Comment by TheTaytay
2 years ago
Im really surprised to see the intense skepticism here. As someone who is just stumbling into this world and studying ADHD as an otherwise successful adult, Chris’ description (and $99 price frankly) resonated with me and made me think I might be in the target market. Even one of his responses to someone thanking someone for feedback is being downvoted. Is there a connotation of ADHD being associated with snake-oil or scams that I’m not familiar with?
(Meta-comment questions aside, congrats on the launch!)
> As someone who is just stumbling into this world and studying ADHD as an otherwise successful adult, Chris’ description (and $99 price frankly) resonated with me and made me think I might be in the target market.
The issue is that this is likely more expensive for someone with health insurance than it would be to go out and engage with a guaranteed licensed medical professional for ADHD therapy.
They use some vague language on the website (look carefully for the "or" in the qualifications listing) to obscure that fact that you might be working with a "coach" instead of a licensed therapist. They also use some moderately misleading language to avoid saying they offer therapy for ADHD, instead offering things like life skills.
Basically, anyone looking at this should first go to their insurance company's website and check the price of true ADHD therapy from a guaranteed licensed medical professional that you can choose yourself. Over the course of several sessions, the cost of doing this through insurance could be much lower and you're arguably likely to get better treatment (coaches cannot provide therapy by law, so they're kind of coaching around it instead).
Thanks for your comments here.
We will definitely look into our language on our website to make sure we're not obscuring anything. We definitely do NOT offer therapy, and you ARE working with an ADHD Coach rather than a licensed therapist. In fact, even if the coach you're working with has a therapist/counselor credential, on our platform that is not the service they are providing.
I'd love to get a better sense of what language you feel is misleading, and we'll work hard to change that to reflect the reality of what we're offering!
Oh - I’m a professional with insurance, as is most of their target market, I’m sure. But most things I do medically require co-pays, feel complicated, require referrals, etc. This feels as accessible as a meditation app subscription, with a better value proposition to me. So I think I was weighing it against that sort of “guided-‘self’-help”, rather than therapy. And I say that as someone who just talked to a therapist, so I’m pro therapy. They just occupied a different headspace to me.
But I can see your point. If I had been looking at this as more of a medical condition that insurance would cover for me, this wouldn’t be my go-to substitute. I also see what you mean about the wording. I gave them the benefit of the doubt since they are trying to convey meaningful authority based on science without trying to claim to be your therapist…they are in an in-between space. But I admit there is likely a way to describe such a positioning without such likelihood of being perceived as being misleading.
>Is there a connotation of ADHD being associated with snake-oil or scams that I’m not familiar with?
With ADHD? Not really, but compared to other disabled people those with ADHD tend to be extremely pro mainstream medicine because they have basically the most effective pharmacological treatments of ANY mental disorder. Stimulants are several times more effective than treatments like SSRIs. So there is a strong bias towards conservatism because well why rock the boat when you have extremely effective treatment options?
Other disabled people tend to have a much more ambivalent or sceptical view of mainstream medicine since trying to treat most mental disorders is akin to trying to stop smoking. It does happen and it's more likely to happen the more times you try, but it's a plodding frustrating business that makes you desire something better. So they're more keen on more, lets call them "speculative" approaches to health.
For me with this specific case, it's them talking up the "science-based" (lol) nature of their program and them directly marketing it to people not diagnosed with ADHD but who suspect they have it. Show me the science showing this is an effective treatment for people who THINK they have ADHD. Thus essentially encouraging people to defer a diagnosis which results in insanely effective treatments to try a program that is experimental at best and is based off methodologies which are far less successful than pharmacological interventions. It smacks of exploitation. I'm not inherently opposed to the fundamental idea they're presenting, I simply don't trust these people AT ALL and think they're dangerous.
Same. As someone well off with inattentive type ADHD, 99$ is money I wouldn't mind throwing away for a shot at getting better with the daily issues I face. And then if it works progressing to something more expensive is also not a problem.
