[HN Gopher] Show HN: Shimmer - ADHD-adapted body doubling
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Show HN: Shimmer - ADHD-adapted body doubling
I'm Chris, one of the co-founders of Shimmer. In 2022, following my
ADHD diagnosis, I launched Shimmer (https://shimmer.care), a 1:1
ADHD Coaching for adults (HN launch here:
https://news.ycombinator.com/item?id=33468611 ). One problem we
discovered while running 1:1 coaching is that people weren't able
to actually follow through (in real life) on the ideas they came up
with during their weekly sessions with their coach. There is a
concept called body doubling that's popular within the ADHD
community--it's basically getting things done in the presence of
other people. The positive accountability is proven to work.
However, our members told us they tried other body doubling
solutions or attempted to organize it themselves in real life but
none of the solutions stuck. So we reverse engineered productive
moments our members described, paired with scientific backing of
what motivates ADHD-ers, and designed an online body doubling
experience for our coaching members that provides a safe but
productive space for them to get things done between weekly
sessions. A few of the motivators we infused into the traditional
body doubling experience were 1) newness/novelty -- each session
has a different guided experience in the break like breathwork or
stretching, 2) urgency -- there's a large visible pomodoro timer on
the top left that counts down from 25 min, 3) community -- the
shared space is ADHD-friendly, and has a mood check-in & sharing
functionality built in so you don't feel alone, 4) accountability
-- there's a task list where each time you check something off, it
notifies the group, and you can view others' as well if they opt
in. Here's a video walking through the product experience:
https://www.tella.tv/video/shimmer-body-doubling-demo-8b1c Our
body doubling was created and iterated alongside thousands of
people with ADHD on our coaching platform over 9+ months of
building & iterating with them. We're excited to unveil this
experience. If you have ADHD (or executive functioning challenges),
we'd love for you to check out coaching & body doubling and give us
critical feedback. _Shimmer's pricing: $140 /mo. for Essentials
plan (15-min weekly sessions), $230/mo. for Standard plan (30-min
weekly sessions), $345/mo. for Immersive plan (45-min weekly
sessions); all plans start with an additional 25% off the first
month, HSA/FSA-eligible. The reason why the price is so high is
that this is not a self-guided app or SaaS tool. You're matched
with a real, credentialed coach (not AI) and 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._
_*We know these prices are still expensive for many people with
ADHD. Here are the actions we're taking: (1) we offer needs-based
scholarships and aim to have 5% of members on them at any time, (2)
we often run fully sponsored scholarships with our partners--over
60 full ride scholarships and 100 group coaching spots have been
disbursed alongside Asian Mental Health Project, Government of
Canada, and more, and (3) we have aligned our coaching model
alongside Health & Wellness Coaching, which is expected to be
reimbursed in the next years. If there are ways we can further
drive down the cost, please reach out to me directly at
chris@shimmer.care._
Author : christalwang
Score : 57 points
Date : 2024-10-31 17:27 UTC (5 hours ago)
(HTM) web link (www.tella.tv)
(TXT) w3m dump (www.tella.tv)
| devmor wrote:
| My question is why anyone but a few people would want to pay
| $140-$340/mo for a therapy-based approach not covered by
| insurance to a condition that is successfully treated in the vast
| majority of patients with medication that costs $10-20/mo with
| insurance?
|
| 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.
| throwway120385 wrote:
| Medication has side effects, and it can be really difficult to
| access unless you can find a psychiatrist who is accepting of
| the idea that an adult has ADD/ADHD. I knew someone who tried
| to get it as an adult and she spent 3 years going between
| therapists and psychiatrists to build up enough history to be
| prescribed medication.
| kstrauser wrote:
| I am eternally grateful that a friend turned me on to a local
| doctor who does video calls[0]. I'd struggled with getting in
| to see someone willing to take my complaints seriously[1],
| but a week after signing up for an online visit I had a
| prescription for something that's been life-changing.
|
| 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.
| christalwang wrote:
| Yeah, so many people have horror stories with medication,
| especially with the shortage going on right now and need
| immediate support. I've personally been impacted by the
| medication shortage, and many of our members.
| bbor wrote:
| I don't think medication "treats" ADHD in the sense of solving
| it completely. For one thing, we're living through an Adderal
| shortage, for another it doesn't last all day, and, most
| importantly, it isn't a cure-all, especially at the low dosages
| required for responsible long term use. As another commenter
| rightfully said, the downsides are also significant, especially
| in terms of exhaustion -- headaches are also a commonly
| reported one for methamphetamine.
