Right Goal, Wrong Strategy — 11 New Treatment Ideas
“When treatment doesn’t work, people admonish the patient. This suggests that the individual with ADHD didn’t succeed because he has a fundamental flaw. But, the therapy is wrong, not the person.” – William Dodson, M.D.
Most parents, teachers, and spouses don’t understand how an ADHD brain is wired, and use techniques that work only for the neurotypical brain. When the treatment doesn't work for the individual with ADHD, they admonish the person (or parent) and insist that he re-try it. This approach suggests that the person didn't succeed because he has a fundamental flaw: “You’re lazy!” or “You didn't really try.” But, the technique is wrong, not the person.
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Say Good-Bye to Non-ADHD Solutions
Treatment tools that work for people with ADHD are easy to acquire, but you have to commit to give up the old neurotypical techniques. It's hard work to undo habits that a person has built up over a lifetime to compensate for a nervous system that plays by different rules. Your life will change when you understand your ADHD nervous system and why the treatments you've used haven’t worked. Here's what does work.
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Find Your Cheerleader
The key to being successful and happy is having a cheerleader who unshakably believes that you are good, intelligent, and loving. The most successful people with ADHD have been loved, supported, and valued as kids by a parent, teacher, brother, or even a sports coach. A cheerleader's chief job is to distinguish between the child’s worth and his achievements.
ADHD therapy should start with understanding what ADHD is — what is possible for the person to achieve, and what is not. Parents should not hold kids with ADHD accountable for things that can’t be accomplished right now (though they may be possible later). Accountability and responsibility are good things, but only if they lead to success. It’s essential that everyone in a person’s family be part of the treatment team — knowing all about ADHD and how to be part of the solution.
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Take Meds to Level the Playing Field
The right ADHD medication at the right dosage can take the patient’s attention span, impulsivity, and motor movements to higher levels. If you've tried ADHD counseling or coaching without ADHD medication and didn't get the outcome you expected, try it again with medication. Most people with ADHD who take medication feel as if they are on a level playing field, often for the first time in their lives.
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Get Things Done with ACT
Meeting a deadline or doing something that your boss thinks is important doesn't motivate people with ADHD. ACT — Acceptance and Commitment Therapy — helps focus and motivate a person with ADHD when rewards don't. With ACT, patients reflect on what matters most to them — family, setting a record or gaining fame, faith in God — to motivate them. ACT requires a patient to ask himself the question: “Am I doing something that matters to me?”
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Fill Your ADHD Toolbox
Once you or your child are on the right medication at the right dosage, carry a pen and small pad with you and make an inventory of things you do right — a list of what has worked and has gotten you this far. Think about those times when you’re in the “zone,” when you’re engaged, productive, and energized. When did it happen? What took you out of the zone and what got you back in it? After a month, you’ll have 20 or so techniques that you know will work for you when you procrastinate.
Individuals with ADHD have to create interest where none exists to access their abilities. Example: A medical student with ADHD was flunking gross anatomy. His ADHD coach had him imagine he was the ER doctor treating President Kennedy — the student’s idol and his inspiration for going to med school — after he was shot. He had to know anatomy to save Kennedy’s life. With this imagined urgency, the student mastered anatomy and graduated second in his class.
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Change the Format
Individuals with ADHD often find it hard to demonstrate what they know to someone else. So they need to look for novel ways to showcase their talent. Example: A young man with ADHD struggled with writing assignments in English class. He was bored by the books he was assigned to read. He talked with his teacher and, instead of writing book reports, he persuaded the teacher to let him write parodies of the books. He zipped through assignments and received the top prize in English.
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Grab the Reins at School
Adults and kids with ADHD want someone else to make things interesting, but we often have to do it ourselves. Example: In school, if there are five English courses to choose from, find out which instructor is bright and engaging. Sit in on classes and ask students for their opinion. Take the course that engages you the most. To make sure that your child gets in the course, write an accommodation into his IEP that allows him to register ahead of his classmates.
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Create Competition to Avoid Boredom
People with ADHD are able to master new jobs and activities quickly, only to lose interest in the things they just mastered. Challenge and competitiveness can help. Trying to beat a personal best or a rival, or imagining the task as a video game in which you have to get to the next level, holds the interest of many individuals with ADHD.
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Find a Nudge to Stay on Task
Body-doubling is a technique used by tutors, but it can also help individuals with ADHD at work. Example: An attorney with ADHD was tired of always meeting deadlines at the 11th hour. He cleared his desk of distractions, and got his assistant to bring him one case at a time. They discussed what he needed to do and she checked up on him. At a set time, she took away the original file and body-doubled him into the next task.
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Stack the Deck in Your Favor
ADHD treatment is at high risk to fail unless a trusted significant other is involved — and stays involved — from the beginning. For at least the first year, the motivation for treatment and the ability to see the benefits will reside primarily in someone other than the patient.