Creating order that lasts

I met Kristien by chance at an info session on ADHD hosted by Rubicon. She talked about how she works at people's homes to help them organize their lives, and I immediately felt I wanted to hear more. This approach would do so much good for so many people with ADHD/autism!

I'd love to walk you through how Kristien goes about her work, as inspiration for working with your own clients.

1. Daring to ask for help

There's a lot of internalized shame when you can't keep on top of your "basic tasks," especially for women. Housework, going to the shop, keeping up with admin… We all tend to think 'Don't make a fuss, you should be able to do this. Just try harder.' Except that's not how it works. Even well-meant advice in therapy sessions, or reading books about tidying and organizing, is often not enough, precisely because neurodivergent people struggle with executing knowledge and getting it automated.

Kristien explains:

"The clients I have are mostly exhausted. They have chronic stress, and sometimes have already been through several burnouts or depressive episodes. The exhaustion is enormous. I see that same tiredness in my own family too. That's why I think it's important to make things as easy as possible for yourself. Even though that often meets resistance, for instance the idea that I was spoiling the kids. But that's not true: this is exactly why it works so much better, because by making things easier, there's energy left over for other things."

2. Core stance: empathic, safe and informed

Empathic: Kristien is also personally familiar with how hard it can be to stay organized. As a woman and mother of people with ADHD, it's often a daily reality for her. Not that you need to live it firsthand to understand how heavy it is. As long as you can feel and acknowledge that the client is genuinely doing their best, and that they're often completely exhausted and it can feel hopeless at times, that's enough.

Safe: Gentleness and withholding judgment go hand in hand with the empathy you feel. If something turns out to be difficult for the client, try to figure out why together, from a stance of curiosity and engagement.

Informed: Kristien has experience both in helping people organize and in the world of ADHD/autism. With a degree in social work (option: social welfare work) and experience at the diagnostic and treatment center Indigo in Mechelen, as well as currently at emino (support for jobseekers and employees with health issues and/or work limitations), she has an important foundation. In the past she also gave guest lectures at the AP university college's autism specialization program and co-authored the book "Levensloopmodel: Werken met autisme" ("Life-Course Model: Working with Autism").

This helps build the cross-disciplinary expertise a working approach needs:

• Practical tools for planning and organizing
• Looking for someone's own capabilities, and how the environment can be made more supportive
• Being able to build the bridge between "what should happen" and "what's possible" in terms of getting tasks done
• Helping people stand in their own strength in a motivating way (empowerment), rather than taking over
• Knowledge and experience with ADHD and autism

3. Focusing on "the point of performance"

An essential part of Kristien's work is supporting people "at the point of performance." She literally steps into her clients' lives, precisely at the moments where things get stuck. The "point of performance" (1) is the precise moment and specific situation in which someone, in real life, fails to do what they actually know is needed.

In ADHD we've long known that practicing outside the therapy room is necessary: the evidence-based offering treats homework/practice in daily life as an essential component (2). Studies in autism also show that targeted practice in a realistic context is effective (3).

So it's not about a lack of understanding, motivation or knowledge, but about a blockage in execution.

4. Adapt strategies and context to where executive functioning breaks down

Kristien offers support in the here-and-now, whenever executive functions fall short. These can be broken down in various ways; I personally prefer the following breakdown (4):

1. Self awareness
2. Inhibition
3. Nonverbal working memory
4. Verbal working memory
5. Emotion regulation
6. Self motivation
7. Planning/problem-solving

How these 7 categories function differs for everyone, which is why the approach is always different. When the client runs into related problems, Kristien helps adapt the strategies that work. This step is essential, since broader research in people with ADHD shows that unadapted, generic tools and offered help are experienced as unhelpful, overwhelming and sometimes even harmful to mental wellbeing (5).

The following is always based on Kristien's examples from client journeys where the solution was found together. The tools and suggestions can offer inspiration: know that many more are possible beyond what's described here.

Self awareness

• Learn to recognize the need to decompress. Gently encourage learning to factor this in. A fully packed schedule is almost never achievable, whereas adjusting our expectations to match works far better for functioning in the long run.
• Learn to recognize your own limits and your own pace. Slowing down actually allows people to get much more done over time, without burning out. This also creates a sustainable process, instead of one driven by last-minute panic cleaning.