In my case the issue is that despite having a growth mindset for learning pretty much anything, in the case of ADHD stuff I've been trying for so long to fix myself that it feels like I'll never be able to. And that trying out this service and making efforts would be more draining than living with the symptoms is.
I realise that's not true so I could force myself to do it, it's just what I feel.
Going to go talk with an ADHD specialized psychologist this month and will see if a service like this can be extra help perhaps.
I definitely feel you, and that's the biggest "con" (in context of pros/cons) of coaching. It definitely takes significant sustained efforts, which is why medication and other methods are often the first line of defense.
We're trying to make it less effort and easier, but at the end of the day we know sustained behavioral change will take effort. Along that vein, it also may not always be the best time, and may not be best fit for everyone. We totally acknowledge that and hope to just be one piece of the greater ADHD-care pie!
Good luck with your ADHD specialized psychologist!!
> In my case the issue is that despite having a growth mindset for learning pretty much anything, in the case of ADHD stuff I've been trying for so long to fix myself that it feels like I'll never be able to.
Oh man this hits too close
Half a century brother. It doesn't get any better but life is still worth living. You can reach your potential with accommodations.
:( +1
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Hi! Chris(tal) here (also, I'm a woman.. she/her, haha. I get that a lot using my nickname)
Unfortunately, yes. There are many businesses that take advantage of not only people with ADHD but people in other vulnerable communities (e.g. other neurological conditions and mental illnesses). I've been in this space for a long time since I started with my Eating Disorder amongst other things in my teenage years.
Of course, as most of you have seen, there's a lot of splash currently in the news especially in the ADHD space so I completely understand the skepticism.
Quite honestly it's not easy for me to have my story out vulnerably in the open and linked to our business but for me it's worth it! So I really appreciate your positive feedback, it goes a long way!
After clicking around, here’s something I wanted to mention: You mentioned in your post that if you have ADHD or “think you do”, you encourage people to check it out. I’m in the camp of, “I probably don’t have ADHD, but boy, some of those self-diagnosis survey questions hit close to home, and I wish they didn’t, so this might be worth looking into whether I have ADHD or not.” I understand that you aren’t in a position to offer diagnosis, but I found myself looking for something in your FAQ or description that spoke to me. I don’t know what it would say to me that wouldn’t sound like it’s trying to convince me i have ADHD, but maybe how to investigate further, or how to know whether to give your service a shot? I might not have found a statement like that because I’m not in your target market, and I’m cool with that too. There is also a fear I have (and that I’ve observed in others) of being one of “those people” who claim they have a problem and go to the doctor and fear they’ll discover nothing is wrong. So it was reassuring when you said, “or think you do” in your pitch, and I think I was looking for the same reassurance/guidance from the website.
I hope that is helpful.
Definitely helpful, thank you for the thoughtful perspetive. I like this: "how to investigate further, or how to know whether to give your service a shot?"
For now... this is a good self test from WHO: https://www.shimmer.care/adhdtest
I'm also glad you felt reassured!
Ah, that is clarifying. (And oh! Thanks for the gender correction. I didn’t read your username)
I can imagine that starting a mental health business that hits close to home can feel more vulnerable than starting a business is already, so kudos.
I really appreciate this. Thank you!
Same here. I think there is a natural undercurrent of skepticism on HN, a lot of which is well-deserved.
The ROI of this could be tremendous for someone in tech. If this helps you get your shit together enough to be promoted a cycle early, for example, or find a new job, it could be a bargain.
I came emotionally prepared for today (I hope enough).
Thank you for your point. Actually one of our members was recently working on a career change and their coach helped them get a job relatively quickly. Of course, the success is the members' and not the coach's! But the member cited it as a massive help :)
> The ROI of this could be tremendous for someone in tech.
Sure, but if someone in tech is seeking help it's better to start with ADHD therapy (not "coaching") from licensed medical professionals, utilizing their insurance to offset the costs.
