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Can psychotherapy treat attention deficit hyperactivity disorder (ADHD)?

Susan Bartell, PsyD
Psychology
Psychotherapy can help some aspects of ADHD such as social difficulties, and low self-esteem that often accompanies ADHD. It is also useful for parents to help them learn good skills for managing a child that might be a challenge to raise. However, in many cases, psychotherapy alone is not effective in managing ADHD. Many kids need medication, and they almost always need a school environment that meets their needs. Psychotherapy along with other interventions is excellent, but alone, it may not meet all of the child's or family's needs. Parents should not give medication without also using other interventions as well.

Psychotherapy is essential in the treatment of ADHD for several reasons. First, it can decrease impulsivity by increasing the ability to label, stay with and let go of emotional reactions. Impulsivity can be tamed if you can put one step in between an impulse and an action. Impulsivity results when behavior becomes automatic. This means there is no thought process - there is simply an action that after the fact seems like a really bad idea. As an example, a person with ADHD may be driving home from work and without really thinking about it, drive into a bar and after the fact notice that he had promised to take his son to his soccer practice.

Another reason psychotherapy is essential is that the diagnosis of ADHD is unreliable. This means that depending on the process of evaluation, there is some chance that the diagnosis of ADHD is wrong. A person who has high levels of anxiety and or depression will have difficulty concentrating, difficulty following direction, difficulty following through and poor judgment. A very thorough evaluation lasting over time is usually required to sort out these difficult differential diagnoses. I treat many people that come to me with the diagnosis of ADHD and by the end of 12 sessions, it is clear that the distractibility and difficulty concentrating are primarily related to anxiety.

Psychotherapy can also target key symptoms such as procrastination. Clients can be asked to predict how difficult a certain task will be and then after they complete the task to record how painful it really was to follow through. Most people find that resistance is caused by a "boogey man." The dreaded and avoided tasks are often not as bad as they seem. As an example, you may find it took 15 minutes to complete some paperwork that you imagined would take hours and would be tormenting to complete.

Simple shifts can help overcome procrastination such as asking clients to shift their attention from how terrible they imagine the task to be to how good they will feel when it is behind them. This can increase motivation enough to overcome procrastination.

Psychotherapists can increase the level of functioning for children and adults who struggle with ADHD. This doesn't mean that it cures ADHD, but many people can have all the symptoms of ADHD but have successful careers and relationships. Psychotherapy can help you reach that state.

 

Dr. Rossi Davis
Psychology

Psychotherapy can assist an individual in learning how to manage their ADHD symptoms. Some helpful forms of therapy are: Cognitive Behavioral Therapy, Behavior Modification Treatment and Neuro feedback. Psychotherapy can also address issues such as low self-esteem, how the disorder is affecting one's daily functioning, social and peer interactions, work and school performance, and assists the client in developing healthy coping skills to deal with their ADHD.

Different types of psychotherapy are used for ADHD. Behavioral therapy aims to help a child change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a child how to monitor his or her own behavior. Learning to give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting, is another goal of behavioral therapy. Parents and teachers also can give positive or negative feedback for certain behaviors. In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior.

Therapists may teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

This answer is based on source information from the National Institute of Mental Health.

Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting, which encourages parent-to-parent support. Behavior management skills may include the following:
- use of "time out"
- point systems
- contingent attention (responding to child with positive attention when desired behaviors occur; withholding attention when undesired behaviors occurs)
Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents. Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself/herself), but are not usually helpful in reducing inattention, hyperactivity, or impulsivity.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.