Addressing Adult ADHD
Dr. Dawn-Elise Snipes
AllCEUs.com Counselor Education
Podcast Hots: Counselor Toolbox, Addiction Counselor Exam Review, Happiness Isn’t Brain Surgery
Objectives
~ Identify current points to remember about ADHD
~ Learn how to help motivate a person with ADHD
~ Identify ways to get someone with ADHD started even without motivation
~ Review treatment goals for clients
~ Identify interventions that can help people reach treatment goals
~ Explore an activity to help clients develop their action plan.
Note
~ While boys are diagnosed with ADD three times more often than girls, this is likely because, in girls, the disorder typically presents as the “inattentive” or “dreamy” type (staring out windows or drifting off midconversation), as opposed to the “hyperactive” type.
~ Giftedness and ADHD often co-occur
~ The brains of people who are gifted operate faster than non-gifted leading to
~ Interrupting
~ Movement
Things to Remember
~ ADHD is not a character flaw
~ ADHD recovery is a team effort
~ ADHD often responds well to medication
~ Pills do not give skills
~ Keep an inventory of things the person does right
~ People with ADHD find it hard to demonstrate what they know to someone else
Things to Remember
~ Motivation is essential (ED)
~ The importance of a task and the rewards of completing it don’t motivate a person with ADHD to get things done
~ Embracing his deeply held values or things that are important to him can help an individual with ADHD get things done and stay focused. (JFK)
~ Competition can help. Even if it is only against self
~ Improved sense of competence also helps
Motivation Prompts
~ What excites you or recharges your batteries?
~ Think about a time in your past when completing a similar type of task wasn’t so hard. What was different? Can you bring some of those elements into the situation now?
~ How can you break this task down into three pieces so it feels more manageable?
~ How will you reward yourself when you complete this?
~ What needs to change to turn this “should” into a “want”?
~ What are you good at?

Motivation
~ What self-talk do you notice that you can let go of?
~ What about this task is important or meaningful to you?
~ When is the best time for you to do this task?
~ What support do you have to get this task done?
~ What obstacles are preventing you from completing this task? Which of these can you eliminate now?
~ How can you make this task fun, interesting, or enjoyable?

Motivation
~ See the goal
~ People with ADHD forget the purpose of their tasks, so they are uninspired to finish them.
~ Imagining the negative consequences of not doing something is not a potent motivator
~ Imagine how great it will feel to get to your goal works better and add visual reminders of the goal—including daily creative visualization.
~ Hint: Put a medication reminder app on his phone to remind him each morning to do his creative visualization for handling that issue

Motivation
~ Envision the end result.
~ Instead of: You need to get these applications done for college
~ Try: Think how awesome it will be when you get in college and can finally start learning the stuff that is important to you!
~ Try: How great will it feel when you have been accepted to college and can see how your hard work paid off?

Get Started (Even Unmotivated)
~ Get started
~ Create urgency
~ Keep a list of must-dos (bills, dishes, homework)
~ Work with a buddy
~ Reward yourself
~ Start with the goal of good enough
~ Work during peak times
Goals
~ For each goal ask
~ How has this issue caused you problems to identify specific goal targets
~ How will your life be improved when this is resolved to help the person visulaize
Goals
~ Chronic lateness
~ Be on time to work/appointments 90% of the time
~ Difficulty controlling anger and low frustration tolerance
~ Reduce anger episodes to less than 1/day
~ Reduce intensity of anger episodes from a 5 to a 2 90% of the time

Goals
~ Forgetfulness
~ Improve memory by reducing “forgetting” episodes to less than 2x/week
~ Poor organizational skills
~ Reduce the number of times per day you cannot find something to less than 1x/day
~ Procrastination
~ Get started on tasks within 5 minutes of chosen or scheduled time

