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10 CEUs Treating Locking In & Blocking Out: ADHD Adults

Section 9
Social Problems in ADHD

Question 9 | Test | Table of Contents | ADHD CEU Courses
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track, we discussed the ADHD adult’s Moral Inventory, which is developed by answering three questions. These three Moral Inventory questions were: "What Can I Do Well?", "What Can I Do Adequately?", and "What Can’t or Shouldn’t I Do?".

On this track, we will continue our discussion of a parallel between the AA Twelve Steps and your ADHD client via a discussion of two common Slippery Social Situations an ADHD adult may encounter. As you know, alcoholics refer to a slippery situation as one that may cause them to drink. However, I have found the two common Slippery Social Situations an ADHD adult may encounter are Good Manners, and the Fear of the Phone. Sound interesting?

2 Slippery Social Situations

Slippery Social Situation # 1 - Good Manners
Aaron, age 32 recently married to Jill, found himself with new problems within a few weeks of getting married. Jill frequently got annoyed with his lack of Good Manners at the dinner table. Aaron would frequently interrupt when she was speaking, and was obviously not always listening to her.

Aaron stated, "Jill just gets fed up with me. I can tell when she’s annoyed with something I’ve said during dinner, and I try to fix it, but sometimes there’s just no use. I grew up in a family full of ADHDers, so I never really learned some of this manners stuff that Jill thinks is just SO basic! When I was growing up, everyone talked at once at the table, and no one really listened to anyone else. Interrupting when someone else was speaking was normal!"

Why are good manners a slippery situation?  Obviously, good manners require adequate communication skills that include your ADHD client having the ability to monitor their behavior and pay close attention to detail. As you know, many adults with ADHD, like Aaron, struggle with these skills, which cause them to make errors in good manners of listening and replying, and not talking over people while they are talking. I have found that many ADHD adults, including Aaron, know the rules of good manners, but haphazardly apply them.

"Asking for Clarification" Technique
Remember Joel’s case and the "Asking for Clarification" technique we discussed on the first track of this CD set? Joel talked over his wife, just like Aaron, and didn’t listen to her speak. Because Aaron’s dinnertime problems were similar to Joel’s, I suggested the "Asking for Clarification" technique to Aaron. After explaining the steps of the technique, I suggested Aaron practice the technique with a family member. I stated, "Since you mentioned that you grew up in a family full of ADHDers, practicing the ‘Asking for Clarification’ Technique with one of them might be beneficial to both of you."

Slippery Social Situation # 2 - Fear of the Phone
In addition to Good Manners, the second common Slippery Social Situation an ADHD may encounter is the Fear of the Phone. Let’s look at how the Fear of the Phone affected Nicole.

Nicole, age 24, has lived with a severe fear of the telephone. Nicole stated, "I’ve never really liked talking on the phone. I get distracted so easily that if I’m on the phone and someone even walks in the room, I get mad at them. When I lived with my parents, I dealt with my fear by never answering the phone, and I refused to make calls myself." Now that she lives on her own, though, Nicole worries because no one can answer the phone except her.

Nicole stated, "I intentionally let my answering machine take a call even though I’m home to avoid answering calls. I know that sounds silly, but I’m just too scared to answer it myself! Then there’s the whole problem of calling other people. I’d sooner just drive somewhere to talk to someone than call them."  Are you currently dealing with a Phone-a-phobic ADHD client? Are they able to define for you what it is about talking on the phone that they don’t like?

Have you noticed, as I have, that many ADHD adults suffer from a Fear of the Phone like Nicole? In my experience, phobic reactions like Nicole’s aren’t always reactions to anxieties or fears of the telephone. As you know, many ADHD adults do have real problems with telephone communication. These problems with telephone communication are rooted in an inability to process the meaning of words without the visual clues of body language. Obviously, the ADHD adult’s inability to filter out background noise also contributes to his or her difficulty with telephone conversation.

I explained the root of Nicole’s fears to her, and stated, "It’s not abnormal for an ADHD adult like you to avoid the telephone." Nicole looked slightly comforted upon hearing this fact, but stated, "I’m still at a disadvantage compared to the rest of the world. Everyone else can handle answering the phone. I mean, it seems like they all have cell phones these days, so they’re not only dealing with it at home, but whenever they go out, too! I just wish I could be that comfortable with a phone."

