Before smartphones existed, a dozen friends and I would sit on webcam for hours, mostly in silence, just doing our things. Studying, surfing the web, whatever. It was a website called tinychat.com . It was a decade before zoom calls. We would carry our laptops around the campus wifi, chilling in the private webcam room, 4x4 grid of feeds, push to talk. Some would leave it on 24/7. It was kind of like this concept, except not $140/hour, and no coach. Most of us were very ADHD. The coffee shop vibe did help us focus on our work.
I love that! I've never heard of that website but I can completely imagine it. I used to do the same thing in libraries and even mall foodcourts.
And just to clarify, our service is not $140/hour. It's $140 per month, which includes 4 video sessions with your coach and unlimited use of body doubling and other features. Body doubling is not the main offering, it's more of an ancillary product to support our coaching members!
There is a discord channel that has rooms you can join to study with others, including rooms with camera/screen share. It also tracks your time studied, has channels to talk about progress/goals etc. https://discord.gg/study
My question is why anyone but a few people would want to pay $140-$340/mo for a therapy-based approach not covered by insurance to a condition that is successfully treated in the vast majority of patients with medication that costs $10-20/mo with insurance?
It is a very cool approach to a well documented and tested therapeutic practice, I just don't see the value proposition unless you're someone that specifically could not find any class of medication that worked for them.
Medication has side effects, and it can be really difficult to access unless you can find a psychiatrist who is accepting of the idea that an adult has ADD/ADHD. I knew someone who tried to get it as an adult and she spent 3 years going between therapists and psychiatrists to build up enough history to be prescribed medication.
I am eternally grateful that a friend turned me on to a local doctor who does video calls[0]. I'd struggled with getting in to see someone willing to take my complaints seriously[1], but a week after signing up for an online visit I had a prescription for something that's been life-changing.
For me, personally, the whole effect of the meds are that I'm slightly more awake, as though I drank a cup of stout coffee, and I can more easily decide what to work on and then work on it. I'm fortunate to have had zero adverse reactions.
[0]And then, knowing their clientele, texts and emails the heck out of me to remind me about upcoming appointments, which isn't strictly necessary but is understandable and appreciated.
[1]One doc told me I had trouble focusing because of anxiety. "Do you know what you might be anxious about?" "Yeah, not being able to focus." That wasn't a productive visit.
Yeah, so many people have horror stories with medication, especially with the shortage going on right now and need immediate support. I've personally been impacted by the medication shortage, and many of our members.
My N=1 experience has been remarkable success with medication. Of course, it does require some work and time to find the right med(s) and dosing. Also, the shortage was previously a problem in my very large HMO but early this year it started getting better and by about 5-6 months ago supply has returned to normal.
I’m skeptical of the pricing, but I could see it having value for working professionals or students who are at risk of failing out and don’t have good support on campus.
I personally have ADHD, and I’m medicated. The medication makes it possible to focus on tasks, not guaranteed. I still have to engage cognitive skills and essentially implement a system similar to this, just without a coach. Specifically: break down tasks, use a Pomodoro timer, walk and make tea between focus sessions, put the phone away, use environmental cues like specific work music, etc.
Sleep and exercise are also incredibly important for success with ADHD, and the stimulant medications can interfere with both, so I could see coaching being useful there as well, not sure if the service offers help there.
I don't want to respond to the top comment so it doesn't look attackish, but expecting the medication to completely cure the symptoms for everyone is laughably wrong.
I've got decades of learned behaviors to deal with. And while my doctor was correct in that a medication that works will be like night and day (I'd rephrase it as life changing), I still struggle more than I like.
100%. Medication is one piece of the pie for many people but definitely not the whole for most. Thanks for sharing a piece of your ADHD story though, I think more people need to hear stories like ours (and others) so that they don't feel discouraged if they try ADHD meds and it doesn't act as a magic pill as they expected. This expectation is dangerous.
Also at least in my case, while medicine worked fine before I became a father. It doesn’t work at all when I’m sleep deprived (which has been my default state in the last 3 years). When I take concerta if I’m sleep deprived I will just constantly doze off. Concerta makes me extremely sleepy in that case
Love what you said about sleep and exercise. In the Shimmer app, we call this "Lifestyle Medicine" but it's basically the foundational pieces of your life that keeps your body running as it should. And this should 100% be considered before more complex treatments. For us we include sleep, exercise, and food/nutrition.
That's awesome that you have a whole bunch of skills that you've found that works for you! For some people, this takes months to figure out the right mix since what works for someone may not work for others. And also, HOW you do something is almost more important than WHAT skill you're using. I would also add that in coaching, in addition to skills, the coach is supporting in long-term thinking, goal setting, so that there's a direction forward as well, which is really important. I like the quote "medication is like glasses, it helps you see more clearer but it doesn't teach you how to read". I think about this quote a lot because for me, the value of coaching has been to help me set a new direction in life, be reflective in what I want, then work to build an ADHD-friendly life around me that helps me go in that direction.
Totally hear you on pricing. We're working on a few routes around reimbursement, partnerships with schools/workplaces, etc. Right now we are HSA/FSA eligible and also many of our members get it paid for through their work's L&D budget or disability/DEI budgets. Of course, that's a bit harder because it requires them to disclose. We also do a whole ton of scholarships for anyone with a financial need!
1. Insurance doesn't always cover ADHD medication, and when it does it can be a pain; every time my employer switched insurers I had to change my medication because the new insurer wouldn't cover the same thing the previous insurer covered. I've never had insurance cover my psychiatrist either, which amortizes out to about $100/mo.
2. Stimulant medication improves symptoms for over 80% of people with ADHD but "normalizes" about 1/3. So If you are in the 2/3 people that still have some ADHD symptoms on medication, then you're still going to have to cultivate healthy coping mechanisms.
3. Sometimes you go on a trip and forget to bring your medication, or you forget to bring the monthly prescription into the pharmacy on time (no refills on Schedule II substances), or your pharm is out of your meds. Now you are temporarily unmedicated and still need to function.
Regarding #1: my insurance pays for 100% of my meds. It seems like the extended release versions are the hardest to get covered, but people who can get by with the plain old all-at-one formulations may have a much easier time with that. Also, insurance doesn't pay for my doctor directly, but their website has a place for me to submit out of network claims. I do that with my doctor's receipts and insurance cuts me a reimbursement check for a large portion of the bill.
It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.
My insurance also covers my meds but there's still a million things that end up getting in the way of me actually getting it. I won't get into the details but things like working memory with appointments, booking the right appointments, getting vitals, the med shortage and navigating calling different pharmacies, and much more. I have a lot of horror stories (that are mainly my fault and due to my ADHD) and similar stories from our members/community.
It's great that you've got it largely down though!
Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.
I hear ya. It's a cruel situation. I've likened it to building an asthma clinic on top of a mountain: if I could jump through all these hoops, I probably wouldn't need the help in the first place.
I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:
- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.
- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.
There are plenty of others that I've been doing so long that they're unconscious habit.
These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!
I have heard ahem that you could get 30 pills that were each an entire day's dose, cut them in half, and take them as 60 separate doses. For example, you and the doc think you should take 10mg in the morning and 10mg at lunch, so get a prescription for 30 20mg pills and buy a pill chopper.
When I was tapering off a capsule med, I used to pull the two halves of the capsule apart, pour out a bit of the powder, and plug the halves back together. Not amazingly accurate I admit. But it shows that it's not impossible to disassemble and manipulate at least some kinds of capsule, tedious though it is to do.
Last time I tried that, I had to vacuum the stuff from the floor. Turns out some CR capsules are filled with a lot of tiny little frictionless spherical pellets instead of powder.
Probably "Extended Release". The ingredient is coated with a range of thicknesses, so that different ones become bioavailable after different lengths of time in the gut. That is actually what my "powder" was
I had a way to avoid spilling them, but it's too long ago and I don't remember what it was.
1. Agree, and to add in all the steps it takes to actually get meds consistently (not a 1-time solve) + the med shortage that a lot of people have been impacted by
2. Yes and some of our members can't take stimulant medication because of other conditions they have that require meds that don't mix with stimulants
3. Yup!
Coaching is different from talk therapy in that it's focused on more action-oriented, future-oriented concerns. For example, in therapy, you'll talk about WHY / WHERE a specific thought process came from, vs. in therapy you'll talk about how you can design your life in a way that minimizes impact of this thought process. Things like calendar design, routine design, how you do to do lists, skills you may need to learn, the list goes on. These are things that ADHD coaches are trained on and things that therapists likely won't support with. Also, coaching is about accountability so things like check-ins throughout the week and nudge/reminders are a key part of ADHD coaching but not therapy.
Also many of our clients have done (or are currently doing) therapy and come to Shimmer because their therapist suggested it.
And on your point of medication, many people do not want to take medication (cultural or other reasons), or cannot take medication (e.g. side effects or can't mix with their other meds).
I don't think medication "treats" ADHD in the sense of solving it completely. For one thing, we're living through an Adderal shortage, for another it doesn't last all day, and, most importantly, it isn't a cure-all, especially at the low dosages required for responsible long term use. As another commenter rightfully said, the downsides are also significant, especially in terms of exhaustion -- headaches are also a commonly reported one for methamphetamine.
