Csíkszentmihályi”: https://www.thecarlatreport.com/StylesofPlay). In a session, we rank their play styles, then look at how they can adapt their approach to the boring work so it fits better with their style (Csíkszentmihályi M. Beyond Boredom and Anxiety. Jossey-Bass: 1977). 

TCPR: Can you give an example?
Dr. Giordano: If a client is very competitive in nature when it comes to play, I encourage them to compete against themselves and raise a bar to be beat by effectively engaging and completing their work. Some of my clients use a gamified app on their smartphone called Forest (Editor’s note: See table “Apps for ADHD”: https://www.thecarlatreport.com/adhdapps). After a study session, they plant a virtual tree that grows as long as they stay focused and don’t get distracted. Later, the virtual trees can be used to sponsor real tree plantings to help the environment. Like a lot of what we’ve covered, what we’re looking to do is change habits.

TCPR: How have smartphones changed the classroom? 
Dr. Giordano: After the iPhone came out, I noticed students had trouble staying focused for an hour-long class. They became dependent on the built-in rewards associated with social media. I also saw a change where more students had what I call “smartphone face.” They’d be talking passionately in class—emotions were high—but their face had this flat affect. I believe this correlates with anxiety, because young people are very concerned about how others perceive them. Remaining poker-faced in class is a protective strategy. This influences how they navigate social media (setting themselves up for constant judgment) in ways that increase their anxiety (Kerr B et al, J Adolesc Health 2025;76(1):18–28). I used to let students take notes on their computers, but I had to shut that down because of constant distractions. And research suggests we learn better when we take notes by hand (Van der Weel FRR and Van der Meer ALH et al, Front Psychol 2024;14:1219945). Smaller classes are better for students with ADHD because they have to stay attentive to the discussion.

TCPR: How do you reduce digital distractions?
Dr. Giordano: I start by asking what else is happening on the computer when studying. Are they getting notifications? If so, we turn them off for the hour or so they are working. We may create a separate user account on their computer without the distracting apps and no web browser bookmarks. Phones are out of sight.

TCPR: What is your approach to habit change?
Dr. Giordano: First, I introduce the idea of habits as a loop. We are cued to a routine, then we perform the particular routine—an action. It is rewarded, and then we are eventually cued again to repeat the action. I work with the client to make an inventory of their habits, both the functional and the dysfunctional, then we look at the ones they want to change. We work toward gradual, incremental change, and try to replace the habit with something that is similar in nature, but more functional.

TCPR: Can you give an example?
Dr. Giordano: A common one is using the phone before bed, leading to poor sleep. A similar replacement might be reading before bed. Many of my clients were voracious readers in the past but have given it up. I often suggest reading magazines because they can grab one and flip through it, not unlike scrolling on a phone. Reading doesn’t activate the same reward loops, so it’s not as likely to keep them up all night.

TCPR: Thank you for your time, Dr. Giordano.