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!
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.
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.
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.
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.
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.
- 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?
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.
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.
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'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.
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.
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.
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 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!
Purely rumor, I'm sure.
I had a way to avoid spilling them, but it's too long ago and I don't remember what it was.
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).
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
Could you elaborate? The ones I know of are St. John's Wort(though that's more for depressive symptoms) and Phenylpiracetam.
Do not take St. John's Wort! That's got all kinds of side effects.
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.
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!
Stop taking advantage of people with neurodevelopmental conditions to line your pockets. It's scummy behavior.
Snake oil bullshit pushed by charlatans.
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.
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.
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.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.
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.
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!
If nobody finds this service useful, it goes away. If people find it useful, then what's the problem.
I'm very glad that there are people out there trying to come up with new ways to help others, even if they are compelled by money like the pharmaceutical company who made my essential medicine.
And it's nice to try out some new options beyond getting cracked out on amphetamine the rest of your life.
My point is: anything technically applied, that needs another tab / app isn't helping in any way. The journey will only cost money and make you dependend on their product in the meantime.
I get it, that a individual cure hast to be found, but the idea to be helpful in that case with exposure to an app is nonsense.
These things are not the field for experiments, but serious enough to be a medical neurological problem that has to be treated by experts, not victims that can create an app to make money while at it.
As someone personally affected by ADHD, what really is ok for me from time to time is "joining" people that are in "deep flow state" in a NY public library
STUDY WITH ME at NEW YORK PUBLIC LIBRARY | [ LIVE 24/7 ] https://www.youtube.com/watch?v=M1ylZUvXzeo
If the stream is down, there are recordings: https://www.youtube.com/watch?v=OgWnLQTwbGU&list=PLHzjftygr0...
People are different and whatever helps should be good enough for me. Again: i'm sorry for my words, that i should have doublechecked and formulated differently before pressing submit.
I wish you and your community a good outcome for every single one! This is a very serious topic for those who suffer.
One of the best quotes I heard about prepping for Hacker News is that "You're speaking to the silent majority, not the loud minority" and I try to keep that in mind and just share useful information about what we're building and why we're building it in case someone reads it and finds it helpful!
I'll leave it like this now.
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.
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!
And Shimmer has a blog post that mentions both them and their company as "partners".
I'd definitely call that associated...
I thought you meant she worked for us or something like that