It's a lifesaver, but it's kinda like Ozempic: it enables you to follow through on your self-improvement goals, it doesn't do them for you.
Also, some people don't have health insurance. We do exist, sadly -- 25 million of us, as of 2023: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/... Typically, a diagnosis/new psych appointment costs $250-350 OOP, and the monthly checkups cost anywhere from $100-200 (unless you can find someone willing to break the rules for you and prescribe without 30d checkins). The baffling coupon system does mean that the refills themselves are cheap, somehow, but I've paid $60 before just because the coupon wasn't working and I couldn't be bothered to go home and figure it out and go without meds for X days.
Of course that all becomes easier if you're willing to stick with non-controlled substances, but still
Guanfacine and clonidine are two non-controlled meds approved for ADHD. They are second line treatments; all the first line treatments are stimulants, because they have the best evidence behind them.
> Do not take St. John's Wort! That's got all kinds of side effects.
That's to simple, but be aware of the side effects when you take it. I still prefer it to any other antidepressants, especially for short time use. Except maybe 5htp.
Yeah, medication does not solve ADHD at all. Medication is like glasses, it gives you the ability to see clearer (focus, etc.) but doesn't teach you how to read or give you direction.
A lot of our members come to Shimmer after getting a diagnosis and the right dose of medication, or even with a therapist. And from that more calm, ready place, can they engage in the thought processes around planning for the future, building skills, etc.
Some really great discussion going on in the replies here but this is where you’ve lost the plot.
For millions of people, medication does in fact solve ADHD. Making misrepresentative blanket statements about the efficacy of medical treatment to promote your product as more necessary is not okay.
If you are looking to have your program eventually treated as a covered therapy under insurance, this kind of messaging can really hurt you.
Sorry, maybe I should have reworded. I meant to say "medication does not solve all of ADHD", "medication does not solve ADHD for all". Hm, still thinking of the right wording.
I use medication myself, so by no means am I anti-medication.
I think the point I'm trying to make is that it's not a magic pill. And there are side effects as well. If you can layer in foundational lifestyle medicine and good, healthy choices, that makes the world of difference and can potentially allow you to take less medication.
The reason I say this is because we get SO many people who come to us feeling dejected that they put all their hope on medication and when their life didn't immediately get to where they'd like, they felt like there was no hope, like there is no other alternative.
I don't need people to use Shimmer, I just want people to know there's hope if your meds don't work, and there are other solutions beyond meds. This could be therapy, coaching, self-management, and other tools!
I totally agree with you, and find the price a big turn off. I pay $30 a month for my meds, this I’m sure would help but no way could I justify the expense.
I agree with you. I want to note that ADHD 'coaches' are not trained or licensed or regulated (they're not healthcare professionals at all) so they aren't at all appropriate to be practicing anything 'therapy-based' like you describe it.
I'm medicated and I still need therapy and support from disability support workers. Therapy should just be practiced by people qualified, trained, registered, and regulated. Support workers are such a better value prop than these ADHD 'coaching' scams.
It's also amazing how high efficacy ADHD meds have. There's loads of reasons why they don't work for people but they're so effective! Every time I see that stupid 'prescription' video game I get frustrated that it exists and it marketed particularly towards kids who I assume aren't getting the most effective medical care (meds and therapy) because people are still fearmongering over meds (and therapy lol). Also the whole war on drugs thing. Inhumane and not necessary. Just let people who want to be be medicated! Still need therapy tho. The meds don't suddenly cure everything
As someone with ADHD, I think this is a great idea. Yes it's expensive, but the reason why a lot of neurotypical solutions don't work for me is because they lack design details and nuances that the ADHD brain requires. I've spoken to non-ADHD therapists in the past (great for some things!), and have also spoken with ADHD coaches and there is a difference.
Yes, 100%. A lot of the design decisions are subtle but solve a pain point and make things easier and more delightful to use. We need every little bit of help to make sure we show up to and work through these sessions.
I've also used non-ADHD therapists and other healthcare providers and it's always tough if they're not neuro-affirming. Especially before I was diagnosed and couldn't even put my finger on what was wrong.
Is this a legal term? Is there any real qualification, proven behind this? Or is it like in Germany, where anyone could call themself a "credentialed coach" and "help" other people.
Because professional help from a therapist would surely be called such, wouldn't it?
Especially from a platform that allows racist hatred onto their comment section.
ADHD 'coaches' are such a predatory scam. It's so prevalent and it's just revolting imo.
If someone is using the term 'coach' it's because they have no credentials thus can't use a term protected for use by only qualified professionals, so like you said anyone can just call themselves a coach.
Additionally, like OP says, as they're 'coaches' they're not actually qualified health professionals of any kind thus won't be covered by insurance. Here in Australia our socialised healthcare system doesn't cover them (nor should it! See a psychologist, which our healthcare system needs to really increase its funding of)
Inappropriate, harmful, or unethical behaviour by these people goes unreported because they're not covered under our national regulatory body for healthcare as well.
It's not just an expensive scam, there's absolutely no protections at all. I really hate it.
I'm genuinely happy for people who have an ADHD coach who isn't terrible but the problem is that there's so many gaps in care and filling them with totally unqualified randos with no registration or regulation who charge at least as much as an actual qualified professional on top of that is just horrendous, abysmal, and not at all a solution to these problems.
The 2 credentialing bodies we hire from are International Coaching Federation (ICF) and National Board Health & Wellness Coaches (NBC-HWC).
But yes, anyone can call themselves a coach. They would not be credentialed though.
That's one of the challenges I personally felt when I was looking for a coach when I was diagnosed and couldn't really figure out what was legit and what wasn't. That's part of the mission behind Shimmer too, so that members know that if they come to Shimmer, they're getting a qualified coach who has went through a robust screening process, and undergo ongoing supervision, training, and community! Actually only 3.7% of qualified coaches who apply actually get through our 4-step process.
While ICF and NBC-HWC provide some structure, these certifications are inadequate for supporting individuals with ADHD and mental health conditions.
ICF requires only 60-125 hours of general coaching training and NBC-HWC, while more health-focused, still lacks deep mental health and neurodiversity education.
For comparison, mental health professionals complete 4-8 years of specialized education, thousands of supervised clinical hours, and must maintain state licenses.
The risk isn't just about qualification inflation - it's about potentially harmful advice. Coaches without extensive mental health training may miss red flags, misinterpret symptoms, or suggest strategies that conflict with evidence-based treatments. While coaches can provide supplementary support, positioning them as primary mental health support for ADHD individuals, even with these certifications, could delay proper treatment and worsen outcomes.
A 4-step screening process is good, but the baseline credentials still fall short for mental health care.
The focus should be on integration with licensed healthcare providers rather than positioning coaching as a standalone solution.
Is it proven method? If so, insurance should cover it so you don't have to pay subscription fees out of your pocket. If not, don't bother. There are thousands of services like this, and I have not heard any one of them that worked for the vast majority of people with ADHD.
Yes, ADHD coaching has been studied and outcomes have been proven. Experts like Russell Barkley also recommend it. The challenge isn't coaching as a modality, but rather the sparseness in quality across the whole coaching field since it's not a protected term. At Shimmer, our coaches are vetted, trained, and supervised, and practice evidence-based methodologies that have been designed in partnership with our clinical partners.
We also track outcomes.
- 83% of Shimmer ADHD coaching members self report better ability to manage their symptoms after 6 weeks.
- Shimmer members improve their BDEFS scores (Executive Functioning Skills) by 12% over a 3 month coaching period.
- Shimmer members reduce their BFIS scores (Life impairment across key life domains) by 17% over a 3 month coaching period.
ADHD coaching is as proven as regular life coaching - not at all. It's done by people who want that therapist money without having to bother with getting a degree or being a practitioner in a regulated industry. The ADHD coaching space is particularly predatory in my experience.
Yes, exactly! You can do body doubling in so many different ways. In real life you can do coffee shops, libraries, having friends over to study/work, or even just calling your mom while you do dishes. These are all technically body doubling. Online there are also options that all have slightly different styles. Key is finding what works for you. For example, focusmate is 1:1 where you meet up with a stranger and what's cool about that service is that you can log on pretty much any time of the day and find someone to work with. There are also tons of communities and creators who will host body doubling as a part of whatever else they're doing!
I'm in the middle of ADHD diagnosis. Might still turn up something else, but ADHD or adhd/Asperger's is where my bets are.
If this works and helps with chronic, pathological procrastination, it easily "produces" a few hours of productivity per week (that wouldn't be there otherwise).
With 20 hours per month, it's enough value that it's not that high threshold for it to be "profitable". Even a no brainer for high grossing vocations like SWE in USA.*
I'm bookmarking this thread and will see it after the diagnosis and next salary.
*I'm not a SWE, but I'm a factory worker in Norway, making me top 1% anyway. This explains why the profitability equation gives a positive result for me.
Feel free to tell me to go away, but here's some unsolicited advice.
I have ADHD and I'd highly recommend you avoid coaching. You're better off seeing a qualified, registered, regulated practitioner, especially at these prices. Therapy will help you build better coping mechanisms and all that. Coaching is a predatory scam that has just exploded recently.
