The Role of Therapy for ADHD and other Disorders

Does therapy work for these children? Big question!

Choosing the treatment of therapy for ADHD and/or other mental health disorders can be a tricky decision.

Children with ADHD, bipolar or whatever CANNOT control their behavior just because we teach them how to calm down, or do relaxation techniques, or let them vent to us or whatever. My own son is a perfect example of this. In a calm and rational moment he can tell you from here to Sunday about what he "should have done" in a situation. But on his own, without his medicine, he can't control much of anything.

So if therapy for ADHD isn't a given solution, what are the therapists, counselors, social workers for you might ask? SUPPORT! I think the single most important job of a mental health professional when dealing with a family who is struggling to raise their difficult child is to listen to the parent(s).

And NO - I do not mean tell them (us) how to parent. I included "us" because this includes me. Since we first started exploring help for our son at the age of 4 I have had more than one therapist type person try to tell me how to "control" or "parent" him. Reward programs, behavior charts, limit setting, blah, blah, blah.

Guess what people? I have a perfectly normal, developmentally appropriate, well mannered second child (currently age 9) as well. So I must not totally suck as a parent, huh?!

So here is what you do...Go into a therapy or a counseling situation with a very specific goal. Or maybe a couple of them. Here are some obvious ones:

• Put your child in therapy to work specifically on the self esteem issues that plague so many of these youngsters
• Put your child in therapy to practice techniques for calming down and controlling their behavior. But understand that they may never be in the state of mind to actually use these techniques when the opportune moment arises.
• Put yourself and/or anyone else in the family in therapy solely for the purpose of being able to vent

I especially like that last one. How often do you vent, unload, complain, etc. to your family, friends, coworkers? Even if they are the most gracious people on the planet, listening can get hard after awhile. And truly, unless they know your child intimately or have one of these that belongs to them, they don't really get it.

Face it, raising a child with any kind of disorder or disability can be REALLY STRESSFUL. Especially for the primary caregiver because there is always one parent who is home more than another.

We have to let it out! And you absolutely should not feel ashamed in doing so. However, if you think that you alone, or you the parental couple, will be the primary client(s) of the therapist, BE VERY CLEAR ABOUT YOUR EXPECTATIONS. Walk in there saying, "I'm not really looking for parenting advice or specific strategies. I just need to vent. I need to let it all out so that I can go home for another day and be a good parent."

I think as therapists and treatment providers we forget how easy it is to offer suggestions, tips, helpful ideas, and in the process so easily make parents feel like we think they are doing a crappy job.

You are not doing a crappy job!!

Okay, so my comment above about children can't control themselves. I want to clarify that.

No child with any disorder that affects their coping, problem solving, anger management, focusing, etc. will be able to make any significant improvement in their daily life through counseling alone. These kids don't have the self control and ego strength to get it right all the time. Developmentally they aren't ready to "white knuckle it" and make rational, controlled choices on a consistent basis.

I am sure many of you have heard the comparison between diabetes and ADHD? Diabetes is a proven medical condition that most often requires medicine intervention. You would not deny a diabetic child their insulin, right? ADHD, bipolar and depression are also proven medical conditions that must be managed medically.

Over-diagnosed? Possibly. If you can't stomach the idea of medication, then visit my page about alternative therapy and treatments. There are other "medical" options that might seem less scary to you and are worth a try.

My point is this : Therapy for ADHD, all by itself, is not enough for these kids.

That said, here are some things to look for if you want a therapist type person to help you out:

• Must have a minimum of a Masters degree and if they are in private practice they should be licensed by something resembling the Board of Behavioral Health in your state
• They should specialize in children and adolescents. And if you are seeing them just for yourself then they should specialize in families at a minimum but absolutely not only in adults
• Depending on the age of your child, they should be skilled in play therapy
• Whether they are male or female depends solely on you and your child. You pick.
• You should ask them how they work. By this I mean that if you want your child to have contact with the therapist as the primary client, ask them if they do that. I have met so many therapists who only want to deal with the parent by handing out parenting advice. How can anyone help you parent your kid if they haven't even met your kid?
• And most importantly you should feel comfortable with them. If at any point you find yourself being uncomfortable, not wanting to talk, or feeling judged, find a new therapist.

And lastly, if what you really want is for your child to practice some structured socialization, work on some coping skills, and simply have a little extra support, check out their school. If their school is lucky enough to have a social worker or counselor, they might very well facilitate social skills/support groups that fit that bill perfectly.

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