The issue a lot of us are trying to raise in this thread is that the program seems designed to take advantage of the lack of understanding about therapy versus coaching and cash-only versus insured programs. They make it easy to pay and get connected with someone, but if you're looking for true therapy (not "coaching") then you want to go through traditional channels. It will likely be cheaper with most tech insurance plans anyway.
Appreciate the thought & explanation here. This is definitely an issue and I'd love to explain a bit more about our thought process here (because we definitely don't want to take advantage, instead seek to raise awareness/ educate!)
I definitely agree ADHD therapy can be hugely beneficial but most of our members have cited it as next to impossible to find a therapist (within their insurance / state / etc) who is even ADHD-informed, let alone practices ADHD-specialized therapy. Unfortunately, I've also gone through this process and found the same.
We in no way aim to replace therapy or put ourselves against therapy. Many of our members are also in therapy (for OCD, anxiety, depression, other things) and we are more than supportive of that. For many of them, their therapists are the ones who recommended them to coaching, and how they found us.
And lastly, yes. If you're looking for therapy, we're definitely not the place to go. We try to make that super clear on our website and in all of our communications (we have many drip campaigns, campaigns, Instagram posts, etc. trying to help raise awareness and shed light on the differences between therapy and coaching for ADHD). Additionally, anyone who comes through our flow (get an email) are given the option to speak with me directly before joining and I can answer any question they have / help them even if the answer is not Shimmer.
ADHD runs very strong in my family. My mom never learned to control it and lets it ruin her interactions. Changing topics 2-3 times in a sentience is not uncommon. My career was a mix of major success and failures. Basically depending how routine or novel the problem set was. Took medication at 40 for the first time.
First time in my life I was able to work on something boring where it didn’t feel physically painful to be doing it. Sadly I don’t tolerate the medication well. (Pain) so I do without it.
Alternatives are always very attractive.
I’ve often thought it would be awesome if I could just pay someone minimum wage to sit behind me and tap on my shoulder every time I got off task.
I've often thought the same thing and have heard it from others too.
Body doubling seems to be a common technique. I've often considered if some form of self surveillance (webcam, heart rate, computer usage metrics) combined with ML could observe and "nudge" you along.
For (intrusive) thoughts sometimes I'd rather not fight it because I'll randomly suddenly remember something that I couldn't recall over an hour ago, or be reminded, or see a vague connection to another topic that could be useful to investigate later.
Maybe it's not so much being reminded to stay on task but make it as frictionless as possible to capture something and put it away safely so before you get completely derailed...
As for attention "drift" when you're forcing yourself to work on something that really saps your energy so your subconscious is trying to protect you by pulling you away? The only thing I've found to help is to organise my life so that the conditions that cause that to occur have less of a chance of happening (getting enough sleep, eating protein, taking medication at consistent time with food, meditating, listening to my body and taking regular breaks to prevent crossing the overwhelm threshold, do enough housework on routine so there's no reasonable excuse to do a load of laundry) which I guess is what a lot of coaching will try and help you do, setting up practical systems to remove triggers and optimise the ideal conditions (my speculation).
I can't remember why I started writing this reply or if I'm even anywhere close to it being on topic now, but rather than delete it, I'm just going to leave it here.
My mom is similar, but I am not. I can stay on topic quite well and inability to do so is bothersome to me, so I see that and think, “I don’t have any of that.”
But when you said boring tasks are painful, and wanting someone to tap you on the shoulder when you get off task, I was nodding along vigorously. My best solution to this (so far) is to ensure my way of contributing meaningfully to things doesn’t require rote, boring work. :) I’ve considered setting up a camera over my shoulder just to give myself the feeling of being observed…
This hit HN two days after my comment, so for anyone else who stumbles across this thread, here is a link to another HN thread where people discuss “body doubling” and similar websites/services to help: https://news.ycombinator.com/item?id=33478562
Maybe the two of you can be that person for each other!