As someone who relies on body doubling, phoning a friend for five minutes is free and does the job. There's even discord servers for this as well. I've hired support workers in short bursts for this as well. For the low key stuff like that there's so many options that are lower cost or free, and are honest about the benefits. See a therapist for all the other stuff.
I really hope you find supports that work for you regardless. Good luck!
> I've hired support workers in short bursts for this as well.
Can you expand on this?
I recently moved and have been procrastinating the myriad of paperwork moving from one state to another involves. What helped was my insurance broker pressuring me to get some of the paperwork completed.
I meant disability support workers, I should have been a bit more precise, sorry! I'm not sure if that clears up what I meant but in case it doesn't: Disability support work is a super broad label so I'll just ramble a little about how they've helped me. I've been really lucky to find people who are interested in the particular tasks at hand to help me. Sometimes it's like hiring an additional frontal lobe, sometimes I need them for really specific things like helping me travel. Sometimes I just need extra support in planning and executing something at home that my ADHD and/or Autism makes very challenging like filling in a bunch of paperwork. It's often that I don't need help with the literal paperwork itself, but I need help/guidance in self regulation, managing my disabilities symptoms that can be destructive and unhelpful like when I just start trying to push though and do a bad job and burning out to boot is something support workers have helped me with. Longer term strategies and capacity building I work with my psychologist on but I'm always going to be disabled and neurodivergent lol.
Unlike 'coaches', disability support workers are regulated (somewhat laughably atm but they are regulated and registered, they have police checks, and professional standards), they must do at least a certificate through a registered training organisation, and if they want to do certain tasks with more like help with dressing changes or helping someone manage their medications, they need to have extra training. Those aren't fantastic examples because those things are often done by nurses, but the point I'm trying to make with that part is that as a general rule, they know their role, their skills, they know their value and don't feel the need to 'dress it up' to manipulate people into thinking they're equivalent to a psychologist or something like these abhorrent 'coaching' services do. They're also regulated and misrepresenting oneself is a bit of a no-no.
My lisdexamfetamine has run out for today. Dunno if that's obvious or not /s
If there's something I can try clarify once I'm back to being medicated please let me know
Thanks a lot for this reply. This is very heartwarming and informative. Looks like there is a world of tools to help me better function in the society.
Norway is a welfare state, but there are caveats. I'm a Polish immigrant, worked here in a slaughterhouse for 14 years, after coming for a summer job after second time I failed first semester on Tech Uni.
Until last year, my doctor was a racist cunt (tho me not showing enough emotions on my face could have same effect). After begging for a year to get a MRI of my lower back (put myself in queue for a different doctor 3 months in, it still took almost a year to change), I paid for the MRI in Poland (expen$ive, but cheaper that private MRI in Norway) and found out I have serious issues with my back that got much worsened because of no treatment and continuing doing very heavy work on the killing line (cows).
Changing the doctor opened a different world to me, because before I felt treated as a N. Stupid outlander, here just to be exploited and to get minimum back. Sorry to people whom it offends. To defend my previous doctor gatekeeping me from any diagnostics for my back (and 6 years ago for autism, which I suspected, but didn't get accepted to see a psychologist), I have to say that a lot of Polish immigrants, with cutthroat post communist mentality of hostility towards the State and using any tricks possible to sit on paid leave and do as little work as possible. (Poland was occupied by Russia and Germany, and later only Russia for 250 out of last 300 years, so the State was never Us but Them).
New doctor pushed the things with my back, but also opened a possibility to try to get a green light for a public health system ADHD diagnosis.
I've already tried doing a rushed diagnosis during summer holidays in Poland, 3 or 4 years ago. I procrastrinated (and it was quite expensive, which added to hesitation) and ended up getting paired with my younger brother's (diagnosed with ADHD) psychologist. Not only I got a negative, but also lost the connection with my youngest brother (with whom I had best relations of all my 4 siblings), because he thought that I'm falsely appropriating the ADHD/Autism to excuse my laziness. Except for my sister, nobody believed (from 4 siblings) when I showed direct quotes from psychiatric books by Thomas Brown about why I'm in a group for a likely false negative from an inexperienced psyhologist. To mention them quickly, why in my case it could have been a false negative:
- high IQ (wish I was smart, I'm just good at solving IQ tests) individuals don't struggle with same things as regular and lower IQ, which makes it harder to spot for less experienced
- age - at 35 I've learned a lot of coping mechanisms and also found a niche in my life where it's not such an issue - f. ex. you can't be late with your work in the slaughterhouse - being distracted and not doing your job fast enough is instantly evident.
- very few issues before life got more complicated - first ADHD issues around age of 13, bigger in high school, even bigger on the University. In some diagnostic criterias, no issues before 6 completely disqualifies you.
- psychologist took a review of my 3 parents (stepdad), but refused to take one from my wife, who lives with me and knows me. My biological dad (obvious case of some form of executive function disorder) left my mom when I was 3. My stepdad thinks psychology is a fraud (even after his son committing suicide at 16y) and my mom has lot of guilt over the brother that killed himself and my "failed life" compared to other siblings who all have awesome jobs in IT at home.
- psychologist was just a couple years out of school, a hard NO for diagnosing adults (children are easy to diagnose, because they don't yet mask),
- psychologist only had 3h for diagnosis, not good in my case,
- psychologist said that biggest factor in negative diagnosis is my performance on the attention/memory/reasoning test, where I used memorizing techniques, brakes and managed to hack one very hard test that tries to bore you out.
Nontheless, my wife, book from my sister about ADHD (Dirty Laundry) and my wish and dire need to change jobs trough completing education pushed me to try to get a "refellal" for an ADHD diagnosis from my new family doctor.
In Norway you still pay for the public health service, but it's never more than 30-40$ for a visit, MRI/X-ray or a specialist visit. And all yearly expenses are capped at 300$.
The catch is that it's HARD to get sent to a psychologist, especially being seen as a foreigner whos trying to milk the state.
I prepared a lot, read diagnostic criteria and about ADHD in general. Understood that I have to prove that I struggle in 2 or more domains in life to get help. Was cued by my wife to avoid my tendency to whitewashing myself and sugaring up my situation. I stopped taking my supplements (vit D & fishoil for mood, magnesium lactate for sleep) and meditating a week before the visit to get a "referal" and the psychologist visit too. It felt very dishonest doing that at first, but when I read my notes, realizing that it's all truth, just underscoring elements showing issues with work, academic performance, mental health and family life, I thought that not doing it is dishonest towards my wife, my family and myself.
After 2 months the Psychological Centre replied to my doctor's note (he makes a note during the visit and sends it to them). This time my doctor was rooting for me, don't know how the note looked, but it was enough. I got the first visit in 6 months.
So far there has been 8 1-2h vists. Psychologist I'm working with is very competent and experienced. Added bonus is that she is Polish. I thought it wouldn't be an issue, but I did struggle a bit with spoken Norwegian when the language was diametrally different than what I use day to day.
I'd love a "slimmed down" version of this since the UI looks really clean and usable. I don't need the coaches, and having an ongoing jump in/out session would be cool. Is something like that available or on the roadmap?
This is something that gets asked a lot. We're exploring what it would look like to have only body doubling and our other asynchronous features pulled out as a separate experience. Some things we're thinking through are
- What impact this will have on the current body doubling experience, where there's a certain "vibe" knowing that every other person in the room is actively engaging in coaching and you can ask them questions about their coaching etc.
- How that will change our team's focus since that product will require larger amounts of moderation, community management, and other tasks that we aren't currently focusing on. Since we're a small team (and mostly neurodivergent), we need to make sure we're super focused in our messaging and efforts
HOWEVER, it is definitely in the medium term roadmap. I think if we get enough people asking for it, it could get pulled forward.
Curious what you use now and what you like/ don't like about it — are you on other body doubling platforms?
Thanks for the reply. That all makes sense, especially around moderation and focus.
I’m not using anything now. I’ve tried out various products like Focusmate but what keeps me away is I experience ‘waiting mode’ where I’ll waste time waiting for a scheduled session to begin.
I’m looking for an open room I can hop into at any time that has a clean UI and is purpose driven for body doubling/co-working (i.e., not Discord or Slack).
I’d also love it if these rooms were organized by who is in them. It would be interesting to see what other ‘indie hackers’ are actively working on (as one example), whereas the todo list of someone not like me isn’t very compelling.
There are discord servers specifically for this not pretending to be anything accredited (like these scam 'coaches' are) that can do this. I also just phone a friend sometimes. If you need a bit more support than that, hire a disability support worker for an hour or five. Actual psychologists are great for building long term skills. Please consider not giving money to predatory scammers like ADHD 'coaches'.
We think a lot about how to structure our privacy policies so that it's not overwhelming, and is understandable.
In instances where it makes sense, we explicitly put the opt-in privacy choices right when that choice is necessary. For example, members have to opt-in (and coaches... double-opt in) before every single session if they want a summary to be generated after the call. We chose this route even though many of our members who opt in every time have given us the feedback that they wish they could just opt in once and never opt in again.
Or psychology or therapy. Psychiatry is paying $300 an hour for a ‘coach’ to prescribe you a pill so you don’t have to talk to a psychologist or coach or therapist.
