therapy/counseling | ADHD Information

Hi folks,

Been a while since I posted, but thought that my experience on this one might be helpful.  We use a therapist who is an expert in ADD/ADHD children.  The therapy sessions are more family oriented than child focus.  We've learned coping skills, scripts to queue behavior modifications, and are advised when med modifications; no he doesn't recommend changes, but partners with a pharmocologist when he thinks behavior changes need chemical support.  More important, he is often a mediator between parents and child when a behavior issue is not acknowledged or ownership claimed.  I guess what I'm trying to say is,  find a therapist who wants parents and child in the room at the same time (and sometimes even siblings) to work together on solutions. 

Paul

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That's all excellent advice!

I recommend thinking ahead of time what your child's key issues are, and then ask each potential therapist what kind of approach they would use for those issues.  Also ask their experience working with similar issues and with kids your child's age.  I'd also ask their theoretical orientation (they'll likely say cognitive-behavioral, eclectic, family systems, or something else.  Feel free to ask them to elaborate on any terms you don't know).  If you think that you might want the therapist to work with the school, ask if the person will do that.  When I was looking into therapists, I got a good feel for how accustomed therapists are to working with schools  -- everything from "Yeah, I guess I could do that" to "Sure, I do that all of the time.  I have lots of phone meetings with teachers to help them develop strategies and to hear their perspective on how the child is doing."  If you would want the person to come with you to school meetings, ask if they do that.  Also make sure you ask their availability.  It's useless to find the perfect therapist if you can't get there for any of their available times.  You also should ask their credentials.  Psychologists have a lot more training than social workers (that's not to say that a social worker can't be a good therapist).  Another good question is how the therapist handles discussing matters with parents.  Personally, I prefer to discuss things over the phone instead of making my child sit in a waiting room while I talk to the therapist.  This makes him feel uncomfortable and wastes his appointment time. 

As for your questions about what to tell your dd, I would discuss that with the therapist you select.  My ds just started therapy to help his anxiety and to help curb some impulsivity, mainly around telling others what to do.  We discussed with the therapist what to tell him about why he's coming.  Since the therapist is working on the anxiety first, we told him that she'll help him be less afraid of things.  Obviously this idea appeals to him.

That's all I can think of!

Mom2ADHDboy39238.8353356481

Hi

   The only therapy my daughter (age 12) has done has been social skills groups. We are finally proceeding to some further counseling/therapy, hopefully behavioral therapy. Can anyone give me some input? What to expect? What I can tell her to expect. She has terrible anxiety and it will be easier for her if I can talk to her about it before we go. The anxiety is one of the reasons I want her to go. I am hoping they'll give her some tools to cope with her disorganiztion, distractability and anxiety. I am sorting through the list of covered therapists in our area then will get a referral from our psychiatrist.

Depending on what is recommended is what your daughter can expect.

I suggest you ask all the questions you need to when you get your referral--then you can pass that info along to your dd so she can be prepared for a group, individual, motivational therapy, behavioural mod,  whatever.

A good pro will always tell you what to expect. Some who have weekly groups or organized programs [say 12 weeks of whatever] can even give you an outline of the weekly program.

Good luck!


Based on your description, you need someone who does Cognitive Behavioral Therapy (CBT). You might want to google that. Many call their therapy "behavioral therapy," in that it is intended to modify the behavior-- but this is not CBT. All therapy is generally intended to modify behavior. Many therapists list ADHD as a specialty, but don't have a solid understanding of ADHD, and really don't have the skillset to help in any appreciable way. Sitting around chatting for an hour isn't going to do much. This is basically what my son has been doing for 7 months now; I am letting it continue b/c he is enjoying it -- it's fun, but that's about it. My only suggestion is that you select the therapist VERY carefully so that you do not waste your valuable time--both the CBT training and a solid understanding of ADHD are important IMHO. I would not be shy about basically interviewing each potential therapist over the phone in depth. Otherwise you could easily be sitting where I am. NoTellin39238.3761805556Thanks No Tellin. I got a list of 50 people to send to her psychiatrist for recommendation. Once he sends me back his recommendation I will go from there. I will read up on CBT.I would think therapy would help w/the anxiety and self-esteem....I bumped the biofeedback thread for you on the alternatives board.

thanks notellin. I am going to look at it some more. I called my insurance company and they said ity all depends on how she bills it. If she bills it as biofeedback, they wont pay. If she bills as individual therapy we'd be all set.

I agree about the anxiety self esteem. I spoke to the other social worker today and she doesnt do CBT or biofeedback, but I really liked her. She "got it", what I was saying and seemd to really understand. The psychologist was all about what she can do. Which is great that's why I called, but I seemed more leaning to the others personality. I am going to see what out pschiatrist says.

Like with meds, I need a magic ball telling me which decision to make!

If I was offered biofeedback under my insurance plan, I'd do it. On the alternatives board, run a search for username "gettingclear." If insurance pays, then the only thing you are risking is your time.