Goals
~ Improved relationships
~ Reduce arguments to less than 2 per week
~ Increase social invitations to 1 per week
~ Better work product
~ Complete paperwork by close of business Friday/Daily
~ Stay on task with 2 or fewer reminders
~ Graduate to: Complete paperwork with 2 or fewer errors (Scaffolding)
Goals
~ More independence in self-care and getting things done
~ Get started getting ready with 2 or fewer reminders
~ Leave for work by 7:45 with 2 or fewer reminders
~ Complete laundry on Sundays and set out clothes for the week
~ Develop meal plan and shopping list each Sunday
Goals
~ Improved self-esteem
~ Reduce unhelpful self critical perseverating to less than 3 times per week
~ Self report of feeling pretty good or good about self 7 days a week
~ Improved self-efficacy
~ Self report of confidence in being able to get things done and be independent 6 of every 7 days

Goals
~ Fewer disruptive behaviors (e.g., interrupting, blurting, fidgeting.)
~ Self-monitoring log shows less than 3 interrupting/blurting instances per day
~ Self monitoring shows ability to sit still for at least 45 min.
~ Safer behaviors (e.g., crossing streets, cooking dinner)
~ Self report of getting side tracked from activities less than 2x/day

Things to Do if You Have ADHD
~ Strategies to Improve self esteem
~ Identify your strengths and good qualities about you.
~ Note each day something you did that shows your character strengths.
~ Learn to reframe mistakes via journaling.
~ Strategy to stop being impulsive
~ Make a list of the inappropriate situations in which you are most likely to behave impulsively.
~ Identify things that make it worse
~ Identify things that help you not be impulsive

Things to Do if You Have ADHD
~ Strategy to stop blurting
~ When you are about to enter one of those situations, try following actions:
~ Before you answer someone, inhale slowly, exhale slowly, put on a thoughtful expression, and say to yourself, “Well, let me think about that.”
~ Put a finger over your mouth for a few seconds, as if you’re considering what you’re going to say.
~ Paraphrase what the person said to you: “Oh, so you want to know about…” or “You’re asking me to….”
~ Imagine locking your mouth with a key to prevent yourself from speaking.

Specific Interventions
~ Get adequate, quality sleep
~ Identify why this is important to recovery and how it will help the person achieve his goals
~ Audit sleep hygiene
~ Develop a plan to improve sleep hygiene
~ Train himself to become more organized
~ Identify why this is important to recovery and how it will help the person achieve his goals
~ Develop a calendar and set alarm and push notification prompts
~ Have a friend call 30 minutes before time to leave
Specific Interventions
~ Prioritize
~ What is most important to move you toward a rich and meaningful life? List 1-10. Tackle one at a time.
~ Control impulsive behavior
~ Identify why this is important to recovery and how it will help the person achieve his goals
~ Develop a list of times when he is impulsive and things that make it worse and better.
~ Create a plan for handing each type of situation (i.e. meetings at work, when he gets angry, during movies…)

Specific Interventions
~ Develop social skills
~ Identify why this is important to recovery and how it will help the person achieve his goals
~ Assess which social skills are lacking (assertiveness, verbal and nonverbal communication, sitting still, not touching things…)
~ Develop a plan to address each deficit.

Specific Interventions
~ Minimize distractions
~ Small space
~ Minimize stimuli
~ Find constructive outlets for excess energy
~ Exercise
~ Worry stones
~ Walking desk
~ Isometrics
~ Crochet/whittling

Specific Interventions
~ Plan Ahead/Impulse Control
~ Adults with ADHD have difficulty drawing on past experiences to guide their actions.
~ They’re not good at recognizing the subtle aspects of problems, and the various tools that might solve them.
~ They hit every problem with a hammer, because, to them, all problems look like nails.
Specific Interventions
~ Plan Ahead/Impulse Control
~ Picture a TV and imagine the last time you were in a situation like this playing on the TV like a movie.
~ What did you learn from that experience?
~ What were some of the details that made it similar and different to this situation?
Specific Interventions
~ Train your brain (Try Luminosity)
~ Get a nudge (personal assistant/environmental supports)
~ Wean off these supports slowly

Summary
~ ADD/ADHD can negatively impact relationships, work and addiction recovery if not addressed
~ It is more important to identify and address symptoms than worry about fitting particular diagnoses
~ Identify which symptom is most problematic for the person and address that one first.