Yeah nah, this just seems like bullshit. I don't know any 'adhd' people where this cluster-fuck website wouldn't distract them or make their condition worse. No design is going to help a medical condition. Your use-case can never help its audience. To me this looks like a depressing attempt to exploit very desperate people with a medical condition for something that can't possibly help.
To the HN aspiring 'entrepreneur' everything is a possible business. Even human suffering. Time and time again this community demonstrates it will trade any morals to make a quick buck.
If you have an ADHD problem get a licensed therapist, get medication, get into a group, read about and study your condition and do sports. I.e. solutions are IRL.
Yeah it’s going to be way more expensive, but the solution to a medical condition is not some slick-UI $140/month gaslight snake-oil “coach” BS.
+1 for medication with a licensed therapist first. That gives you this massive boost to your own ability to think clearly, that the remaining 80% of things you can do to improve symptoms (exercise, get into a group, etc) will be a lot easier.
Ah, yes, thank you for pointing that out. Sorry OP, I thought you charged for every session like a normal therapist, but you charge for every 4.3 sessions. I’m deleting my comment to avoid false disparagement. This is a much more reasonable price. The imputed annual ‘salary’ is $260,465, which makes sense, given the cost of running a business and the development of the platform.
Here’s a thought: Outsiders can approximate your cash flow by scraping the number of unique therapists and calculating their hours worked by analyzing their availability windows. Something worth thinking about, I suppose.
I didn't see the original post, but yes we charge per month which is just over 4 sessions. The price also includes all of our events, body doubling, learning modules, and task list tools (in other apps these other features in itself cost $40+/mo., and events require maintenance as well).
Yes, agreed. People can probably back into our cash flow, but we have been pretty transparent at each funding round anyway. Not trying to hide anything!
The website (and your comments) go on about 'the science' and 'evidence based' I cannot find a single resource on your website or in your comments to back that up. Why is that? If there's evidence and that's a core part of your branding, where is it???
As I have commented so so so many times in this thread, 'coaching' is a predatory scam. It's unregulated, not at all evidence based, and it's preying on those of us who need better access to proper medical and disability-related supports.
It's so great there's a couple of staff listed on the website who do apparently have degrees that would allow them to practice as proper allied health professionals. Where I live, someone could be risking their proper license by working as a 'lifestyle coach'. It's a violation of professional ethics. Is that not a problem in the US? I know y'all generally let nurses refer to themselves as 'doctor' (and let them run urgent care centres with no actual doctors on staff which is insane to me), so is this just normal there? I'm not just being snide, I'm genuinely asking; are the standards for medical care that low? Why not just be licensed then? If there's mental health professionals as staff, why is shimmer so hellbent on skirting regulatory bodies?
One staff member on the website, Xenia Angevin, is described as a psychologist on the website but she doesn't appear to be a clinical psychologist and it feels like you're trying to present her as something she's not. She isn't a clinical psychologist as far as I can find. Bit predatory. It's a bit like lying to sell something (well, she has an MBA!). There's a handful of staff who do have some further education (most of it not at all relevant to psychology or therapy) but it's not clear what (...if any) the educational and regulatory standards actually are or what those standards actually mean for the actual coaches. You keep trying to dress it up to make it look like the coaches are actual professionals and they're just not.
I think it is an utter disgrace to try push this scam as 'evidence based' and you should all be ashamed for preying on (allegedly) your own fellow ADHDers.
I am trying to express how appalled I am in a way that at adds to the conversation per the rules but it really is challenging because of how unscrupulous you (and other coaching scams) are. It is distressing how often 'evidence based' and 'the science' appears on the website with literally no evidence or science to be found. None! Evidence based is also a thought terminating cliche, particularly in the neurodivergent disability spaces where it's often pushed hard core to justify abhorrent things like the Judge Rotenberg Center electrocuting Autistic kids for not taking their jumpers off fast enough, but that's a rant for another day. Give us this alleged evidence so we can read and evaluate it ourselves! The audacity of slapping 'evidence based' and 'the science' all over the website with literally none is genuinely gobsmacking. I know I have said that like five times but come ON, it's cartoonishly evil!
To my fellow ADHDers, my (utterly brilliant) clinical psychologist is about the same cost as this and he's qualified, registered, regulated, and actually practices as an allied health professional so as well as having a great education and professional standards, he can interface with other healthcare professionals if and when needed.
Other allied health like occupational therapists are also worth seeing; they're professional problem solvers and strategists who are also qualified, registered, regulated allied health professionals who can help you discover and implement strategies to help you manage. If this shimmer thing sounds good to you and you don't want to do talk therapy, seriously, find an OT who works with neurodivergent adults and see them for a few months.
Disability support workers are also an amazing resource; they're qualified, regulated, and are my go-to for when I need assistance directly with something (rather than learning and implementing mechanisms).
YES there are MASSIVE issues with the various regulatory bodies, but they're genuinely worlds apart compared to these snake oil salespeople bald-faced lying about evidence based practice while refusing to even try providing any evidence and intentionally avoiding regulations that protect practitioners and clients. I strongly urge you all to avoid propping up the scam 'coaching' industry, especially when they're priced as high as actually qualified, registered professionals practicing within their scopes of practice. You can still see an OT or psychologist via telehealth if that's what you prefer!
I only shared this video with Hacker News today, so the comments are from this community. I just signed up for Tella today also, and they aren't allowing me to disable it or delete comments self-serve. I've contacted their support so hopefully I can hear back soon and disable it!
> One problem we discovered while running 1:1 coaching is that people weren’t able to actually follow through (in real life) on the ideas they came up with during their weekly sessions with their coach.
Really?
No, you did not discover this, it's quite predictable.
> since ADHD coaching is not reimbursed in the US, the price is hard for us to bring down because the largest cost component is the coach’s compensation.
Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
> we’d love for you to check out coaching & body doubling and give us critical feedback.
Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
> No, you did not discover this, it's quite predictable.
Maybe I should have specified: We discovered this for a subset of our users and wanted to help solve that problem
> Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
I'm referring to ADHD coaching that is not reimburseable yet. Though some types of coaching like health & wellness coaching and mental health coaching already are, and weren't in the past. So there is precedent and potential path to reimbursement by health insurance. I didn't mean scaling the human body
> Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
I'm glad analog way works for you! Finding the strategies/methods that work for you is key.
Unfortunately that doesn't work for everyone, especially our members. Many of them want to body double with other ADHD-ers but don't want to tell the people in their life about their ADHD. Others also just want an online hosted space because it's too much effort to organize these themselves and want a consistent, reliable space where they're not the one organizing. A whole bunch of other reasons!
The potential value in this is immense. You wouldn't experience success from some $40 course. Thank you for making helpful experts and tools accessible!
A tweet from them in 2022 says Shimmer partnered with them, you even follow them personally on Twitter (and their company on Instagram) so does Shimmer's Twitter account and both of your companies also follow each other on Instagram and Twitter.
And Shimmer has a blog post that mentions both them and their company as "partners".
Before smartphones existed, a dozen friends and I would sit on webcam for hours, mostly in silence, just doing our things. Studying, surfing the web, whatever. It was a website called tinychat.com . It was a decade before zoom calls. We would carry our laptops around the campus wifi, chilling in the private webcam room, 4x4 grid of feeds, push to talk. Some would leave it on 24/7. It was kind of like this concept, except not $140/hour, and no coach. Most of us were very ADHD. The coffee shop vibe did help us focus on our work.
I love that! I've never heard of that website but I can completely imagine it. I used to do the same thing in libraries and even mall foodcourts.
And just to clarify, our service is not $140/hour. It's $140 per month, which includes 4 video sessions with your coach and unlimited use of body doubling and other features. Body doubling is not the main offering, it's more of an ancillary product to support our coaching members!
There is a discord channel that has rooms you can join to study with others, including rooms with camera/screen share. It also tracks your time studied, has channels to talk about progress/goals etc. https://discord.gg/study
Nice, thanks for the share!!
My question is why anyone but a few people would want to pay $140-$340/mo for a therapy-based approach not covered by insurance to a condition that is successfully treated in the vast majority of patients with medication that costs $10-20/mo with insurance?
It is a very cool approach to a well documented and tested therapeutic practice, I just don't see the value proposition unless you're someone that specifically could not find any class of medication that worked for them.
Medication has side effects, and it can be really difficult to access unless you can find a psychiatrist who is accepting of the idea that an adult has ADD/ADHD. I knew someone who tried to get it as an adult and she spent 3 years going between therapists and psychiatrists to build up enough history to be prescribed medication.
I am eternally grateful that a friend turned me on to a local doctor who does video calls[0]. I'd struggled with getting in to see someone willing to take my complaints seriously[1], but a week after signing up for an online visit I had a prescription for something that's been life-changing.
For me, personally, the whole effect of the meds are that I'm slightly more awake, as though I drank a cup of stout coffee, and I can more easily decide what to work on and then work on it. I'm fortunate to have had zero adverse reactions.
[0]And then, knowing their clientele, texts and emails the heck out of me to remind me about upcoming appointments, which isn't strictly necessary but is understandable and appreciated.