Inhibition

Use what you run into to your own advantage, e.g.

• If you want to cut back on sweets, put them somewhere you can only reach with a chair.
• If you want to spend less time on your phone in the evening, charge it in a different room.

Every extra step in between is a possible reason not to do the action after all.

Working memory (nonverbal and verbal)

• If you can't see it, it doesn't exist
• When asking what the client wants/needs, also give examples to choose from and explain what already exists
• Visualize as much as possible
• Send a summary of what you did together after a session
• During the session, have the client write it down in their own words
• Make an online overview per category worked on (e.g. going to the shop), and have the client rate in the following weeks whether it's still going well

Emotion regulation

• Always act and speak from a safe core stance of gentleness and a non-judgmental view
• Keep in mind that people can vary in how they feel on a given day and how much energy they have to carry something out
• When there's a clear need for more support with emotion regulation, refer to therapy for that

Self-motivation

Help the client zoom out and gain insight into the short- and long-term consequences of decisions and actions. For example: what causes the most stress?

Exercises like these make motivation much more emotionally tangible, where it would otherwise fail to appear by staying purely in the here and now.

Planning/problem-solving

This always addresses the substantive problem the client is dealing with, and will vary a lot:

• Try to trim how many steps a task has
• Work with the method that meets the least resistance
• Adjust the strategy if it doesn't quite work, not the client
• Make the context more accessible (e.g. being able to grab a pan more easily to cook)
• Schedule harder activities for the time of day the client functions best
• Etc.

5. A few more suggestions I offered

1. Offering a longer safety net with a check-in 4–6 months after the initial support. This lets us keep adjusting for the durability of the learned strategies, in a population that's stronger at starting things than at maintaining them.
2. More consistently working out what's possible for clients on "green," "orange" and "red" days. You don't have the same amount of energy every day, so what's the minimum that needs doing on those days, and how do you do that?
3. We still have sessions planned where I'll walk Kristien through an evidence-based course on planning and organizing for ADHD, based on a CBT program developed by Prof. Dr. Mary V. Solanto (6). I hear that she's already getting a lot right by gut feel (lowering the barrier to starting, easing the load on working memory, giving everything a fixed place, offering body doubling, etc.), but this way she can expand her approach with more grounding.

Closing thoughts

Offering tailor-made support with gentleness is the fixed rule of thumb. Learn to understand what doesn't work and why, before building on someone's strengths. Think of it as a process of learning, where every time something doesn't work out, there's something new to learn from it.

Want to know more about Kristien and what she offers? Take a look at her website, Organice.

Continuing to search together for what does work can bring surprising results and a boost to confidence. The longer it goes on, the more order will start to emerge!

References

1. Barkley, R. A. (n.d.). The important role of executive functioning and self-regulation in ADHD [Fact sheet]. Retrieved June 21, 2025, from https://www.russellbarkley.org/factsheets/ADHD_EF_and_SR.pdf
2. Kim, J. H., Kim, Y. A., Song, D.-Y., Cho, H. B., Lee, H. B., Park, J. H., Lim, J. I., Hong, M. H., Chae, P. K., & Yoo, H. J. (2021). An intervention program targeting daily adaptive skills through executive function training for adults with autism spectrum disorder: A pilot study. Psychiatry Investigation, 18(6), 513–522. https://doi.org/10.30773/pi.2020.0423
3. Knouse, L. E., Cooper-Vince, C., Sprich, S., & Safren, S. A. (2008). Recent developments in the psychosocial treatment of adult ADHD. Expert Review of Neurotherapeutics, 8(10), 1537–1548. https://doi.org/10.1586/14737175.8.10.1537
4. Barkley, R. A. (2020). Executive functions: What they are, how they work, and why they evolved (2nd ed.). The Guilford Press.
5. William, V., Gudka, R., Partridge, K., Taylor, S., Asherson, P., & Young, S. (2024). Experience of CBT in adults with ADHD: A mixed methods study. Frontiers in Psychiatry, 15, 1341624. https://doi.org/10.3389/fpsyt.2024.1341624
6. Solanto, M. V. (2011). Cognitive-behavioral therapy for adult ADHD: Targeting executive dysfunction (Reprint ed.). Guilford Press.

Originally published on the previous Brainspark website (22 June 2025).