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Behavior Therapy and ADHD

Posted by on Sep. 7, 2016 at 3:00 AM
  • 15 Replies

BY: THE UNDERSTOOD TEAM   (www.understood.org)

 

At a Glance

  • Behavior therapy focuses on replacing negative habits and actions with positive ones.
  • Parents use a rewards system that targets very specific behaviors.
  • Part of the therapy is teaching parents how to change their behavior, too.

If your child has ADHD, you might be looking into treatment options. One non-medication approach that can be helpful for some kids is behavior therapy. The goal of behavior therapy is to replace a child's negative actions and habits with positive ones. And parents are the ones who lead the process.

Learn more about behavior therapy and how it can help kids with ADHD.

How Behavior Therapy Works

When some people hear the term therapy, they may think of clients sitting with a therapist to talk about emotions and work through problems. Behavior therapy is very different from this, however. It focuses on a person's actions, not on thoughts and emotions.

Therapists-typically clinical psychologists-work with clients to create a plan to help change behavior. The plan is designed to replace negative habits and actions with positive ones.

Behavior therapy for kids is as much about changing the parents' behavior as the child's. Parents can get into the habit of nagging and yelling, which can reinforce their child's negative actions. A big piece of behavior therapy is coaching parents on how to replace their negative actions with positive ones, too.

What to Expect From Behavior Therapy

So what can you expect from behavior therapy? It starts with you, your child and the therapist having a meeting.

Together, you'll talk about the behaviors that are most challenging at school or at home. Those might be things like talking out of turn, not finishing homework, or having angry outbursts.

The therapist will help you come up with a plan for you and your child to follow that addresses the most troublesome behaviors. The plans are based on a system of rewards and consequences. (That's why it's important for your child to be there. You'll need his help to come up with rewards that are really motivating!)

Next, you'll create a chart listing the specific actions your child needs to take. These should be clear, concrete and measurable, so your child knows exactly what the expectations are.

The chart can use pictures or words-or both. It should be posted at home where he can easily see and use it. When your child does what he's supposed to do, you'll check it off. And he'll earn points toward a reward.

Once you start using the chart, you'll meet with the psychologist on a weekly basis-without your child. The purpose of those sessions is to talk about how things are going, troubleshoot problems, and adjust the plan as needed. In essence, the therapist will be training you to be the "therapist" at home. Once a month, your child will join you at those sessions.

How Behavior Therapy Can Help Kids With ADHD

Behavior therapy can be helpful for lots of kids, and for adults, too. But it can be especially helpful for kids with ADHD. Kids with ADHD can struggle with self-control and anger, which can lead to problem behaviors. It's also not uncommon for kids with ADHD to lie frequently about everyday tasks like chores.

Behavior therapy takes a very businesslike approach to helping kids with ADHD change how they act and respond to situations. One of the goals is to eliminate arguing at home and give kids the motivation to change without parents being so involved.

The point of behavior therapy is to replace negative behaviors with positive ones. So the system of rewards and consequences is very specific. But whatever the reward is, it's always coupled with praise to reinforce good behavior. (It's important that your child's teacher be aware of this plan, so she can reinforce the behavior at school, too.)

Let's say one of the behaviors you want to change is putting off starting homework. On his chart, you'll put the desired behavior: "Start my homework when I'm supposed to."

You'll also decide on a reward. It might be: "For every five times I start on time, I'll get an extra hour of screen time." So each time he does his homework with only one cue from you, you'll mark it off and he'll earn points.

Equally important is the verbal recognition and praise he'll get from you. For instance, you might say, "You did a great job remembering to raise your hand in class. I'm really pleased with how hard you're trying."

If he doesn't remember to raise his hand, he simply doesn't get a point. But he doesn't get in trouble either, or lose any points. The point is to reward positive behavior and ignore negative behavior.

If this approach isn't successful, however, you might need to switch to negative consequences like losing points. And if the negative behavior you're trying to change is aggression, you might have to use negative consequences in that situation, too.

Sometimes therapy targets in-school behavior. In those cases, teachers have to be part of the process. You'll need to get your child's teacher to agree to help enforce the behavior plan. You'll also need to make sure the plan is simple enough that it won't eat up too much of the teacher's time and attention.

It's important to know that therapy isn't always enough to help with ADHD symptoms. If your child is still struggling, talk to his doctor. Together you can discuss whether to consider ADHD medication in addition to or instead of behavior therapy. You may also want to read about different professionals who help kids with ADHD.

Key Takeaways

  • Along with giving rewards, parents need to give recognition and praise when their child behaves the way he's supposed to.
  • When rewards don't work, negative consequences like losing points may be necessary.
  • If behavior therapy isn't enough to help with symptoms, consider talking to your child's doctor about ADHD medication.