[1]One doc told me I had trouble focusing because of anxiety. "Do you know what you might be anxious about?" "Yeah, not being able to focus." That wasn't a productive visit.
Yeah, so many people have horror stories with medication, especially with the shortage going on right now and need immediate support. I've personally been impacted by the medication shortage, and many of our members.
My N=1 experience has been remarkable success with medication. Of course, it does require some work and time to find the right med(s) and dosing. Also, the shortage was previously a problem in my very large HMO but early this year it started getting better and by about 5-6 months ago supply has returned to normal.
I’m skeptical of the pricing, but I could see it having value for working professionals or students who are at risk of failing out and don’t have good support on campus.
I personally have ADHD, and I’m medicated. The medication makes it possible to focus on tasks, not guaranteed. I still have to engage cognitive skills and essentially implement a system similar to this, just without a coach. Specifically: break down tasks, use a Pomodoro timer, walk and make tea between focus sessions, put the phone away, use environmental cues like specific work music, etc.
Sleep and exercise are also incredibly important for success with ADHD, and the stimulant medications can interfere with both, so I could see coaching being useful there as well, not sure if the service offers help there.
I don't want to respond to the top comment so it doesn't look attackish, but expecting the medication to completely cure the symptoms for everyone is laughably wrong.
I've got decades of learned behaviors to deal with. And while my doctor was correct in that a medication that works will be like night and day (I'd rephrase it as life changing), I still struggle more than I like.
100%. Medication is one piece of the pie for many people but definitely not the whole for most. Thanks for sharing a piece of your ADHD story though, I think more people need to hear stories like ours (and others) so that they don't feel discouraged if they try ADHD meds and it doesn't act as a magic pill as they expected. This expectation is dangerous.
Also at least in my case, while medicine worked fine before I became a father. It doesn’t work at all when I’m sleep deprived (which has been my default state in the last 3 years). When I take concerta if I’m sleep deprived I will just constantly doze off. Concerta makes me extremely sleepy in that case
Love what you said about sleep and exercise. In the Shimmer app, we call this "Lifestyle Medicine" but it's basically the foundational pieces of your life that keeps your body running as it should. And this should 100% be considered before more complex treatments. For us we include sleep, exercise, and food/nutrition.
That's awesome that you have a whole bunch of skills that you've found that works for you! For some people, this takes months to figure out the right mix since what works for someone may not work for others. And also, HOW you do something is almost more important than WHAT skill you're using. I would also add that in coaching, in addition to skills, the coach is supporting in long-term thinking, goal setting, so that there's a direction forward as well, which is really important. I like the quote "medication is like glasses, it helps you see more clearer but it doesn't teach you how to read". I think about this quote a lot because for me, the value of coaching has been to help me set a new direction in life, be reflective in what I want, then work to build an ADHD-friendly life around me that helps me go in that direction.
Totally hear you on pricing. We're working on a few routes around reimbursement, partnerships with schools/workplaces, etc. Right now we are HSA/FSA eligible and also many of our members get it paid for through their work's L&D budget or disability/DEI budgets. Of course, that's a bit harder because it requires them to disclose. We also do a whole ton of scholarships for anyone with a financial need!
I'm not a Shimmer user, but a few things:
1. Insurance doesn't always cover ADHD medication, and when it does it can be a pain; every time my employer switched insurers I had to change my medication because the new insurer wouldn't cover the same thing the previous insurer covered. I've never had insurance cover my psychiatrist either, which amortizes out to about $100/mo.
2. Stimulant medication improves symptoms for over 80% of people with ADHD but "normalizes" about 1/3. So If you are in the 2/3 people that still have some ADHD symptoms on medication, then you're still going to have to cultivate healthy coping mechanisms.
3. Sometimes you go on a trip and forget to bring your medication, or you forget to bring the monthly prescription into the pharmacy on time (no refills on Schedule II substances), or your pharm is out of your meds. Now you are temporarily unmedicated and still need to function.
Regarding #1: my insurance pays for 100% of my meds. It seems like the extended release versions are the hardest to get covered, but people who can get by with the plain old all-at-one formulations may have a much easier time with that. Also, insurance doesn't pay for my doctor directly, but their website has a place for me to submit out of network claims. I do that with my doctor's receipts and insurance cuts me a reimbursement check for a large portion of the bill.
It's a pain in the neck in the sense that getting all the insurance stuff straight is extra hard when you're in need of being treated for ADHD in the first place. It does give me something to hyperfocus on every couple of months.
My insurance also covers my meds but there's still a million things that end up getting in the way of me actually getting it. I won't get into the details but things like working memory with appointments, booking the right appointments, getting vitals, the med shortage and navigating calling different pharmacies, and much more. I have a lot of horror stories (that are mainly my fault and due to my ADHD) and similar stories from our members/community.
It's great that you've got it largely down though!
Personally, I like to know that I have a foundation (and a person) to fall back on when all the med stuff doesn't pan out the way I want it to (which is unfortunately frequently), and a big part of the value of coaching & body doubling too is community and not going through this alone.
I hear ya. It's a cruel situation. I've likened it to building an asthma clinic on top of a mountain: if I could jump through all these hoops, I probably wouldn't need the help in the first place.
I absolutely, 100%, completely agree that the medicine is only a small part of it. I have a hundred little rituals and coping mechanisms that had let me manage my life without it. Small examples:
- Appointments go straight to my calendar the instant I schedule something. If something's not on my calendar, it doesn't exist. I make liberal use of early reminders, too.
- I'm not a GTD purist, but I track it pretty closely. When I say I'll do something, I put it in my inbox. Same as with my calendar: if a to-do isn't in my to-do app, it's not getting to-done. There's nothing I've committed to that isn't in one of those 2 places.
There are plenty of others that I've been doing so long that they're unconscious habit.
These are the things that work for me. If the things you talk about work for you, and other people are willing to pay you to help get them on track, excellent!
Extended release was hard with some, but I had one insurer that would only pay for 1 pill per day, so I had to use ER with them.
I have heard ahem that you could get 30 pills that were each an entire day's dose, cut them in half, and take them as 60 separate doses. For example, you and the doc think you should take 10mg in the morning and 10mg at lunch, so get a prescription for 30 20mg pills and buy a pill chopper.
Purely rumor, I'm sure.
That would work if the pharmacy reliably provided tablets rather than capsules.
When I was tapering off a capsule med, I used to pull the two halves of the capsule apart, pour out a bit of the powder, and plug the halves back together. Not amazingly accurate I admit. But it shows that it's not impossible to disassemble and manipulate at least some kinds of capsule, tedious though it is to do.
Last time I tried that, I had to vacuum the stuff from the floor. Turns out some CR capsules are filled with a lot of tiny little frictionless spherical pellets instead of powder.
Probably "Extended Release". The ingredient is coated with a range of thicknesses, so that different ones become bioavailable after different lengths of time in the gut. That is actually what my "powder" was
I had a way to avoid spilling them, but it's too long ago and I don't remember what it was.
1. Agree, and to add in all the steps it takes to actually get meds consistently (not a 1-time solve) + the med shortage that a lot of people have been impacted by 2. Yes and some of our members can't take stimulant medication because of other conditions they have that require meds that don't mix with stimulants 3. Yup!
Coaching is different from talk therapy in that it's focused on more action-oriented, future-oriented concerns. For example, in therapy, you'll talk about WHY / WHERE a specific thought process came from, vs. in therapy you'll talk about how you can design your life in a way that minimizes impact of this thought process. Things like calendar design, routine design, how you do to do lists, skills you may need to learn, the list goes on. These are things that ADHD coaches are trained on and things that therapists likely won't support with. Also, coaching is about accountability so things like check-ins throughout the week and nudge/reminders are a key part of ADHD coaching but not therapy.
Also many of our clients have done (or are currently doing) therapy and come to Shimmer because their therapist suggested it.
And on your point of medication, many people do not want to take medication (cultural or other reasons), or cannot take medication (e.g. side effects or can't mix with their other meds).
I don't think medication "treats" ADHD in the sense of solving it completely. For one thing, we're living through an Adderal shortage, for another it doesn't last all day, and, most importantly, it isn't a cure-all, especially at the low dosages required for responsible long term use. As another commenter rightfully said, the downsides are also significant, especially in terms of exhaustion -- headaches are also a commonly reported one for methamphetamine.
It's a lifesaver, but it's kinda like Ozempic: it enables you to follow through on your self-improvement goals, it doesn't do them for you.
Also, some people don't have health insurance. We do exist, sadly -- 25 million of us, as of 2023: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/... Typically, a diagnosis/new psych appointment costs $250-350 OOP, and the monthly checkups cost anywhere from $100-200 (unless you can find someone willing to break the rules for you and prescribe without 30d checkins). The baffling coupon system does mean that the refills themselves are cheap, somehow, but I've paid $60 before just because the coupon wasn't working and I couldn't be bothered to go home and figure it out and go without meds for X days.
Of course that all becomes easier if you're willing to stick with non-controlled substances, but still
>non-controlled substances
Could you elaborate? The ones I know of are St. John's Wort(though that's more for depressive symptoms) and Phenylpiracetam.