My son does not have self-esteem or confidence issues, and he still has attention issues, so I'm not sure that improving self esteem will improve attention. I will tell my son to go brush his teeth and wash his hair, etc. The "morning routine" list is located in the bathroom. Some mornings I'll check on him 5 min later, and he'll be staring off into space, playing with his toothbrush, or making faces in the mirror. Sometimes this is a step by minute step morning -- put toothpaste on the brush, pick the brush up, put the brush in your mouth, begin brushing your teeth. Every time I am astounded that I have to do this. Other mornings he'll be doing the whole morning routine solo. I think to myself "ok, the neurons just aren't firing this morning" -- and it seems to help (me).

NoTellin39251.6360185185

oh boy! Ok, so maybe the nice therapist wit the therapy dog just sounds good, but wont help us much.

I see how parents can just baby their kids. It would be so much easier if I just did it all for her, and she wouldnt even care .

I'm going to try to search the alternatives borad. Very time I search for something it times out. Hard to sort through it all. I'd like to read the threads about crawling too.

There is also an interesting thread about serine (spelling?) it's an amino acid that some have tried and say they are getting good results. I haven't tried for my dd because they recommend being off the stimulants (I'd need to be medicated to prepare for that!) when trying it. and I was also a little leary because from what little I understood in what I tried reading on my own, the origianl research was done on serine from bovine (cow) brains sources (I know- mad cow!) but of course they found another source. I can't remember the source but seemed safer although this source hasn't been researched.  I actually have some PS in my cabinet! My daughter takes a tricylcic antidepressant which I cannot just stop. We are mid dose adjustment and you have to give a new dose 2 full weeks. So I will try the PS this weekend or early next week if we are not looking better. So far, not so good.

DIaneV wrote The psychiatrist says this behavior is her way of trying to gain some control since everything in her head is always so out of control. This makes sense, but life just really doesnt work like this.

I couldn't agree more to both statements! I have found setting the kitchen timer helps (ie you need to be down here in ____ minutes" to eat breakfaast SOMETIMES helps to get her going in the morning. I als have written out schedules, and made several copies  It makes my dd focus/motivate a bit more.  

Let's hope the therapist has some good ideas as well as they come out with a new ADHD med without all of the side effects!

 

I'm asking for the world I guess! New ADHD med AND tactics until we get there. We use kitchen timer for EVERYTHING! Gets her upsatirs, but not necessarily getting tasks completed. And apper schedules, perfect doodle for, She spends more time writing her chk marks and stars than actually doing the task, we're better off without it.

I have read that meditation and relaxation techniques help with anxiety. I really do not think that therapy is going to help with attention issues, unless the anxiety is causing some of the attention problems. But usually, anxiety is just a secondary condition to the ADHD.

Is your insurance going to cover the services that the psychologist is talking about, including the biofeedback? If so, you might want to search the alternatives board on biofeedback or neuorfeedback. There are actual studies showing that this particular treatment is promising -- more promising than other alternatives. But is is very costly.

The girls social skills group sounds good to me. I enrolled my son in one, but at the same time there was a parent managment group. I really think this is what you need!! I got so many great ideas on how to manage an ADHD child, and I think this could help with the uncooperative behavior (which is very common).

BTW, just handing her marbles to drop into a jar may work better than drawing stars or checks.

I know. I am going to implement the marble system in September for school work. This summer without the stress of school I will work on the self grooming skills one at a time (again) until she gets it.

My insurance says she is under 18 and eligible for unlimited therapy with just a copay. But I am not sure how specific that is. Maybe it's worth checking into. I just get leery of people who tell me they can fix it all.

I am a little bit thinking we really just need to boost her self confidence and self esteem and some of the behaviors will fall into place. It's not really like she is intentionally trying to be uncooperative. I really think she wants to do the right thing, but doesnt know how.

The girsl group is my priority. She is in one at school which is great, but its the same kids in it since she was in 2nd grade. Some of her "stuff" she does they've just learned to accept because she is who she is . Which is great, but I'd like to see her with some new kids and learning from them and how to socailize with the general population and new kids. We are a small town and there are only 125 sixth gradres, they all know each other.

OK, I'm back needing a little more advice. I've talk to a few people off my list. Of course the woman I like the best isn't accepting new patients, isn't that always the way. There are a 2 others I am thinking about.

One is a psychologist who sounds like she does it all, except group therapy which I'd kind of like. Anyway she says she does CBT, then for ADHD she does meditation, hypnosis, relaxation training for anxiety. She uses biofeedback and decides on meds or chiropractor. Not sure how I feel about all this. I like our psychopharmocolgist who manages her meds and dont want to get into a control thing where we are stuck in the middle. Also dont know what to think about the hypnosis for attentional issues????

