A growing number of our youth in school are being identified as having attention-deficit / hyperactivity disorder or similar diagnosis. Students displaying the following behavioral patterns may be diagnosed as having this disorder: a pattern of restlessness and hyperactivity leading to attention deficit or a learning disability;
inability to focus attention long enough to learn appropriately; often fidgets with hands or squirms in seat;
often leaves seat in situations where sitting is required;
moves about excessively in situations in which it is inappropriate;
unable to exclude extraneous stimulation;
blurts out answers before the questions have been completed;
has difficulty waiting in lines or waiting his or her turn;
often intrudes or talks excessively;
acts too quickly on feelings without thought or deliberation;
low self-esteem and poor social skills that lead to alienation from peers.
PROBLEM AREAS Problem areas addressed may include: Attention -Deficit-Hyperactivity Disorder, Combined Type: Attention-Deficit/Hyperactivity Disorder Predominantly Hyperactivity-Impulsive Type; Attention-Deficit/Hyperactivity Disorder NOS; Conduct Disorder; Oppositional Defiant Disorder; Disruptive Behavior Disorder NOS; Alcohol-Induced Mood Disorder; Substance-Induced Mood Disorder; Adjustment Disorder With Mixed Disturbance of Emotions and Conduct; and Impulse-Control Disorder NOS. Antisocial Personality Disorder; Borderline Personality Disorder.
LONG TERM GOALS Some typical long-term goals may include: to maintain a program of recovery from substance abuse and reduce the negative effects of Attention-Deficit- Hyperactivity Disorder (ADHD) on learning, social interaction, and self-esteem; to develop the coping skills necessary to improve ADHD and eliminate substance abuse; to understand the relationship between ADHD symptoms and substance abuse; to develop the skills necessary to bring ADHD symptoms under control, normal learning can take place; to create an environment relatively free of extraneous stimulation so the client / student can concentrate; and to decrease impulsivity by learning how to stop, think, and plan before acting.
SHORT TERM GOALS Typical short-term goals may include: Complete psychological testing to confirm the diagnosis of ADHD;
Complete psychological testing to rule out emotional factors as the basis for maladaptive behavior or Complete psychological testing to rule out learning disabilities as the basis for maladaptive behavior;
Monitor symptoms of ADHD on a daily basis and rate the severity of symptoms each day on a scale of 1 to 10;
and Verbalize the Powerlessness and Unmanagability that resulted from treating ADHD symptoms with and without substance abuse.
CLINICAL INTERVENTION Clinically therapeutic interventions may include:
Arranging for a thorough psychological testing to confirm the presence of ADHD in the client/student;
Arranging for psychological testing to rule out emotional factors or learning disabilities as the basis for the client’s / student’s maladaptive behavior; Verbalizing the relationship between ADHD and substance abuse;
Implementing a program of recovery structured to bring ADHD and substance abuse under control; failure to learn;
Teach the client/student how to monitor ADHD symptoms and rate the severity of symptoms on a scale of 1 to 10 each day;
Using a step one exercise, help the client/student accept his/her powerlessness over and inability to manage ADHD symptoms and substance abuse;
Using a biopsychosocial approach, explain the relationship between ADHD symptoms and the use of substances to control symptoms;
Help the client /student develop a program of recovery that includes the elements necessary to bring ADHD and substance abuse under control (e.g., medication, behavior modification, Environmental controls;
Report instances when relaxation techniques reduced tension and frustration while increasing focus in a learning situation;
Give feedback to the client /student and his/her family regarding psychological testing results;
Develop and implement an exercise program that includes exercise at a training heart rate (220- age x.75 to .85) for at least 20 minutes at least 3 times weekly;
develop an aftercare program that includes regularly attending recovery group meetings, getting a sponsor and continuing the therapy necessary to bring ADHD and substance abuse under control;
Teach the client /student how to make lists and keep a calendar to remind him/her about appointments and daily obligations;
Using modeling, role playing, and behavioral rehearsal, show the client /student how to take time-out and breaks when feeling restless or irritable;
List five ways a higher power can be used to assist in recovery from ADHD and substance abuse;
Comply with a physician evaluation to determine if psychotropic intervention is warranted and take any medications as directed;
Implement remedial procedures for any learning disabilities that add to frustration;
Reduce environmental stimulation to the point that the client /student can can concentrate and new learning can take place;
Keep a list and use a calendar to remember daily appointments and obligations;
use modeling, role playing, and behavioral rehearsal, to show the client/student how to stop, think, and take breaks as needed to keep ADHD symptoms under control;
assist the client in setting up learning periods in small increments; explain how to extend periods of concentration in small increments; then teach them hew to reinforce him/ herself;
verbalize an understanding of the importance of learning explore the emotions associated with events;
train client /student to replace negative expectations and disparaging self-talk with positive self-talk in a learning situation;
review specific instances of failure to learn and the negative errors associated with the experience;
role play and model constructive alternative coping behaviors using cognitive focusing;
role play and model constructive alternative coping behaviors by making lists;
role play and model constructive alternative coping behaviors using relaxation/deep breathing;
role play and model constructive alternative coping behaviors using reduce distractions;
role play and model constructive alternative coping behaviors using shorten learning sessions;
role play and model constructive alternative coping behaviors using repeat instructions verbally;
role play and model constructive alternative coping behaviors using repeat instructions verbally;
using role playing, modeling, and behavioral rehearsal, teach social skills to control impulsivity, reduce esteem;
direct therapy sessions that focus on social skill development, getting feedback from peers for client /student socialization behavior;
reinforcement positive social interaction with peers and explore the positive self-esteem that results from the successful interactions and relaxation;
teach the client/student how to relax;; then assign the client/student to relax twice a day for 10-20 minutes;
encourage client/student to implement relaxation skills when feeling tense/frustrated by a learning situation, as a coping and focusing mechanism;
Practice taking time-outs and breaks when feeling stressed or irritable;
Above all please remember that help is available for ADD, ADHD, Attention Deficit Disorder and or Hyperactivity Disorder.