You got a good chuckle from me on that last comment.
Thank you for sharing your story. I'm sorry about the pain re: Medication :(
> Is there a connotation of ADHD being associated with snake-oil or scams that I’m not familiar with?
Yes. Well, not really snake-oil, but this spaces is definitely associated with low-effort pill mills and broken marketing promises.
Therapy is hard. Doing it at scale is nearly impossible. Doing it at scale at a price point consumers expect is literally impossible. As a result, you end up with a bunch of "mental health" "tech" companies that are making big promises, but essentially just putting their patients through checkboxes.
Probably going to get downvoted - but I'll hypothesize anyway...
I imagine for the younger folks on HN, we grew up with what seemed like >50% of people claiming to have ADHD, OCD, Tourettes - or some other TikTok-fad "cool" disorder - which obviously not that many people actually have these problems.
At least not too long ago when I was young enough to be in that crowd - ADHD was the king of "cool" disorders. Everyone wanted to have ADHD. If you were "normal" - that was "uncool". It was like - what's wrong with you? Why don't you have some debilitating problem like everyone else?
So like claimed gluten intolerance in the adult population - I think there could be some skepticism to the occurrence and severity of some of these disorders - and to anyone making products for such groups to be a snake-oil salesman trying to capitalize.
But, who cares? Is anyone getting hurt? Let people do what makes them happy.
> At least not too long ago when I was young enough to be in that crowd - ADHD was the king of "cool" disorders. Everyone wanted to have ADHD. If you were "normal" - that was "uncool". It was like - what's wrong with you? Why don't you have some debilitating problem like everyone else?
Speaking as someone who definitely, definitely has rather severe hyperactive type ADHD complete with anxiety comorbidity and tactile defensiveness that presents sufficiently severely to look like mild ARFID and was diagnosed over a decade ago in early adulthood:
How, just -how-, could anyone want this disorder? It's miserable, it's embarrassing to constantly blurt things out and to immediately regret it and yet not be able to change the behavior, it fucked up my educational experience (I wasn't diagnosed until AFTER that happened), every day is a struggle with it, and because of the stigma it has, I can't even communicate to people effectively what it means that I have it!
So who cares? I care! It hurts ME when people self diagnose or claim to have my disorder when they don't. It's a struggle every. Single. Day. And thanks to people apparently deciding it's cool to pretend to have, a lot of people don't even believe my disorder exists
Endlessly frustrating.
> How, just -how-, could anyone want this disorder?
Because they don't understand just how debilitating it is and how much trauma it causes a person. It's absolutely shit, especially for those of us who find out later in our lives like both of us apparently. Aside from the normal issues that go with it, now I'm also plagued by the thought of how things could have gone had literally anyone picked up on it when I was a kid.
I don't think it's about being cool, at least not completely, I legitimately think some folks want at least some struggle in their lives. Something to fight against, something to give them...purpose? I'm honestly not sure, but I know if they did have it they'd do everything they could to get rid of it.
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Oh! Your hypothesis makes a lot of sense to me, so I appreciate you risking the downvotes. I missed the ADHD over-diagnosis and that TikTok self-diagnosis stuff by a generation, but seen through that lens, I could imagine people are tired of exploitative fad-chasers in this space. I have recently talked with a couple of adults who were only recently diagnosed with ADHD and it sounded enlightening/clarifying for them, so that’s the lens through which I initially read this.
If you have genuine adhd, you are not going to be the best at money management. You will likely also not hold high paying jobs because of the executive function requirements. They probably need to be 21cfr compliant in order to qualify as a medical device. I only did part 11 and clinical analyzers so I don't know about medical devices such as an app.
How many adults do you think would describe themselves as having some level of ADHD? With all the distractions of today it is a ripe market so when someone offers "treatment" with no diagnosis necessary and no actual medical professionals (I am not sure what an ADHD-coach is) it does ring a few alarm bells.