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Section 5
Intervention with Parents of Children with ADHD

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In the last section, we discussed three types of counseling that may be beneficial for children with ADHD. The three types of counseling were individual counseling, self-control training, and social skills training.

In this section, we will be discussing marital therapy for parents of children with ADHD.

As you are aware, the divorce rate is higher in families with ADHD children. This higher divorce rate can be attributed to the stress of having an ADHD child. However, the high divorce rate can also be partly attributed to the problems, like depression, alcoholism, and anxiety disorders, that parents of ADHD children are more vulnerable to.

For the parents of Jake, age 9 diagnosed with ADHD, marital therapy seemed to be the best option. Jake had problems with disruptive classroom behavior. He would hit other children, jump off chairs, and talk out. Even in Jake’s more "quiet moments," he cracked his knuckles, played with the buttons on his clothes, and couldn’t sit still.

When Jake was diagnosed, his mom, Sheryl, accepted it, stating, "Jake is always into things and on the go, and he has no interest span." Jake’s father, Richard, reacted to the diagnosis with hostility, stating, "I was like that as a boy, too, and I did pretty well!" They could not agree on how to parent their son anymore.

Four Steps of Marital Therapy

♦ Step #1 - Evaluation
Marital therapy, like the therapy Richard and Sheryl participated in, can occur in four steps. As you know, the first step of marital therapy is evaluation. I met with Richard and Sheryl to get an idea of the state of their marriage. After meeting with them together, I met with each Richard and Sheryl individually to explore issues more in depth and talk about topics that they may not have been comfortable discussing with their spouse present.

Together, we evaluated which issues were causing the most trouble. Topping the list was "Communication." Sheryl complained of Richard’s habit to contradict everything she said, especially issues related to Jake’s ADHD. She stated, "Saying Richard was like Jake as a boy and turned out fine is like denying Jake’s ADHD exists, if you ask me!" Richard was annoyed because he thought Sheryl didn’t listen to him. He stated, "Every time I try to talk to Jake, she defends him because of his ADHD. She doesn’t even listen to what I’m trying to say!"

♦ Step #2 - Introduction to Cognitive Therapy
The second step I use in marital therapy is an introduction to cognitive therapy. Like in the individual counseling we discussed earlier in this section, in this step, Sheryl and Richard were both trained how to think about themselves and their spouses more realistically. As you know, realistic thinking includes learning how to stop blaming each other and how to take responsibility for one’s own anger or depression.

In this step, Richard came to accept that some of his frustrations from work were being taken out on Jake because of Jake’s ADHD. Sheryl admitted that her depression may have worsened after Jake’s diagnosis, causing her to be oversensitive to Richard’s criticism.

♦ Step # 3- Straightforward Negotiation
Following the first two steps of evaluation and cognitive therapy, the third step in marital therapy is negotiation training. As you know, many couples with an ADHD child are not good at talking things over in a productive way. I have found that some attention to and assistance with basic negotiating procedures is often necessary for couples with an ADHD child. I ask clients who have difficulty negotiating to do an exercise I call "Straightforward Negotiation." In the "Straightforward Negotiation" exercise, clients use six steps to straightforward negotiation methods.
The six steps to straightforward negotiation are
--1. Agreeing on a time and place to talk,
--2. Defining clearly one problem to be discussed,
--3. Letting each person express their opinion without being interrupted,
--4. Sympathetically listening, rather than simply preparing a rebuttal,
--5. Generating possible solutions, and
--6. Agreeing on something to try out.

I asked Sheryl and Richard to do the "Straightforward Negotiation" exercise and practice these six steps of straightforward negotiation methods. They first agreed on a time and place to talk. Sheryl and Richard then decided to talk about just one problem, disciplining Jake for his bad behavior in school. Third, each Sheryl and Richard had an opportunity to express their opinion.

While Sheryl spoke about taking into consideration Jake’s ADHD, Richard listened patiently. Sheryl did the same, listening to Richard while he spoke about the necessity of punishment. In the fifth step, they brainstormed some possible punishments together. Finally, Sheryl and Richard agreed to an arrangement. In their arrangement, Jake may be grounded for bad behavior, but they would take his ADHD into consideration to keep from being too severe.

♦ Step #4 -Getting it Together
Finally, the fourth step of marital therapy I find is getting it together. In getting it together, the parents can take the skills they learned from therapy and apply them to situations outside the therapist’s office.

I explained getting it together to Richard and Sheryl as two steps.
--1. The first step of getting it together is straightening out one’s own thinking about the problem at hand.
--2. I then explained that the second step was applying the negotiation methods to the chosen problem in order to come up with a solution.

In summary, the four steps of marital therapy for the parent’s of a child with ADHD are: evaluation, an introduction to cognitive therapy, negotiation training, and getting it together. Can you think of a client with ADHD whose parents might benefit from the six steps of straightforward negotiation method?

In this section, we have discussed marital therapy for the parents of a child with ADHD. The four steps of marital therapy are evaluation, cognitive therapy, negotiation training, and getting it together.

In the next section, we will talk about the Five Tactics for Start Behavior. The Five Tactics for Start Behavior are Sloppy Positive Verbal Feedback, Kitchen Timers, the Docking System, Natural Consequences, and Charting.

Peer-Reviewed Journal Article References:

Harvey, E. A., Metcalfe, L. A., Herbert, S. D., & Fanton, J. H. (2011). The role of family experiences and ADHD in the early development of oppositional defiant disorder. Journal of Consulting and Clinical Psychology, 79(6), 784–795.

Overgaard, K. R., Oerbeck, B., Friis, S., Biele, G., Pripp, A. H., Aase, H., & Zeiner, P. (2019). Screening with an ADHD-specific rating scale in preschoolers: A cross-cultural comparison of the Early Childhood Inventory-4. Psychological Assessment, 31(8), 985–994.

Patros, C. H. G., Tarle, S. J., Alderson, R. M., Lea, S. E., & Arrington, E. F. (Mar 2019). Planning deficits in children with attention-deficit/hyperactivity disorder (ADHD): A meta-analytic review of tower task performance. Neuropsychology, 33(3), 425-44.
Weyers, L., Zemp, M., & Alpers, G. W. (2019). Impaired interparental relationships in families of children with attention-deficit/hyperactivity disorder (ADHD): A meta-analysis. Zeitschrift für Psychologie, 227(1), 31–41.

Wymbs, B. T., Pelham, W. E., Jr., Molina, B. S. G., Gnagy, E. M., Wilson, T. K., & Greenhouse, J. B. (2008). Rate and predictors of divorce among parents of youths with ADHD. Journal of Consulting and Clinical Psychology, 76(5), 735–744.

Ziperfal, M., & Shechtman, Z. (2017). Psychodynamic group intervention with parents of children with attention-deficit/hyperactivity disorder: Outcomes for parents and their children. Group Dynamics: Theory, Research, and Practice, 21(3), 135–147.

What are two types of counseling for parents of ADHD children? To select and enter your answer go to Test

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