Change How You Think (About ADHD Therapy)

An ADHD-friendly form of cognitive behavioral therapy promises to help ADD adults and children better manage their symptoms. Could it help you?

brain-memory

People with ADHD spend a lot of time putting out fires, instead of thinking ahead to prevent those fires.

Dr. Mary Solanto, Ph.D.
   
 

DIY Therapy

Some ADDers put off doing tasks they are convinced they cannot do — often because of past experience. If you've failed at something many times before, you may be reluctant to try it again.

"Ask yourself what you are assuming will happen if you try," says J. Russell Ramsay, Ph.D., assistant professor of psychology at the University of Pennsylvania. "Is there another way this could possibly turn out? If a friend had ADHD, how would you advise and encourage him? Why assume that the same thing wouldn’t work for you?"

Another way to beat procrastination is to cut tasks into pieces. "Keep reducing the piece of the task until you can say, ‘I can do this easily,’" says Mary Solanto, Ph.D., of the Mount Sinai School of Medicine. "Once you get started, you may be buoyed by the results and continue spontaneously."

 
   

Josh, a 35-year-old journalist, struggled with undiagnosed ADHD for most of his life. He had trouble managing personal commitments and organizing his time at school. "I was hopeless," he said. "My education, employment, and finances were in jeopardy."

Early last year, however, Josh discovered that he had inattentive-type ADHD and began to take stimulant medication to control his symptoms. A few months later, he also began a new style of cognitive behavioral therapy (CBT), which was developed for those with ADHD.

Originally used to help people cope with anxiety and depression, CBT aims to change irrational thought patterns that get in the way of staying on task or getting things done. For an ADDer who thinks "This has to be perfect or it's no good" or "I never do anything right," CBT challenges the truth of those cognitions.

The ADHD-specific version of CBT also tries to change people's thoughts. It does this by instilling practical strategies and instruction to solve three of the most common ADHD problems: time management, organization, and planning.

In the program that Josh entered, which was created by Dr. Mary Solanto, Ph.D., associate professor of psychiatry at the Mt. Sinai School of Medicine, adults with ADHD learn in small group settings. The first half of each two-hour session begins with a review of the home exercise that was assigned at the end of the previous session. Here, individuals share the difficulties and successes they had with the task, and with other challenges they may be having. For many participants, this is the most important part of the class. "The knowledge that I am not going through this alone allowed me to be a little easier on myself," says Brian, a 46-year-old publicist, who completed Solanto's CBT course last summer.

During the rest of the session, the group's mediator leads participants through a discussion of ADHD-related problems, followed by exercises to teach them how to set up a schedule and keep track of time.

Some of the in-session exercises are based on simple ideas: "Many people with ADHD don’t wear a watch," says Solanto. However, remembering to wear a watch, placing clocks all over the house, and keeping a detailed log of the day helps a lot with time management. How does someone with ADHD remember to do all that? Simple mantras ("If it’s not in the planner, it doesn’t exist") are basic forms of CBT. They serve as reminders to change one’s thought patterns.

"We teach them that, if they are having trouble getting started on a project, the first step is too big," says Solanto. A year later, this mantra has stuck with Brian. "‘I’ll never get this done’ can paralyze you," he says. "Now I don’t get overwhelmed."

Next: Evidence for CBT and ADHD

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