"Scripted Calling"Technique - Four Steps
I decided to suggest a technique I call "Scripted Calling" to Nicole. There are four steps to the "Scripted Calling" Technique. As I explain them to Nicole, think of your ADHD client who suffers from a Fear of the Phone.

-- Step One - Rehearse Script
I stated, "First, write down and rehearse what you’re going to say before you make a call." I explained that her script should include a greeting, major points that she wants to make, and a way to politely end the conversation.

-- Step Two - Quiet Location
I then gave her the second step, to make the call from a quiet, distraction-free place. I stated, "If you need to, have a phone jack installed in a room where you know there will be no distractions or purchase a cordless phone. For example, when I suggested this technique to another client, he decided to use his cordless phone in the bathroom where the noise from the fan blocked out all other distractions."

-- Step Three - Keep Notes in Front
I then explained to Nicole the third step, keeping her notes in front of her. I stated, "Having your notes in front of you will help you jog your memory if you forget something during the call."

-- Step Four - Stick to the Script
Finally, I gave her the fourth step, sticking to the script. I stated, "It could be fairly easy to stick to the script with your notes in front of you. Sticking to the script will help you avoid wandering conversation. List the two or three key points or the crucial piece of information that you need to get from the other person."

Nicole looked relieved for a moment, but then asked, "And what if someone calls me? This ‘Scripted Calling’ technique sounds fine for when I need to call someone, but what do I do when someone’s calling me back?" I stated that a quick tip for dealing with unexpected calls may be to briefly excuse herself. I stated, "You can say you need to switch phones, or that you have to answer the door but will call right back. Then, simply take a few minutes to compose yourself and gather any written information you may need for the conversation."

Do you have an ADHD client who has problems with either of the Slippery Social Situations? Is your client like Aaron, who only haphazardly applies rules of Good Manners? Or is your client a Nicole, who suffers from a Fear of the Phone? Would either the "Asking for Clarification" technique or the "Scripted Calling" technique be beneficial to him or her?

On this track, we have discussed two common Slippery Social Situations an ADHD adult may encounter. The two common Slippery Social Situations an ADHD adult may encounter were Good Manners, and the Fear of the Phone.

On the next track, we will discuss three difficulties ADHD adults face in group interfacing. These three difficulties are shifting gears rapidly, running out of gas, and setting the cruise control for mega-speed. We will also discuss five tips for group interfacing. These five tips are Being Prepared, Doing Your Homework, Practicing, Watching and Listening, and Watching Your Watch.

Peer-Reviewed Journal Article Reference:
Acuff, S. F., Soltis, K. E., Dennhardt, A. A., Borsari, B., Martens, M. P., Witkiewitz, K., & Murphy, J. G. (2019). Temporal precedence of self-regulation over depression and alcohol problems: Support for a model of self-regulatory failure. Psychology of Addictive Behaviors, 33(7), 603–615.

Atherton, O. E., Lawson, K. M., Ferrer, E., & Robins, R. W. (2020). The role of effortful control in the development of ADHD, ODD, and CD symptoms. Journal of Personality and Social Psychology, 118(6), 1226–1246.

Kofler, M. J., Harmon, S. L., Aduen, P. A., Day, T. N., Austin, K. E., Spiegel, J. A., Irwin, L., & Sarver, D. E. (2018). Neurocognitive and behavioral predictors of social problems in ADHD: A Bayesian framework. Neuropsychology, 32(3), 344–355.

Kofler, M. J., Larsen, R., Sarver, D. E., & Tolan, P. H. (2015). Developmental trajectories of aggression, prosocial behavior, and social–cognitive problem solving in emerging adolescents with clinically elevated attention-deficit/hyperactivity disorder symptoms. Journal of Abnormal Psychology, 124(4), 1027–1042.

Ramsay, J. R., & Rostain, A. L. (2016). Adult attention-deficit/hyperactivity disorder as an implementation problem: Clinical significance, underlying mechanisms, and psychosocial treatment. Practice Innovations, 1(1), 36–52.

What are the four steps in the "Scripted Calling" technique to help your Phone-a-Phobic ADHD client? To select and enter your answer go to Test


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