 

Next one sounds like right up my daughters ally. She is a social worker, works with kids and is supposedly very nice. The girls love her, she even has a therapy dog . My daughter loves animals. She is from a big practice and there is another person within the practice that has a girls group. I am waiting to find out if it specific for social skills, which is what I'd like. So anyway I still have to talk to her to find out what her methods are relating to ADHD and anxiety. I guess my question is sort of how much are they really going to help her attentional issues? We dont have the anger/aggression problems a lot of people have to deal with. We have other things, like poor social skills, poor self esteem. Lack of motivation (for anything), but she is not depressed. Another thing is her constantly disagreeing with everyone. For example when she has a horseback riding lesson, the intructor will say OK go around the ring this way, she'll say, I want to go this way first. I might say, ok go take your shower then put your stuff away, she'll say I'm going to put my stuff away first then take my shower. If I say take a shower she'll say I am taking a bath. I get it about offering her the choice, but about every single thing, every time I open my mouth? Or she'll say out loud to no one in particular I am taking a Kool-aid and twinkie for my school snack, KNOWING I'll say no your not, take water and an apple. (she hasnt figured out yet to just take the stuff without saying it and I wouldnt probably even realize). So I cant tell if it's a challenge or she wants to try to get away with it?? I dont know but she does it CONSTANTLY all day every day about everything with everyone. Says I am doing "whatever" and knowing it is not what that person would want her to be doing. Another thing I'd like to see help with and not sure if anyone can help this. She puts no effort into anything. She brushes her teeth for 2 secods, unless I'm standing there. She brushes her hair she just barely pulls the brush through it. Making her bed, throws the blankets up and pays no attention to what she is doing. Again it's not that she's depressed, she just doesnt put effort in. She doesnt have anything that she LOVES enough for a motivator.

The woman I liked who recommended the social worker above, her advice was that I cant do it all (which is how I feel) between school and all the things at home she doesnt put effort into that I have to literally step by step her every move, she must be sick of listening to me! I'm sick of listening to me. But what do I do? When I asked, she said, sometimes these kids could just use a friend. so maybe this is a better fit for us. I'd like to think if her self esteem goes up, her effort will get better.

I don't know .

Anyway, I'm rambling, any thoughts?

Diane V39251.1280324074

DianeV - i don't know what to tell you, other than I feel for you! I think i recall you saying your dd can't tolerate stimulants? My dd is like that off of her meds (Concerta) - it is a chore to get her to do anything. I ask her to put her clothes away - she starts rolling around on the floor. I ask her to brush her teeth and she starts wimpering like she just doess't have the energy to lift the toothbrush. At bathtime, its not fair if she is first in the tub, its not fair if she is last in the tub. If I ignore her bad behavior she says I do not love her if I get mad at her she says I do not love her - her little sis has more air to breath and therefor I must love her more.....On the meds, she is a different child. She is still pretty thin skinned and so feelings are easily hurt, but at least she snaps out of it more quickly and it is not a constant battle like it is when she is off meds.

I am so tired of the evening/morning battles we have now added Starterra to see if that helps. We started about 4 wks ago and I just upped the dose this weekend. So far, we have not seen much change. A few nights a week, I have a short acting ritalin that i give to her about 6 pm. She burns through it in a little of 2 hours. so I get her to bed by 8:30 pm and she can read in beduntil she falls asleep. It is such a relief to not deal with the mouth - we have also found the next morning she is easier to deal with until the morning.

All this to say - I am so desperate to not deal with that behavior for a couple of hours, I d no not see how you can deal with it all the time! I do feel for you!

No you are correct, she cannot tolerate stimulants. You know thinking back she isn't as bad about all this stuff on stimulants. WE were never really probably at the highest dose for complete symptom relief either becasue the side effects were always too bad. It's difficult too because like I say to the outsider, she is sweet and easy going (and in a lot of ways she is), and with the comments it's not done maliciously or even really argumentatively, it's just every single thing every single second of every single day. I wouldnt care if she got the tasks completed in her own way, but she doesn't. Today she went to school, hair looks messy, I already remidned twice about the brushing, wanted to wear crocs after complaining how much her back hurt, so I had to override that to sneakers. Did not put on a bra (new thing she "forgets" every day, but at close to 13 needs). Then walking out the door I saw a huge hole in her pantyhose and run all the way up the back of her leg. So again, it is never smooth. I cant imagine how this child will ever take care of herself.

The psychiatrist says this behavior is her way of trying to gain some control since everything in her head is always so out of control. This makes sense, but life just really doesnt work like this. She overcomplicates EVERYTHING. She cant just go get a drink of juice in the morning, she has to mix cranberry and orange in a fancy cup with a cool straw. This is after 30 minutes spent doing who knows what while dressing and 10 minutes to make the bus.

Her and her friends wanted to do a school trip last wek to an amusement park. GREAT! Love to see her doing school activiites, but they wanted a parent to go and drive them becasue they didnt want to take the bus and what if they wanted to leave earlier..............it's ALWAYS something, even with fun stuff!