Dr. Samantha Morel August 14th, 2020
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Working with families that have a child that’s been (appropriately) diagnosed with ADHD can be such rewarding and fun work. What I find is that with a few simple strategies, we can make some big impact changes in a relatively short amount of time. Notice I said we… that’s where we start in this blog all about ADHD treatment!
Where do we start?
1) ADHD treatment is a team sport.
When we are working on children’s mental health in general, it’s a collaborative approach! The better our “team” can communicate, plan, stick together, rally one another, and connect, the better the outcome. There are few that types of players that might get drafted onto the team (therapists, teachers, medical doctors)- but rest assured, the parents are the team’s MVP’s. Parents are the most valuable players for so many obvious reasons, but mostly, because they are the expert on their own children. Parents provide a lot of guidance about what they’ve tried, how it worked, and how some of the suggestions the therapist make might work within their family structure.
When I’m working in ADHD treatment, I’m often talking to the parents just as much, if not more than, the child (depending on the child’s age). We work together on treatment goals, making plans for how to get there, outcomes of those efforts, and what needs our most immediate attention. A therapist might spend 2 to 4 hours per month with the child, a psychiatrist even less. Parents are a child’s primary support and we need them to be active in this process for big outcomes. And spoiler alert – our thorough assessment means that we already have an in-depth understanding of this team, and we can hit the ground running to put that information to good use.
2) A holistic approach is best.
What we know is that ADHD treatment works best when we approach it from a wholistic mindset. This means circling back to all of those strengths and areas for growth that we uncovered in the assessment phase! All types of behaviors ranging from diet/exercise, sleep habits, social support, environmental norms become important for meaningful change. From here, we can begin making a specific set of goals for how to improve your child’s functioning. For example, ADHD is often linked with sleep disturbances like difficulty falling asleep (kicking off a cycle of a whole host of issues). Part of a holistic approach would address the nighttime routines in the home. Things like preparing the child to settle down and transition into sleep become important. We can use strategies like:
– meditation or soft music
-quiet time connecting with siblings or parents (think about reading time or lying in bed chatting),
– and reducing screen time to get there.
I know it sounds “common sense” but these things are hard to implement into a routine. And, they feel 10-times harder without support and guidance on what changes to start with and how implement them most effectively… like perhaps when there is pushback from a child? 🙂
3) Medication with intention.
So, I don’t hope to write a controversial opinion here, but here’s the thing… the most common form of medication physicians (medical providers) use to treat ADHD fall into the category of “stimulants.” These medications work to increase certain levels of neurotransmitters in the brain (usually dopamine but also norepinephrine in some cases) leading to improved mood, better motivation, memory and more focused attention. The tricky thing is that most of us would have a noticeable improvement in mood, memory, motivation, etc. if we took stimulants. Simply seeing improvement of these things is not indicative that a stimulant is being used effectively in ADHD treatment.
We know ADHD is a neurological condition and so it’s wonderful to see people have positive results from integrating medication into treatment. Here’s the trouble- these medications do not come without some significant side effects (please consult a medical provider for more about this) and the results are often short-lived if true behavioral changes are not implemented (at the family and individual level). Sometimes, this short-lived effect creates difficulties with dependency to this medication, which is a tough battle to face down the line.
So, back to medication with intention. The intention with medication in ADHD treatment is to provide relief such that we can implement healthy and long-lasting behavioral habits…. not to solely remove symptoms. Some find a healthy balance of medication and behavioral treatment that they stay with for years. Others find relief and systems to support their functioning and choose to reduce use of medication as their needs change. Both can be totally healthy and acceptable outcomes. I just like to keep a focus on intention.
4) Great therapy.
Much of this blog so far has been focused on treatment outside of the therapy room. That’s because I do believe much of the treatment occurs outside a therapy room. That being said, therapy is often the birthplace of much of that work. So in therapy with kids, therapists use play to gain insight into how the child understands or experiences their world. We can gain a sense of things like feelings of shame, isolation, or feeling “different” than everyone else. All of these are very personal parts of ADHD treatment that we need to work on so that the child continues to develop a healthy self-image and relationships skills. Again, falling back on that great assessment that we already did, we likely already know some important places to start with each individual child.
In therapy, we talk and teach about ADHD in a developmentally appropriate way. This might look like, for example, “Ya know, your brain works a little different from other kids”. We can work to rewrite shaming messages that might contribute to the idea that something is “wrong” with them.
We work on:
– self-awareness (teaching them how to notice what’s going on inside),
– communication (teaching them how to communicate what’s going on inside),
– and coping (teaching them how to begin developing autonomy for soothing their own big emotions).
Therapy is a perfect place to learn and practice healthy coping skills such as breathing, taking breaks, distraction techniques and learning to become comfortable with their own emotions; these are wonderful benefits of therapy that can have positive effects for years to come. We make these tools fun, like games, so that kids can access when they need them. Finally, we do a lot of positive reinforcement for the hard work they are doing.
5) This is not about “if”—it’s about “how.”
Truly! ADHD treatment is not about if your child and family can thrive more fully, it’s about how. We want them to have fun when it’s time for fun, relax when it’s time to relax, etc. What we need to do is find the formula of adjustments that are helpful for your child. This will allow them to express themselves, reach their goals, engage in meaningful relationships with friends and family, and continue on in their healthy development.
I hope these series of blogs have been helpful at calming fears and concerns related to ADHD diagnosis, ADHD assessment and ADHD treatment. The reality is, many highly effective and super smart people in our society have ADHD. Just think about how much brighter our world is for their creativity, energy, spontaneity, and curiosity.
Stay well,
– Dr. M
P.S. – If you are ready to take next steps to get ADHD Treatment for your Child, Contact Me.