Guanfacine and clonidine are two non-controlled meds approved for ADHD. They are second line treatments; all the first line treatments are stimulants, because they have the best evidence behind them.
The stimulants also have fewer and simpler side effects. But they don't work 24/7, At least not if you want to sleep.
Strattera and Intuniv are ADHD medicines that are not controlled substances.
Do not take St. John's Wort! That's got all kinds of side effects.
> Do not take St. John's Wort! That's got all kinds of side effects.
That's to simple, but be aware of the side effects when you take it. I still prefer it to any other antidepressants, especially for short time use. Except maybe 5htp.
Yeah, medication does not solve ADHD at all. Medication is like glasses, it gives you the ability to see clearer (focus, etc.) but doesn't teach you how to read or give you direction.
A lot of our members come to Shimmer after getting a diagnosis and the right dose of medication, or even with a therapist. And from that more calm, ready place, can they engage in the thought processes around planning for the future, building skills, etc.
> Yeah, medication does not solve ADHD at all.
Some really great discussion going on in the replies here but this is where you’ve lost the plot.
For millions of people, medication does in fact solve ADHD. Making misrepresentative blanket statements about the efficacy of medical treatment to promote your product as more necessary is not okay.
If you are looking to have your program eventually treated as a covered therapy under insurance, this kind of messaging can really hurt you.
Sorry, maybe I should have reworded. I meant to say "medication does not solve all of ADHD", "medication does not solve ADHD for all". Hm, still thinking of the right wording.
I use medication myself, so by no means am I anti-medication.
I think the point I'm trying to make is that it's not a magic pill. And there are side effects as well. If you can layer in foundational lifestyle medicine and good, healthy choices, that makes the world of difference and can potentially allow you to take less medication.
The reason I say this is because we get SO many people who come to us feeling dejected that they put all their hope on medication and when their life didn't immediately get to where they'd like, they felt like there was no hope, like there is no other alternative.
I don't need people to use Shimmer, I just want people to know there's hope if your meds don't work, and there are other solutions beyond meds. This could be therapy, coaching, self-management, and other tools!
That’s a much better outlook, thank you for clarifying!
I totally agree with you, and find the price a big turn off. I pay $30 a month for my meds, this I’m sure would help but no way could I justify the expense.
I agree with you. I want to note that ADHD 'coaches' are not trained or licensed or regulated (they're not healthcare professionals at all) so they aren't at all appropriate to be practicing anything 'therapy-based' like you describe it.
I'm medicated and I still need therapy and support from disability support workers. Therapy should just be practiced by people qualified, trained, registered, and regulated. Support workers are such a better value prop than these ADHD 'coaching' scams.
It's also amazing how high efficacy ADHD meds have. There's loads of reasons why they don't work for people but they're so effective! Every time I see that stupid 'prescription' video game I get frustrated that it exists and it marketed particularly towards kids who I assume aren't getting the most effective medical care (meds and therapy) because people are still fearmongering over meds (and therapy lol). Also the whole war on drugs thing. Inhumane and not necessary. Just let people who want to be be medicated! Still need therapy tho. The meds don't suddenly cure everything
As someone with ADHD, I think this is a great idea. Yes it's expensive, but the reason why a lot of neurotypical solutions don't work for me is because they lack design details and nuances that the ADHD brain requires. I've spoken to non-ADHD therapists in the past (great for some things!), and have also spoken with ADHD coaches and there is a difference.
Yes, 100%. A lot of the design decisions are subtle but solve a pain point and make things easier and more delightful to use. We need every little bit of help to make sure we show up to and work through these sessions.
I've also used non-ADHD therapists and other healthcare providers and it's always tough if they're not neuro-affirming. Especially before I was diagnosed and couldn't even put my finger on what was wrong.
> credentialed coach
Is this a legal term? Is there any real qualification, proven behind this? Or is it like in Germany, where anyone could call themself a "credentialed coach" and "help" other people.
Because professional help from a therapist would surely be called such, wouldn't it?
Especially from a platform that allows racist hatred onto their comment section.
ADHD 'coaches' are such a predatory scam. It's so prevalent and it's just revolting imo.
If someone is using the term 'coach' it's because they have no credentials thus can't use a term protected for use by only qualified professionals, so like you said anyone can just call themselves a coach.
Additionally, like OP says, as they're 'coaches' they're not actually qualified health professionals of any kind thus won't be covered by insurance. Here in Australia our socialised healthcare system doesn't cover them (nor should it! See a psychologist, which our healthcare system needs to really increase its funding of)
Inappropriate, harmful, or unethical behaviour by these people goes unreported because they're not covered under our national regulatory body for healthcare as well.
It's not just an expensive scam, there's absolutely no protections at all. I really hate it.
I'm genuinely happy for people who have an ADHD coach who isn't terrible but the problem is that there's so many gaps in care and filling them with totally unqualified randos with no registration or regulation who charge at least as much as an actual qualified professional on top of that is just horrendous, abysmal, and not at all a solution to these problems.
The 2 credentialing bodies we hire from are International Coaching Federation (ICF) and National Board Health & Wellness Coaches (NBC-HWC).
But yes, anyone can call themselves a coach. They would not be credentialed though.
That's one of the challenges I personally felt when I was looking for a coach when I was diagnosed and couldn't really figure out what was legit and what wasn't. That's part of the mission behind Shimmer too, so that members know that if they come to Shimmer, they're getting a qualified coach who has went through a robust screening process, and undergo ongoing supervision, training, and community! Actually only 3.7% of qualified coaches who apply actually get through our 4-step process.
While ICF and NBC-HWC provide some structure, these certifications are inadequate for supporting individuals with ADHD and mental health conditions.
ICF requires only 60-125 hours of general coaching training and NBC-HWC, while more health-focused, still lacks deep mental health and neurodiversity education.
For comparison, mental health professionals complete 4-8 years of specialized education, thousands of supervised clinical hours, and must maintain state licenses.
The risk isn't just about qualification inflation - it's about potentially harmful advice. Coaches without extensive mental health training may miss red flags, misinterpret symptoms, or suggest strategies that conflict with evidence-based treatments. While coaches can provide supplementary support, positioning them as primary mental health support for ADHD individuals, even with these certifications, could delay proper treatment and worsen outcomes.
A 4-step screening process is good, but the baseline credentials still fall short for mental health care.
The focus should be on integration with licensed healthcare providers rather than positioning coaching as a standalone solution.
Is it proven method? If so, insurance should cover it so you don't have to pay subscription fees out of your pocket. If not, don't bother. There are thousands of services like this, and I have not heard any one of them that worked for the vast majority of people with ADHD.
Yes, ADHD coaching has been studied and outcomes have been proven. Experts like Russell Barkley also recommend it. The challenge isn't coaching as a modality, but rather the sparseness in quality across the whole coaching field since it's not a protected term. At Shimmer, our coaches are vetted, trained, and supervised, and practice evidence-based methodologies that have been designed in partnership with our clinical partners.
We also track outcomes. - 83% of Shimmer ADHD coaching members self report better ability to manage their symptoms after 6 weeks. - Shimmer members improve their BDEFS scores (Executive Functioning Skills) by 12% over a 3 month coaching period. - Shimmer members reduce their BFIS scores (Life impairment across key life domains) by 17% over a 3 month coaching period.
Do you have a published peer-reviewed studies on your method?
ADHD coaching is as proven as regular life coaching - not at all. It's done by people who want that therapist money without having to bother with getting a degree or being a practitioner in a regulated industry. The ADHD coaching space is particularly predatory in my experience.
I suspect twitch is a pseudo form of whatever this is, also, coffee shops
Yes, exactly! You can do body doubling in so many different ways. In real life you can do coffee shops, libraries, having friends over to study/work, or even just calling your mom while you do dishes. These are all technically body doubling. Online there are also options that all have slightly different styles. Key is finding what works for you. For example, focusmate is 1:1 where you meet up with a stranger and what's cool about that service is that you can log on pretty much any time of the day and find someone to work with. There are also tons of communities and creators who will host body doubling as a part of whatever else they're doing!
I'm in the middle of ADHD diagnosis. Might still turn up something else, but ADHD or adhd/Asperger's is where my bets are.
If this works and helps with chronic, pathological procrastination, it easily "produces" a few hours of productivity per week (that wouldn't be there otherwise).
With 20 hours per month, it's enough value that it's not that high threshold for it to be "profitable". Even a no brainer for high grossing vocations like SWE in USA.*
I'm bookmarking this thread and will see it after the diagnosis and next salary.
*I'm not a SWE, but I'm a factory worker in Norway, making me top 1% anyway. This explains why the profitability equation gives a positive result for me.
Hi! I hope your diagnosis goes smoothly.
Feel free to tell me to go away, but here's some unsolicited advice.
I have ADHD and I'd highly recommend you avoid coaching. You're better off seeing a qualified, registered, regulated practitioner, especially at these prices. Therapy will help you build better coping mechanisms and all that. Coaching is a predatory scam that has just exploded recently.
As someone who relies on body doubling, phoning a friend for five minutes is free and does the job. There's even discord servers for this as well. I've hired support workers in short bursts for this as well. For the low key stuff like that there's so many options that are lower cost or free, and are honest about the benefits. See a therapist for all the other stuff.