|
| 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
| Dilettante_ wrote:
| >non-controlled substances
|
| Could you elaborate? The ones I know of are St. John's
| Wort(though that's more for depressive symptoms) and
| Phenylpiracetam.
| hypatiadotca wrote:
| Guanfacine and clonidine are two non-controlled meds
| approved for ADHD. They are second line treatments; all the
| first line treatments are stimulants, because they have the
| best evidence behind them.
| christalwang wrote:
| Yeah, medication does not solve ADHD at all. Medication is
| like glasses, it gives you the ability to see clearer (focus,
| etc.) but doesn't teach you how to read or give you
| direction.
|
| 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.
| aidenn0 wrote:
| I'm not a Shimmer user, but a few things:
|
| 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.
| kstrauser wrote:
| Regarding #1: my insurance pays for 100% of my meds. It seems
| like the extended release versions are the hardest to get
| covered, but people who can get by with the plain old all-at-
| one formulations may have a much easier time with that. Also,
| insurance doesn't pay for my doctor directly, but their
| website has a place for me to submit out of network claims. I
| do that with my doctor's receipts and insurance cuts me a
| reimbursement check for a large portion of the bill.
|
| 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.
| aidenn0 wrote:
| Extended release was hard with some, but I had one insurer
| that would only pay for 1 pill per day, so I had to use ER
| with them.
| kstrauser wrote:
| I have heard _ahem_ that you could get 30 pills that were
| each an entire day 's dose, cut them in half, and take
| them as 60 separate doses. For example, you and the doc
| think you should take 10mg in the morning and 10mg at
| lunch, so get a prescription for 30 20mg pills and buy a
| pill chopper.
|
| Purely rumor, I'm sure.
| aidenn0 wrote:
| That would work if the pharmacy reliably provided tablets
| rather than capsules.
| christalwang wrote:
| My insurance also covers my meds but there's still a
| million things that end up getting in the way of me
| actually getting it. I won't get into the details but
| things like working memory with appointments, booking the
| right appointments, getting vitals, the med shortage and
| navigating calling different pharmacies, and much more. I
| have a lot of horror stories (that are mainly my fault and
| due to my ADHD) and similar stories from our
| members/community.
|
| 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.
| kstrauser wrote:
| I hear ya. It's a cruel situation. I've likened it to
| building an asthma clinic on top of a mountain: if I
| could jump through all these hoops, I probably wouldn't
| need the help in the first place.
|
| 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!
| christalwang wrote:
| 1. Agree, and to add in all the steps it takes to actually
| get meds consistently (not a 1-time solve) + the med shortage
| that a lot of people have been impacted by 2. Yes and some of
| our members can't take stimulant medication because of other
| conditions they have that require meds that don't mix with
| stimulants 3. Yup!
| n8cpdx wrote:
| I'm skeptical of the pricing, but I could see it having value
| for working professionals or students who are at risk of
| failing out and don't have good support on campus.
|
| 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.
| christalwang wrote:
| Love what you said about sleep and exercise. In the Shimmer
| app, we call this "Lifestyle Medicine" but it's basically the
| foundational pieces of your life that keeps your body running
| as it should. And this should 100% be considered before more
| complex treatments. For us we include sleep, exercise, and
| food/nutrition.
|
| 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!
| NegativeK wrote:
| I don't want to respond to the top comment so it doesn't look
| attackish, but expecting the medication to completely cure
| the symptoms for everyone is laughably wrong.
|
| 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.
| christalwang wrote:
| 100%. Medication is one piece of the pie for many people
| but definitely not the whole for most. Thanks for sharing a
| piece of your ADHD story though, I think more people need
| to hear stories like ours (and others) so that they don't
| feel discouraged if they try ADHD meds and it doesn't act
| as a magic pill as they expected. This expectation is
| dangerous.
| christalwang wrote:
| Coaching is different from talk therapy in that it's focused on
| more action-oriented, future-oriented concerns. For example, in
| therapy, you'll talk about WHY / WHERE a specific thought
| process came from, vs. in therapy you'll talk about how you can
| design your life in a way that minimizes impact of this thought
| process. Things like calendar design, routine design, how you
| do to do lists, skills you may need to learn, the list goes on.
| These are things that ADHD coaches are trained on and things
| that therapists likely won't support with. Also, coaching is
| about accountability so things like check-ins throughout the
| week and nudge/reminders are a key part of ADHD coaching but
| not therapy.
|
| 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).
