ADHD and Behavioural Interventions
When a child or adult has had a diagnosis of attention deficit disorder or ADD, otherwise known as ADHD, one of the first treatments that should be offered is cognitive behaviour therapy. But what is behaviour therapy? If you have been referred to get help with ADD for yourself or your child, what can you expect?
Cognitive Behaviour TherapyIn essence, this form of therapy is all about teaching strategies and techniques to modify problem behaviour. Its ultimate goal is to help an individual improve their self-esteem and their relationships with others.
The term ‘cognitive’ refers to the way in which an individual thinks about themselves, and specific situations where a response or action is needed. The term ‘behaviour therapy’ refers to the teaching of strategies that will help an individual react or act in a more appropriate manner when challenged with situations.
In ADD or ADHD, behaviour therapy might involve training to help organisation at work or school, make friends, solve problems, or provide strategies to avoid acting impulsively or inappropriately in given situations.
Parent and Family TrainingOne of the most important first steps in ADD therapy is for the entire family to gain a detailed understanding of the disorder. Everyone within the family needs to know about ADD, how it affects their loved ones and what unique challenges it presents to all of them. Everyone needs to be involved in teaching and enforcing the new behaviours and strategies.
Additionally, by understanding that ADD is a largely hereditary condition, any feelings of blame and parental responsibility for the behaviours can be laid to rest. Instead, efforts can be directed to helping a child or loved one.
Behavioural Management StrategiesA child or adult with ADHD or ADD does not respond to situations or events in the way that a normal person would. For this reason, the usual measures and techniques of discipline are not going to work with an ADD sufferer; a different approach is needed. Parents and families are instead taught a range of positive reward strategies that they can use to help their child or teenager deal with the world in an effective way.
Developing StructureA child or adult with ADHD finds it very difficult to organise themselves and plan ahead because of differences in the way their memory works. Therefore, one of the most important elements of therapy will be for the family develop a strict structure and routine for each day.
Life must be governed by easy and simple rules that can be understood, with a positive reward structure to encourage good behaviour.
Defining TasksTasks need to be broken down into incremental elements. For example, a task of ‘getting ready for school on time’ could, be broken down into:
- getting school books ready the night before
- getting school uniform ready the night before
- getting up on time
- getting dressed on time
- having breakfast on time
- being ready to leave on time
Positive re-enforcement helps to breed an environment of success and achievement rather than one of disgrace and failure. With adults and children alike, feelings and expectations of success are more likely to breed further success; expectations of failure are usually met.
Individual ADD CoachingCoaching is carried out on a one to one basis, and is designed to teach new social skills that can be practiced by the affected individual. Individuals can be taught to stop and think about situations, or can learn what sort of response is expected by others in specific situations. Most importantly, this coaching will help to teach life skills that improve the ability of someone with ADD to make and keep friends, reducing their social isolation and in turn, improving their self esteem.
Which Therapists?In the UK, behaviour therapy may be offered by educational psychologists, clinical psychologists, psychotherapists or psychiatrists. People will be referred to one or more of these health providers; much depends on local resources and waiting times.
Is Behavioural Therapy Effective in ADD?The aim of behavioural therapy is to change how children or adults think and respond to given situations. A course of therapy can be expected to last for between 10 and 20 weeks, during which time the techniques will be taught that can bring about long term change.
Some individuals can make marked improvements with behavioural therapy alone, but many children and adults will get far better results when therapy is given with medication.
What is certain is that everyone needs to be fully committed to making changes; if used well, behavioural therapy can be very effective indeed.