Comment by thenerdhead

> Is this a better price than a licensed therapist? Yes

Good luck finding a licensed therapist who has bookings or availability. In Seattle I have had almost 0 luck over multiple years, and I have talked to many other people who have had the exact same amount of luck. The very few therapists around here who do specialize in ADHD either specialize in children, or they are so booked up they don't even bother with a wait list.

Mind you this is for cash payments, if you want insurance to cover care you are completely out of luck no matter how good your insurance is.

Thanks for your comment and perspective. Our services, as mentioned, are not medical services for ADHD. It is forward-looking, goal-oriented coaching with a specialty in ADHD and executive functioning. The entire modality is represented by organizations like ACO https://www.adhdcoaches.org/ and recommended by top ADHD experts and doctors alike - specifically as a non-clinical, non-medical addition to support people with ADHD. We welcome anyone who wants to come and be coached on ADHD-related skills & goals. For example, if you want to work on your executive functions but you don't have an ADHD diagnosis, you're completely welcome here! This is also because certain cultures (or an array of different circumstances could put someone in this position) prevent folks from getting a timely diagnosis and/or they don't want to tell their parents, etc. But in this case they can still get coaching with less of the stigma.

> But it just feels ethically wrong to promote your services to people who are "undiagnosed" or "think they have" ADHD.

You don't have to 'actually have' ADHD (whatever that means!) to benefit from advice, habits, or practices typically leveraged by ADHDers. You just have to have a similar enough struggle that works in a similar enough way that those techniques help you somewhat. Whether you have ADHD matters way less than whether those things help you.

That said, idk how to really evaluate for-profit companies orienting themselves around the ADHD label to provide services along those lines as opposed to freely associating online communities or whatever.

But the truth is that just like with an actual therapist (or medication) you actually have to evaluate the efficacy of the treatment for yourself. There actually isn't a formula for treating ADHD, and it's not something you can just hand off to someone else. In that respect, services like this are no different from their more authoritative counterparts in psychiatry or psychology.

> This is exactly what social media is doing today in the sense of trying to convince you have something because you happen to engage in said content.

Not quite, imo. The TikTok phenomenon is decidedly less practical (that is, less about doing anything) and more identitarian. It's about asserting membership in an informal group and differentiating yourself from others. It's 'finding yourself' like teens and young adults have always done laden so heavily with (sloppy use of) medicalizing language and a tendency to essentialize, run a bit amok. It's also innocent stuff, like in-jokes about the catharsis of finding a suitable label, of discovering that your struggles aren't totally idiosyncratic but 'a thing'.

But 'if you think you might have ADHD, check this thing out' isn't at all the same thing as 'if you laughed at this meme, you have ADHD'.

You're making a lot of assumptions here. Let's tackle them one by one:

1. "I see them all in the same light unfortunately of profiteering in various ways around the incompetent medical system the US has."

You're right, it is unfortunate that you see them all as profiteering off of the failures of the American medical system. As you've noted, the issue here is your choice not to look for nuance or independently evaluate each service.

2. "Is this a better price than a licensed therapist?"

Shimmer has been very clear every step of the way that coaching is not the same thing as — or a substitute for — therapy. For some people, therapy isn't necessary. For others, like me, therapy isn't enough. Coaching fills in the gaps and covers areas that aren't necessarily a great use of time in therapy. In my case, I use therapy to dig into major mental health issues (MDD and PTSD, primarily). I use coaching to help me figure out how to overcome executive functioning barriers and prioritize day-to-day tasks. Both are incredibly helpful in different ways.

3. "It just feels ethically wrong to promote your services to people who are 'undiagnosed' or 'think they have' ADHD."

Have you ever tried to get an ADHD diagnosis in the US? Until recently, testing was virtually impossible for many Americans to access because of scarcity and cost. I was initially quoted $1,700 for an ADHD evaluation from an out-of-network provider, and that was after calling around to numerous places that took insurance, all of which were booked up indefinitely and required referrals (which not everyone's PCP will provide for ADHD testing). I got lucky and found a $500 option, which was then treated as "unofficial" by some prescribers. Finally, I got an "official" diagnosis from an online testing service (unrelated to Shimmer) for $150. I'm incredibly fortunate to have had access to the $650 it cost me to get a diagnosis, along with medical and therapy providers who supported me along the way. Others are less privileged. Do those people not deserve help simply because they can't access a formal diagnosis?

4. "This is exactly what social media is doing today in the sense of trying to convince you you have something because you happen to engage in said content."

Shimmer isn't in the business of telling people they have ADHD or handing out stimulants to any random undiagnosed person who asks. If you take a few moments to look up Shimmer's website and social media, you'll see that they're clearly not aiming to convince people they have ADHD. Each potential client meets with one of the founders (or, I assume, another qualified team member) to discuss their specific situation and needs. If they're a good fit for one of those coaches, they're allowed to sign up and begin coaching. On the off chance that someone did fall through the cracks and begin coaching despite not having ADHD, and their coach didn't notice it right away, then one of two things might happen. Either they'd leave because ADHD coaching isn't suitable for them, or they'd continue because a lot of what happens in ADHD coaching is helpful for all kinds of people with executive dysfunction and trouble focusing.

5. "I mean just look at the eligibility"

"Eligibility" requirements are a bare minimum. One can easily infer from the content Shimmer creates that its services aren't intended (or useful) for all adults with smartphones and internet access.

6. Your link to an article titled "Teens Turn to TikTok in Search of a Mental Health Diagnosis"

Take another look at the eligibility requirements you posted. Shimmer is for adults only. Yes, technically people ages 18 and 19 have ages in the "teens," but they are legally and developmentally considered adults capable of making informed, reasoned decisions about their health. An adult seeking out ADHD one-on-one ADHD coaching from a mental health professional is not the same thing as a teenager scrolling tiktok and diagnosing themselves based on their uninformed interpretation of a video.

What's wrong with any of the eligibility?