Lowering the Startup Cost

Task initiation is where many ADHD clients feel the most shame. They know what they need to do. They might even want to do it. But the gap between deciding and starting feels impossible. Your job as a clinician is to help them understand that this isn't a willpower problem — it's an activation energy problem — and then give them techniques that directly lower the threshold.

The Two-Minute Bridge

This is the single most reliable technique for task initiation difficulties. Have the client commit to two minutes of the task. Only two. They set a timer. They have full permission to stop when it goes off.

What usually happens is that once they're two minutes in, the activation energy problem resolves itself. Starting was the hard part, and they already did that. But the permission to stop is what makes starting possible. They're not committing to finishing — they're committing to beginning.

One client used this technique to finally clean out her garage after avoiding it for over a year. Two minutes a day. The first day, she carried one box to the recycling bin. The second day she broke down some cardboard. By the fourth day she was in there for an hour and didn't want to stop. The two-minute commitment was the door. Once she walked through it, momentum did the rest.

Teach this in session by having the client identify a task they've been avoiding. Practice the setup together: name the task, set the timer for two minutes, begin. Debrief what happened. Most clients discover that starting is the entire problem.

Body Doubling

A body double is another person present while your client works. They don't need to help. They don't even need to talk. Their physical presence provides just enough external stimulation and accountability to keep the ADHD brain engaged.

This is why clients can somehow do their taxes at a coffee shop but not at their own desk. It's why a child does homework better at the kitchen table than alone in their room. The mechanism is external regulation — the other person's presence creates a low-level structure that the ADHD brain struggles to generate on its own.

If in-person body doubling isn't available, virtual options work too. Several free platforms offer video body doubling sessions where people work silently alongside each other. Recommend these to clients who work from home and struggle with task initiation in isolation.

Task Chunking

When a task is ambiguous or large, the ADHD brain struggles to find an entry point. Help clients break tasks into the smallest possible first step — something so small it feels almost silly. Not "do taxes" but "open the folder with tax documents." Not "write the report" but "open a blank document and type the title."

The goal is to make the first action require almost no decision-making and almost no effort. Once the client is in motion, the next step usually becomes obvious.

In Session

Have the client identify their three most-avoided tasks right now. For each one, work together to define the two-minute version and the smallest possible first step. Write these down. This becomes their homework — not to finish the tasks, but to start them using these techniques and report back on what happened.