I really hope you find supports that work for you regardless. Good luck!
> I've hired support workers in short bursts for this as well.
Can you expand on this?
I recently moved and have been procrastinating the myriad of paperwork moving from one state to another involves. What helped was my insurance broker pressuring me to get some of the paperwork completed.
I meant disability support workers, I should have been a bit more precise, sorry! I'm not sure if that clears up what I meant but in case it doesn't: Disability support work is a super broad label so I'll just ramble a little about how they've helped me. I've been really lucky to find people who are interested in the particular tasks at hand to help me. Sometimes it's like hiring an additional frontal lobe, sometimes I need them for really specific things like helping me travel. Sometimes I just need extra support in planning and executing something at home that my ADHD and/or Autism makes very challenging like filling in a bunch of paperwork. It's often that I don't need help with the literal paperwork itself, but I need help/guidance in self regulation, managing my disabilities symptoms that can be destructive and unhelpful like when I just start trying to push though and do a bad job and burning out to boot is something support workers have helped me with. Longer term strategies and capacity building I work with my psychologist on but I'm always going to be disabled and neurodivergent lol.
Unlike 'coaches', disability support workers are regulated (somewhat laughably atm but they are regulated and registered, they have police checks, and professional standards), they must do at least a certificate through a registered training organisation, and if they want to do certain tasks with more like help with dressing changes or helping someone manage their medications, they need to have extra training. Those aren't fantastic examples because those things are often done by nurses, but the point I'm trying to make with that part is that as a general rule, they know their role, their skills, they know their value and don't feel the need to 'dress it up' to manipulate people into thinking they're equivalent to a psychologist or something like these abhorrent 'coaching' services do. They're also regulated and misrepresenting oneself is a bit of a no-no.
My lisdexamfetamine has run out for today. Dunno if that's obvious or not /s
If there's something I can try clarify once I'm back to being medicated please let me know
Thanks a lot for this reply. This is very heartwarming and informative. Looks like there is a world of tools to help me better function in the society.
Good luck on your diagnosis. How is that like in Norway?
Norway is a welfare state, but there are caveats. I'm a Polish immigrant, worked here in a slaughterhouse for 14 years, after coming for a summer job after second time I failed first semester on Tech Uni.
Until last year, my doctor was a racist cunt (tho me not showing enough emotions on my face could have same effect). After begging for a year to get a MRI of my lower back (put myself in queue for a different doctor 3 months in, it still took almost a year to change), I paid for the MRI in Poland (expen$ive, but cheaper that private MRI in Norway) and found out I have serious issues with my back that got much worsened because of no treatment and continuing doing very heavy work on the killing line (cows).
Changing the doctor opened a different world to me, because before I felt treated as a N. Stupid outlander, here just to be exploited and to get minimum back. Sorry to people whom it offends. To defend my previous doctor gatekeeping me from any diagnostics for my back (and 6 years ago for autism, which I suspected, but didn't get accepted to see a psychologist), I have to say that a lot of Polish immigrants, with cutthroat post communist mentality of hostility towards the State and using any tricks possible to sit on paid leave and do as little work as possible. (Poland was occupied by Russia and Germany, and later only Russia for 250 out of last 300 years, so the State was never Us but Them).
New doctor pushed the things with my back, but also opened a possibility to try to get a green light for a public health system ADHD diagnosis.
I've already tried doing a rushed diagnosis during summer holidays in Poland, 3 or 4 years ago. I procrastrinated (and it was quite expensive, which added to hesitation) and ended up getting paired with my younger brother's (diagnosed with ADHD) psychologist. Not only I got a negative, but also lost the connection with my youngest brother (with whom I had best relations of all my 4 siblings), because he thought that I'm falsely appropriating the ADHD/Autism to excuse my laziness. Except for my sister, nobody believed (from 4 siblings) when I showed direct quotes from psychiatric books by Thomas Brown about why I'm in a group for a likely false negative from an inexperienced psyhologist. To mention them quickly, why in my case it could have been a false negative: - high IQ (wish I was smart, I'm just good at solving IQ tests) individuals don't struggle with same things as regular and lower IQ, which makes it harder to spot for less experienced - age - at 35 I've learned a lot of coping mechanisms and also found a niche in my life where it's not such an issue - f. ex. you can't be late with your work in the slaughterhouse - being distracted and not doing your job fast enough is instantly evident. - very few issues before life got more complicated - first ADHD issues around age of 13, bigger in high school, even bigger on the University. In some diagnostic criterias, no issues before 6 completely disqualifies you. - psychologist took a review of my 3 parents (stepdad), but refused to take one from my wife, who lives with me and knows me. My biological dad (obvious case of some form of executive function disorder) left my mom when I was 3. My stepdad thinks psychology is a fraud (even after his son committing suicide at 16y) and my mom has lot of guilt over the brother that killed himself and my "failed life" compared to other siblings who all have awesome jobs in IT at home. - psychologist was just a couple years out of school, a hard NO for diagnosing adults (children are easy to diagnose, because they don't yet mask), - psychologist only had 3h for diagnosis, not good in my case, - psychologist said that biggest factor in negative diagnosis is my performance on the attention/memory/reasoning test, where I used memorizing techniques, brakes and managed to hack one very hard test that tries to bore you out.
Nontheless, my wife, book from my sister about ADHD (Dirty Laundry) and my wish and dire need to change jobs trough completing education pushed me to try to get a "refellal" for an ADHD diagnosis from my new family doctor.
In Norway you still pay for the public health service, but it's never more than 30-40$ for a visit, MRI/X-ray or a specialist visit. And all yearly expenses are capped at 300$.
The catch is that it's HARD to get sent to a psychologist, especially being seen as a foreigner whos trying to milk the state.
I prepared a lot, read diagnostic criteria and about ADHD in general. Understood that I have to prove that I struggle in 2 or more domains in life to get help. Was cued by my wife to avoid my tendency to whitewashing myself and sugaring up my situation. I stopped taking my supplements (vit D & fishoil for mood, magnesium lactate for sleep) and meditating a week before the visit to get a "referal" and the psychologist visit too. It felt very dishonest doing that at first, but when I read my notes, realizing that it's all truth, just underscoring elements showing issues with work, academic performance, mental health and family life, I thought that not doing it is dishonest towards my wife, my family and myself.
After 2 months the Psychological Centre replied to my doctor's note (he makes a note during the visit and sends it to them). This time my doctor was rooting for me, don't know how the note looked, but it was enough. I got the first visit in 6 months.
So far there has been 8 1-2h vists. Psychologist I'm working with is very competent and experienced. Added bonus is that she is Polish. I thought it wouldn't be an issue, but I did struggle a bit with spoken Norwegian when the language was diametrally different than what I use day to day.
I'd love a "slimmed down" version of this since the UI looks really clean and usable. I don't need the coaches, and having an ongoing jump in/out session would be cool. Is something like that available or on the roadmap?
This is something that gets asked a lot. We're exploring what it would look like to have only body doubling and our other asynchronous features pulled out as a separate experience. Some things we're thinking through are
- What impact this will have on the current body doubling experience, where there's a certain "vibe" knowing that every other person in the room is actively engaging in coaching and you can ask them questions about their coaching etc.
- How that will change our team's focus since that product will require larger amounts of moderation, community management, and other tasks that we aren't currently focusing on. Since we're a small team (and mostly neurodivergent), we need to make sure we're super focused in our messaging and efforts
HOWEVER, it is definitely in the medium term roadmap. I think if we get enough people asking for it, it could get pulled forward.
Curious what you use now and what you like/ don't like about it — are you on other body doubling platforms?
Thanks for the reply. That all makes sense, especially around moderation and focus.
I’m not using anything now. I’ve tried out various products like Focusmate but what keeps me away is I experience ‘waiting mode’ where I’ll waste time waiting for a scheduled session to begin.
I’m looking for an open room I can hop into at any time that has a clean UI and is purpose driven for body doubling/co-working (i.e., not Discord or Slack).
I’d also love it if these rooms were organized by who is in them. It would be interesting to see what other ‘indie hackers’ are actively working on (as one example), whereas the todo list of someone not like me isn’t very compelling.
There are discord servers specifically for this not pretending to be anything accredited (like these scam 'coaches' are) that can do this. I also just phone a friend sometimes. If you need a bit more support than that, hire a disability support worker for an hour or five. Actual psychologists are great for building long term skills. Please consider not giving money to predatory scammers like ADHD 'coaches'.
A little up the thread somebody linked a discord server that seems aimed at that kind of idea.
Shimmer, body doubling - inspired by the film Annihilation ?
https://www.youtube.com/watch?v=Gi3K-CApAS4
Hello, have you considered switching to opt-in privacy choices? Not all ADHD persons will read the privacy policy, and yours is a doozy.
We think a lot about how to structure our privacy policies so that it's not overwhelming, and is understandable.
In instances where it makes sense, we explicitly put the opt-in privacy choices right when that choice is necessary. For example, members have to opt-in (and coaches... double-opt in) before every single session if they want a summary to be generated after the call. We chose this route even though many of our members who opt in every time have given us the feedback that they wish they could just opt in once and never opt in again.
