What should the goals for counseling be when the patient has Attention Deficit Hyperactivity Disorder?

Every therapist will have their own opinions, but I'll give you some of my thoughts.

First, it is important to teach the child or teen with ADHD how to recognize problems and how to solve problems. There are many good problem solving techniques that young people can quickly learn, and these are great tools to teach them.

Second, it is important to teach the child or teen how to think before they act, how to be less impulsive, how to have greater self-control. Without good internal controls the natural tendency toward impulsive behaviors will cause the ADHD person many heart aches.

Third, it is important to teach the child or teen with ADHD to respect others, and other's property, as well as to respect himself and his property.

Even though the "Stop and Think" movement in ADHD treatment has lost some momentum lately, the basic strategies and techniques are still worth teaching your children. My favorite version of the technique it the "Five Step Problem Solving Strategy," and it goes something like this. . .

Teach your child this five step problem solving strategy:

1. Ask yourself, "What is the problem?" 2. Think up three possible solutions (options) to the problem. 3. Look at each option for a minute. Ask yourself, "Is this a good move or a bad move?" 4. Pick the best option/solution. 5. Try it out and see if it works.

I use Checkers in my practice to teach this formula. It is a great way to practice without it effecting anything in the "real world." I use this formula:

We have often felt sorry for those impulsive children who blurt out the first thing that comes to their mind when asked a question, especially if they are about to get into trouble. As most parents know, that first thing that comes out as the answer is usually a lie. And then the child has to spend the rest of the hour covering up the lie, that both he and his parents know is a lie. This is a classic scene of a child with ADHD getting into trouble because of his impulsivity.

As a remedy, we encourage parents to warn the child that they are about to be asked a very serious question, and that their honesty is absolutely required. And that the child is not to answer the question for 30 seconds after being asked, so that they can clearly think about what they want to answer and get it right the first time. This works.

But that is not what this article is about...

Impulsivity in ADHD

Impulsivity in ADHD is seen in two ways: (1) either doing or saying something without thinking first; or (2) not saying "no" to yourself, inhibiting yourself, when you ought to do so.

It seems that a person with impulsivity as a part of their ADHD has a normal ability to say "Go" at the neurological level, but their ability to say "No" or "Stop" comes just a fraction of a second slower. As a result, things are often done, or said, without much self-control practiced.