Attention deficit hyperactivity disorder, also known as ADHD, is commonly diagnosed in children. Symptoms include difficulty sustaining attention and hyperactive and impulsive behavior. Children with ADHD often participate in some form of psychotherapy to help manage their symptoms. This may include behavioral therapy, social skills training, direct contingency management or treatment in combination with medication. Parents may also take part in skills training to help in working with their children.
Behavioral Therapy
As described by the National Institute of Mental Health, behavioral therapy strives to alter a child's behavior by reinforcing positive behavior and teaching the child to supervise his own actions. Therapists can help children to organize tasks, provide structure in their environment, and give understandable instructions. The goal of behavioral therapy is to modify behavior in such a way that children with ADHD learn how to control their own actions.
Social Skills Training
Social skills training can be an important component of ADHD psychotherapy. According to the National Institute for Mental Health, therapists explain a particular social skill to children, such as sharing with others or raising their hand, and demonstrate how to engage in it appropriately.As described by Robert Weis in "Introduction to Child and Adolescent Psychology," social skills training may include role-playing of behaviors as well. For example, a therapist might demonstrate how to raise a hand in class by explaining the behavior, why and in what context it occurs and then modeling it. The therapist would then ask the child, or children in a group setting, to role-play a scenario where it was appropriate and be given feedback.
Parent Skills Training
Therapists often work with parents to learn how to work with children with ADHD. The National Institute of Mental Health states that therapists may teach parents how to reward good behavior, punish negative behavior and use time-out to control a situation. Parents are also taught how best to help their children, by breaking down tasks into smaller pieces, structuring their environment so they do not become overstimulated, and engaging in positive joint activities with their child. It is critical to give consistent feedback, keep the child's schedule structured and organized and to commend them for doing well.
Direct Contingency Management
As described by Weis, direct contingency management is a form of therapy that can be used in schools to shape behavior. Therapists manipulate the environment in order to reward positive behavior and punish negative behavior. These therapists provide clear instructions to children and reward them immediately when they behave appropriately. Rewards may include a token or point system, high fives, or stickers. Weis reported that this therapy may also include social skills and parent training as well as managing medication. This therapy has been shown to improve behavior and self-esteem in children with ADHD; however, children may not generalize what they learn to other settings.
Combination Treatment
The Multimodal Treatment of Children with ADHD (MTA) Study found that children who received behavioral therapy with medication as well as those who received only medication saw significant improvements in their symptoms. These improvements were greater than those children who only received behavioral therapy. The National Institute of Mental Health suggests that the addition of therapy to medication can help to manage ADHD symptoms. It is suggested that using psychotherapy in conjunction with medication can provide the best outcomes for children with ADHD.
References
- Introduction to Abnormal Child and Adolescent Psychology; Robert Weis; 2008
- National Institute of Mental Health: ADHD Psychotherapy
