ADHD Group Approaches

Social skills training groups

Most children gradually develop an awareness of their impact on and interactions with others. Children with ADHD, on the other hand, can be described as a “bull in a china shop”. They move through the day quickly, often without giving much thought to the feelings or needs of others. Hyperactive, aggressive, and impulsive behaviors also cause extreme problems in relationships with peers and adults. Although children with ADHD do care about other people, they are simply unaware of the need to consider the perspective of others.

Social skills training classes are designed to improve peer relationships, and teach interpersonal interaction skills that facilitate success in the classroom or at home. These classes differ from individual or group therapy in that the focus is primarily on interpersonal interactions rather than managing emotions or personal change. Group settings are the most common format because they provide ready opportunities to practice recently acquired skills with other children in the class. Classes are aimed at school-age children and teach awareness of disruptive behaviors, voluntary control (self-talk) strategies; as well as developing problem solving, conflict resolution, and anger management skills.

These programs are often available at schools or in the local community. Many social skills training classes are offered by mental health practitioners who specialize in working with children with ADHD.

Cognitive behavioral therapy groups

Cognitive behavioral therapy group programs are somewhat similar to social skills training classes. Social skills training focuses on the development of an awareness of the impact of ADHD behaviors on others and the self-management skills needed to limit associated disruptions. Cognitive therapy also pursues the development of awareness of disruptive behaviors and ADHD symptoms, but focuses on self-awareness rather than environmental awareness. Guided by cognitive behavioral theory (i.e., that changing thoughts leads to a change in behavior and mood), specific self-management skills, such as self-soothing behaviors and positive self-talk techniques, are taught.

Cognitive behavioral therapy groups can be quite beneficial to children with ADHD. Not only is the associated cost less than that of individual therapy, but the child has an opportunity to interact with other children who have similar types of challenges. The group therapy environment provides a structured setting in which children can discuss their unique feelings and situations, develop an understanding of the feelings of others and realize that they are not the only ones who face challenges. The development of a sense of belonging to a group, in a structured, safe environment, can be particularly helpful to ADHD children. Another benefit is the opportunity to practice newly evolving social skills in the safe environment of a therapeutic group.

Parent education groups/Parenting skills classes

Much of the previous discussion has focused on how ADHD affects the child. The impact of the disorder on the parent is almost as dramatic. Parenting classes can provide caregivers with a clearer understanding of the disorder; its symptoms, problems and treatment options. A group format is an efficient way to deliver this information, as well as an excellent technique for normalizing the situation. The group approach of a class can reduce the sense of hopelessness and isolation that many parents experience. The recognition that other families are struggling with similar (or even more difficult) problems can be reassuring.

Many parents may be resistant to the idea that their child has a “problem”. Others are grateful to have a name for the condition that is causing such disruption in their lives. It is sometimes difficult to see that behavior problems can have their roots in biology. Parents may sometimes mistake ADHD for laziness and irresponsibility, thus making an attributional (reasoning) error that kids could be different if they wanted to. This type of thinking contributes to an antagonistic relationship between parents and children. In contrast, understanding that a child’s problem behavior has nothing to do with conscious intent and everything to do with impulsive behaviors can aid parents in remaining calm enough to act instead of react to a child’s negative behavior.

70% of children with ADHD have at least one parent who also has the disorder. This underlying condition makes it extremely difficult to organize and manage the details of the life of a child with ADHD. Some of the skills necessary to parent a child with ADHD are exactly those skills that are most difficult for an adult with ADHD. For example, increasing organization and structure within the home is probably not an area in which a parent with ADHD excels.

One of the most significant challenges in parenting an ADHD child is that it requires a great deal of parental participation. As a result, the parent of a child with ADHD must not only learn to help manage their child’s difficulties, but also to examine their own history for clues as to how to be most effective. Although many parents may find it difficult to acknowledge that their own lifestyle or behaviors can impact their child’s behavior, their child’s difficulties may provide a stimulus to develop new skills to meet old challenges. Thus, having a child with ADHD can provide an opportunity for the parent with ADHD to master tasks that were difficult in their own childhood. Who can better understand a child’s challenges than a parent who experienced a similar dilemma?

Family Therapy

Parents that need more intensive help than that which can be provided by parent training classes may find a family therapist useful. Many parents have a need for emotional support beyond just receiving accurate and detailed educational information. A family therapist can play a fundamental role in sorting through issues and maintaining positive relationships within the family system.

Prior to their child’s diagnosis, parents may have had any number of faulty ideas and fears. Parents often argue among themselves about being “too permissive” or “too strict” in a constant struggle to find something that impacts the child in a positive direction. Family therapy can help reduce the negative emotions connected with parenting a child with ADHD. In addition, individual parents have their own emotions in response to their child’s condition and behavior, often including feelings of guilt, frustration, anger and fear for the future. Family therapy provides a venue to sort through these concerns and clarify their reality. This type of therapy also provides a safe environment for parents and children to discuss what may have become extremely volatile issues. Therapists support both parents and children in the process of reaching a fair and equitable compromise.

Once emotional issues have been addressed, family therapy can assist parents with more practical concerns such as readjusting their expectations of the child and more effectively structuring their child’s environment. Therapists can provide invaluable support and knowledge about setting up an environmental behavior modification plan (as described above). Issues such as goal setting and the selection of appropriate rewards and punishments can be discussed in depth. Therapists with a behavioral and/or cognitive behavioral theoretical orientation have a specialized skill in the development of such plans, although most therapists who specialize in ADHD family work will also be able to provide similar information.

As when looking for an individual therapist, it is helpful to search for a clinician who has experience and specialized skills in working with families of children with ADHD. families.