| penjelly wrote:
| I suspect twitch is a pseudo form of whatever this is, also,
| coffee shops
| christalwang wrote:
| Yes, exactly! You can do body doubling in so many different
| ways. In real life you can do coffee shops, libraries, having
| friends over to study/work, or even just calling your mom while
| you do dishes. These are all technically body doubling. Online
| there are also options that all have slightly different styles.
| Key is finding what works for you. For example, focusmate is
| 1:1 where you meet up with a stranger and what's cool about
| that service is that you can log on pretty much any time of the
| day and find someone to work with. There are also tons of
| communities and creators who will host body doubling as a part
| of whatever else they're doing!
| helsinki wrote:
| -
| aidenn0 wrote:
| There are 4.3 weeks per month, so you are off by a factor of
| 4.3
|
| 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.
| helsinki wrote:
| Ah, yes, thank you for pointing that out. Sorry OP, I thought
| you charged for every session like a normal therapist, but
| you charge for every 4.3 sessions. I'm deleting my comment to
| avoid false disparagement. This is a much more reasonable
| price. The imputed annual 'salary' is $260,465, which makes
| sense, given the cost of running a business and the
| development of the platform.
|
| 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.
| christalwang wrote:
| I didn't see the original post, but yes we charge per month
| which is just over 4 sessions. The price also includes all
| of our events, body doubling, learning modules, and task
| list tools (in other apps these other features in itself
| cost $40+/mo., and events require maintenance as well).
|
| 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!
| rchaud wrote:
| Why on earth do you have an open comments section on your landing
| page? One that is currently being deluged with racist and abusive
| messages no less?
| christalwang wrote:
| I only shared this video with Hacker News today, so the
| comments are from this community. I just signed up for Tella
| today also, and they aren't allowing me to disable it or delete
| comments self-serve. I've contacted their support so hopefully
| I can hear back soon and disable it!
| vladsanchez wrote:
| Why reinvent the wheel with something as glitchy as Tella!?
| Just post it on YouTube!!!!
| christalwang wrote:
| I really wanted the Zoom feature, but maybe it wasn't worth
| it.
| anigbrowl wrote:
| A better question might be why some people on HN think this is
| an acceptable way to behave.
| christalwang wrote:
| Agree
| christalwang wrote:
| Update, it's off now. Thanks for the flag!
| sdoering wrote:
| > credentialed coach
|
| 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.
| christalwang wrote:
| The 2 credentialing bodies we hire from are International
| Coaching Federation (ICF) and National Board Health & Wellness
| Coaches (NBC-HWC).
|
| 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.
| day_visit wrote:
| There is a discord channel that has rooms you can join to study
| with others, including rooms with camera/screen share. It also
| tracks your time studied, has channels to talk about
| progress/goals etc. https://discord.gg/study
| christalwang wrote:
| Nice, thanks for the share!!
| alis0nlaura wrote:
| The potential value in this is immense. You wouldn't experience
| success from some $40 course. Thank you for making helpful
| experts and tools accessible!
| christalwang wrote:
| Yes! ADHD is not a problem of knowing, it's a problem of doing.
| It's important to find the right support and strategies to
| actually get things done.
| KomoD wrote:
| (This person is associated with Shimmer)
| christalwang wrote:
| Why do you say this? I recognize the name, it's someone in
| the tech community. But they are not associated with Shimmer
| KomoD wrote:
| A tweet from them in 2022 says Shimmer partnered with them,
| you even follow them personally on Twitter (and their
| company on Instagram) so does Shimmer's Twitter account and
| both of your companies also follow each other on Instagram
| and Twitter.
|
| And Shimmer has a blog post that mentions both them and
| their company as "partners".
|
| I'd definitely call that associated...
| steve_adams_86 wrote:
| The tweet for anyone interested:
| https://x.com/ALiS0NLAURA/status/1580958381288091648
| christalwang wrote:
| That's a social campaign with a discount code swap. We do
| that with hundreds of organizations, anyone that are
| mission-driven.
|
| I thought you meant she worked for us or something like
| that
| chrsig wrote:
| > One problem we discovered while running 1:1 coaching is that
| people weren't able to actually follow through (in real life) on
| the ideas they came up with during their weekly sessions with
| their coach.
|
| 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.
| christalwang wrote:
| > No, you did not discover this, it's quite predictable.
|
| 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!
| decide1000 wrote:
| I actually like this Idea.
| christalwang wrote:
| Thanks! Let us know if you have feedback if/when you give it a
| try. Here to answer any questions!
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