I think paying $115 an hour for a 'coach' to help with a mental disorder is just called psychiatry.
Or psychology or therapy. Psychiatry is paying $300 an hour for a ‘coach’ to prescribe you a pill so you don’t have to talk to a psychologist or coach or therapist.
The basic plan is $140 a month.
That gets your an hour of time split into 4 sessions, so are you saying it's $140 an hour?
Yeah nah, this just seems like bullshit. I don't know any 'adhd' people where this cluster-fuck website wouldn't distract them or make their condition worse. No design is going to help a medical condition. Your use-case can never help its audience. To me this looks like a depressing attempt to exploit very desperate people with a medical condition for something that can't possibly help.
To the HN aspiring 'entrepreneur' everything is a possible business. Even human suffering. Time and time again this community demonstrates it will trade any morals to make a quick buck.
I actually like this Idea.
Thanks! Let us know if you have feedback if/when you give it a try. Here to answer any questions!
These people are back again.
If you have an ADHD problem get a licensed therapist, get medication, get into a group, read about and study your condition and do sports. I.e. solutions are IRL.
Yeah it’s going to be way more expensive, but the solution to a medical condition is not some slick-UI $140/month gaslight snake-oil “coach” BS.
+1 for medication with a licensed therapist first. That gives you this massive boost to your own ability to think clearly, that the remaining 80% of things you can do to improve symptoms (exercise, get into a group, etc) will be a lot easier.
Not this shit again. It is just as much of a scam as when you tried to shill it here last year, and the year before.
Stop taking advantage of people with neurodevelopmental conditions to line your pockets. It's scummy behavior.
Snake oil bullshit pushed by charlatans.
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There are 4.3 weeks per month, so you are off by a factor of 4.3
i.e. you get a little over 1 hour of 1:1 coach time per month for the 15 minute weekly sessions.
[edit] I originally wrote 4.3 weeks per year which is wrong.
Ah, yes, thank you for pointing that out. Sorry OP, I thought you charged for every session like a normal therapist, but you charge for every 4.3 sessions. I’m deleting my comment to avoid false disparagement. This is a much more reasonable price. The imputed annual ‘salary’ is $260,465, which makes sense, given the cost of running a business and the development of the platform.
Here’s a thought: Outsiders can approximate your cash flow by scraping the number of unique therapists and calculating their hours worked by analyzing their availability windows. Something worth thinking about, I suppose.
I didn't see the original post, but yes we charge per month which is just over 4 sessions. The price also includes all of our events, body doubling, learning modules, and task list tools (in other apps these other features in itself cost $40+/mo., and events require maintenance as well).
Yes, agreed. People can probably back into our cash flow, but we have been pretty transparent at each funding round anyway. Not trying to hide anything!
The website (and your comments) go on about 'the science' and 'evidence based' I cannot find a single resource on your website or in your comments to back that up. Why is that? If there's evidence and that's a core part of your branding, where is it???
As I have commented so so so many times in this thread, 'coaching' is a predatory scam. It's unregulated, not at all evidence based, and it's preying on those of us who need better access to proper medical and disability-related supports.
It's so great there's a couple of staff listed on the website who do apparently have degrees that would allow them to practice as proper allied health professionals. Where I live, someone could be risking their proper license by working as a 'lifestyle coach'. It's a violation of professional ethics. Is that not a problem in the US? I know y'all generally let nurses refer to themselves as 'doctor' (and let them run urgent care centres with no actual doctors on staff which is insane to me), so is this just normal there? I'm not just being snide, I'm genuinely asking; are the standards for medical care that low? Why not just be licensed then? If there's mental health professionals as staff, why is shimmer so hellbent on skirting regulatory bodies?
One staff member on the website, Xenia Angevin, is described as a psychologist on the website but she doesn't appear to be a clinical psychologist and it feels like you're trying to present her as something she's not. She isn't a clinical psychologist as far as I can find. Bit predatory. It's a bit like lying to sell something (well, she has an MBA!). There's a handful of staff who do have some further education (most of it not at all relevant to psychology or therapy) but it's not clear what (...if any) the educational and regulatory standards actually are or what those standards actually mean for the actual coaches. You keep trying to dress it up to make it look like the coaches are actual professionals and they're just not.
I think it is an utter disgrace to try push this scam as 'evidence based' and you should all be ashamed for preying on (allegedly) your own fellow ADHDers.
I am trying to express how appalled I am in a way that at adds to the conversation per the rules but it really is challenging because of how unscrupulous you (and other coaching scams) are. It is distressing how often 'evidence based' and 'the science' appears on the website with literally no evidence or science to be found. None! Evidence based is also a thought terminating cliche, particularly in the neurodivergent disability spaces where it's often pushed hard core to justify abhorrent things like the Judge Rotenberg Center electrocuting Autistic kids for not taking their jumpers off fast enough, but that's a rant for another day. Give us this alleged evidence so we can read and evaluate it ourselves! The audacity of slapping 'evidence based' and 'the science' all over the website with literally none is genuinely gobsmacking. I know I have said that like five times but come ON, it's cartoonishly evil!
To my fellow ADHDers, my (utterly brilliant) clinical psychologist is about the same cost as this and he's qualified, registered, regulated, and actually practices as an allied health professional so as well as having a great education and professional standards, he can interface with other healthcare professionals if and when needed.
Other allied health like occupational therapists are also worth seeing; they're professional problem solvers and strategists who are also qualified, registered, regulated allied health professionals who can help you discover and implement strategies to help you manage. If this shimmer thing sounds good to you and you don't want to do talk therapy, seriously, find an OT who works with neurodivergent adults and see them for a few months.
Disability support workers are also an amazing resource; they're qualified, regulated, and are my go-to for when I need assistance directly with something (rather than learning and implementing mechanisms).
YES there are MASSIVE issues with the various regulatory bodies, but they're genuinely worlds apart compared to these snake oil salespeople bald-faced lying about evidence based practice while refusing to even try providing any evidence and intentionally avoiding regulations that protect practitioners and clients. I strongly urge you all to avoid propping up the scam 'coaching' industry, especially when they're priced as high as actually qualified, registered professionals practicing within their scopes of practice. You can still see an OT or psychologist via telehealth if that's what you prefer!
Why on earth do you have an open comments section on your landing page? One that is currently being deluged with racist and abusive messages no less?
I only shared this video with Hacker News today, so the comments are from this community. I just signed up for Tella today also, and they aren't allowing me to disable it or delete comments self-serve. I've contacted their support so hopefully I can hear back soon and disable it!
Why reinvent the wheel with something as glitchy as Tella!? Just post it on YouTube!!!!
I really wanted the Zoom feature, but maybe it wasn't worth it.
A better question might be why some people on HN think this is an acceptable way to behave.
Agree
Update, it's off now. Thanks for the flag!
> One problem we discovered while running 1:1 coaching is that people weren’t able to actually follow through (in real life) on the ideas they came up with during their weekly sessions with their coach.
Really?
No, you did not discover this, it's quite predictable.
> since ADHD coaching is not reimbursed in the US, the price is hard for us to bring down because the largest cost component is the coach’s compensation.
Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
> we’d love for you to check out coaching & body doubling and give us critical feedback.
Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
> No, you did not discover this, it's quite predictable.
Maybe I should have specified: We discovered this for a subset of our users and wanted to help solve that problem
> Yeah, body doubling doesn't scale. The whole need for another human body thing is a real hurdle, huh?
I'm referring to ADHD coaching that is not reimburseable yet. Though some types of coaching like health & wellness coaching and mental health coaching already are, and weren't in the past. So there is precedent and potential path to reimbursement by health insurance. I didn't mean scaling the human body
> Too much text with numbers too big. I already utilize body doubling the analog way, you've told me absolutely nothing about what on earth you're adding to the equation.
I'm glad analog way works for you! Finding the strategies/methods that work for you is key.
Unfortunately that doesn't work for everyone, especially our members. Many of them want to body double with other ADHD-ers but don't want to tell the people in their life about their ADHD. Others also just want an online hosted space because it's too much effort to organize these themselves and want a consistent, reliable space where they're not the one organizing. A whole bunch of other reasons!
The potential value in this is immense. You wouldn't experience success from some $40 course. Thank you for making helpful experts and tools accessible!
Yes! ADHD is not a problem of knowing, it's a problem of doing. It's important to find the right support and strategies to actually get things done.
(This person is associated with Shimmer)
Why do you say this? I recognize the name, it's someone in the tech community. But they are not associated with Shimmer
A tweet from them in 2022 says Shimmer partnered with them, you even follow them personally on Twitter (and their company on Instagram) so does Shimmer's Twitter account and both of your companies also follow each other on Instagram and Twitter.
And Shimmer has a blog post that mentions both them and their company as "partners".
I'd definitely call that associated...
The tweet for anyone interested: https://x.com/ALiS0NLAURA/status/1580958381288091648
That's a social campaign with a discount code swap. We do that with hundreds of organizations, anyone that are mission-driven.
I thought you meant she worked for us or something like that
No, I didn't comment one way or another. Only referencing the tweet mentioned. I'm aware I'm lacking any context otherwise.
True, good points! I may have misinterpreted the intent of op's comment