 

by on Sep. 7, 2016 at 3:00 AM
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Replies (1-10):
maxswolfsuit
by Max on Sep. 7, 2016 at 6:32 AM

Thank you for posting this. 

It's frustrating working with so many parents who think medication is the only treatment for ADHD. Even when parents choose to medicate the medication doesn't fix everything. Kids with ADHD still need to be taught limits and how to use self control.

Khooks
by Jessica on Sep. 7, 2016 at 7:15 AM
Therapy is always a good tool, if you find the right therapist.
EarlGrayHot
by on Sep. 7, 2016 at 9:26 AM

I would use every tool possible including meds to make progress.  I also think too many parents refuse to consider meds as an option and that is a mistake.

maureen813
by Member on Sep. 7, 2016 at 9:29 AM

I am a therapist. I treat children and adolescents within a large community based mental health clinic and have also worked in various settings including schools and homes. A large majority of the children I treat carry this diagnosis and some are on a stimulant medication, some are not but all will benefit from developing tools and strategies to manage their symptoms.

Northern.Maple
by on Sep. 7, 2016 at 9:36 AM

This what my family needs. I say family because my dd who is expected to have ADHD and is going through the diagnosis aspect right now. I keep telling my dh (dds stepdad) that we need to change out behaviour in order to help her with her own. He is so old school and on the whole "do as I say not as I do thing" which to a certain extent is fine, but dd needs help with handling her frustration and how it brings out her anger which leads her to misbehave and then that is it, listening at this point is beyond understanding for her. 

Once we get our actual diagnosis the Pedi will point us to all the options out there. I am ADD.

Ritata
by Bronze Member on Sep. 7, 2016 at 10:26 AM

My daughter was not very receptive to behavior modification until she was on medication.  I felt so bad for her because she WANTED to "be good" so badly but she was very impulsive and would feel bad for her outbursts and misbehavior.  The medication has helped a lot and I was very reluctant to put her on meds but we had a good therapist that showed us that there were roadblocks and the meds could help those to disappear.  So we were able to work with her and we had great results. Her behaviors and focus have improved so much, she's much happier. We all are.  Her 2nd grade teacher was a great communicator, she was a very calm and soothing presence and she let the kids have a minute to compose themselves if they became upset and then it was back to work.  So having all these great resources have helped my little girl so much. 

coala
by on Sep. 7, 2016 at 10:39 AM

I've never heard this called Behavior Therapy.  Our ped calls is Behavior Modification.

I have an ADHD child and we have ONLY used behavior modification.  Our ped has asked us for the last 4 years if we were ready for an evaluation.  I keep letting her know that I will contact her when we are ready.  She understands why we aren't ready yet.  WE can implement any form of behavior modification that we need because she is homeschooled.  There are battles that dad has had to let up on because he was seeing the need to force her to stay in her chair while working or reading.  In reality she can lay on the floor and roll around while reading a book and we get better results.  You just have to know which battles you are willing to fight and which one's aren't really that big in the grand scheme of things.

MPH_2010
by Member on Sep. 7, 2016 at 1:27 PM

I love that there are others ways besides pushing meds. Around here it is pushed on a child even as young as 3 and it makes me sick. If Meds are an only option so be it but to,make it the first or only option is horrible to me!

MixedCooke
by Bronze Member on Sep. 7, 2016 at 1:36 PM
Is there a definitive tool that can even diagnose ADHD? There seems to be mainly questionnaires from the parent and teachers.

Quoting maureen813:

I am a therapist. I treat children and adolescents within a large community based mental health clinic and have also worked in various settings including schools and homes. A large majority of the children I treat carry this diagnosis and some are on a stimulant medication, some are not but all will benefit from developing tools and strategies to manage their symptoms.

MixedCooke
by Bronze Member on Sep. 7, 2016 at 1:41 PM
So many miss a diagnosis in girls so what drove you to get her tested and what tests/evaluations did they do to say that yeah she had it? Is there anyone else in the family?

Quoting Ritata:

My daughter was not very receptive to behavior modification until she was on medication.  I felt so bad for her because she WANTED to "be good" so badly but she was very impulsive and would feel bad for her outbursts and misbehavior.  The medication has helped a lot and I was very reluctant to put her on meds but we had a good therapist that showed us that there were roadblocks and the meds could help those to disappear.  So we were able to work with her and we had great results. Her behaviors and focus have improved so much, she's much happier. We all are.  Her 2nd grade teacher was a great communicator, she was a very calm and soothing presence and she let the kids have a minute to compose themselves if they became upset and then it was back to work.  So having all these great resources have helped my little girl so much. 

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