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Section 9
Behavioral Interventions for ADHD

Question 9 | Test | Table of Contents | ADHD CEU Courses
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In the last section, we discussed the Four Common Errors a parent of an ADHD teenager may make. The Four Common Errors for the parent of an ADHD teenager were 1. spontaneous discussions about problems, 2. nagging, 3. insight transplants, and 4. arguing.

In this section... we will discuss the Four Steps to use in dealing with an ADHD teenager’s social and behavioral problems. These four steps are 1. Doing nothing, 2. Consulting, 3. Negotiating, and 4. Taking Charge. Let’s look at how these four steps helped Jill decide how to handle problems with her daughter, Melissa.

Melissa, age 16, had stereotypical ADHD problems. Melissa was disorganized, forgetful, and easily distracted in the middle of a task. Jill, Melissa’s mother an office manager, was stressed at work and stressed in her marriage, and tried to manage her daughter’s behavior at home, but was having difficulty. Jill could not set clear expectations for Melissa and frequently lost her temper over minor matters.

Jill stated, "I know it’s stupid, but sometimes Melissa’s decisions in friends, study methods, and even eating habits irritate the hell out of me!" Jill often threatened punishment, but rarely followed through.

Four Steps in Dealing with an ADHD Teen

I explained to Jill that she might consider using Four Steps for dealing with an ADHD teenager’s social and behavioral problems with Melissa.

♦ Step 1 - Doing Nothing
The first step of the Four Steps for dealing with an ADHD teenager’s social and behavioral problems I suggested to Jill is Doing Nothing. This surprised Jill. I explained to Jill that sometimes if parents are having difficulties in their own lives, such as depression, they may be in no shape to deal with a troublesome teen.

I stated, "If you are having your own problems, keep a watchful eye on what’s happening with Melissa, but take care of your own issues first." Jill got defensive and stated, "I’m really not having a lot of problems of my own right now, though. My husband and I are getting along fine, and work is great! I just want to help my daughter handle her problems."

Learning to 'Grin and Bear It'
I then suggested Jill try more aggressively to let go of trivial issues. I stated, "The ‘Grin and Bear It’ approach is one of the best methods of dealing with little problems. For example, you said earlier that you don’t like some of Melissa’s friends. You may not like them, but that’s not going to change the fact that Melissa considers them friends. When Melissa brings those friends home, try to just grin and bear it. Eventually her friends will leave, and you’ll have avoided a conflict with Melissa." Thus, step one is doing nothing.

♦ Step 2 - Consulting
I have found that the second step of the Four Steps for dealing with an ADHD teenager’s social and behavioral problems is Consulting. I explained to Jill that a consultant is a person hired to give advice, but on the condition that the receiver of the advice has the right to reject that advice. I explained to Jill that in using the second step of Consulting, she was not using power and that Melissa would have the right to reject her advice.

I stated, "If Melissa asks you for advice on something, like how to do her homework, you can give her advice. Just remember that she might not take that advice." I then suggested that Jill try written advice sometimes. I explained, "If you’re giving her too much advice, it may seem like nagging. Writing suggestions down seems less like nagging."

♦ Step 3 - Negotiating
In addition to Doing Nothing and Consulting, the third step of the Four Steps for dealing with an ADHD teenager’s social and behavioral problems is Negotiating. I stated to Jill, "Your concern over her choice in after school snacks may be an appropriate area to negotiate." As you know, by negotiating, parents recognize that their ADHD children are older now and should have some say about many of the things they do.

I explained to Jill, "Negotiating is the statement that you feel it is important that you are involved. But it is also a statement that you are willing to bargain." I explained to Jill that I use five guidelines for negotiating.

These five guidelines for negotiating are:
1. agreeing to negotiate,
2. picking a time and place to negotiate,
3. defining the problem,
4. making a deal that both parent and child could live with, and
5. experimenting with the deal and changing that deal if necessary.

I stated, "If you are negotiating after school snacks, you might want to try a bargain where Melissa eats healthy snacks every other day, or is allowed junk food on Fridays only." Jill stated, "I could try that. I don’t mind if Melissa eats junk food once in a while, I just don’t want her to do it all the time." Does Negotiating sound like something a client of yours might like to try?

♦ Step 4 - Taking Charge
I then explained to Jill the fourth step of the Four Steps for dealing with an ADHD teenager’s social and behavioral problems, Taking Charge. I stated, "There might be times when no amount of consulting or negotiating will work. That is when you may want to draw the line." As you know, a parent like Jill may want to consider this step only after all other steps have failed, and usually only with serious matters.

♦ Technique: Using a 'Three Category System
I explained to Jill that she may want a "Three Category System" for Taking Charge. I stated, "In the Three Category System, you could break down offenses into Major, Medium, and Minor offenses."

--1. Major Offenses - I explained that Major Offenses might include staying out all night, physical violence, or drinking and driving. I then suggested, "Consequences for Major Offenses could be a $25 fine, no TV for a month, no phone or car for a month, or grounding for two weeks." I then asked Jill if she would like to create her own system for Medium and Minor offenses. I gave Jill a notebook and pencil, and she began to write.

--2. Medium Offenses - Under "Medium Offenses," she wrote, "Getting in trouble at school, smoking, inviting friends over without permission." Jill then listed under Medium Offenses Consequences, "$10 fine, No phone or car for 2 weeks, one week grounding." Next, Jill wrote "Minor Offenses" and listed "leaving homework out, swearing, leaving house unlocked."

--3. Minor Offenses - Finally, Jill wrote "Minor Offenses Consequences" and listed "$2 fine, no phone or car for 3 days, 4 days grounded." I then explained to Jill that for the Three Category System to work, she would need to stick to the punishments she gave Melissa. Jill stated, "I’ve threatened to punish her before but never had guidelines for actually doing it. Maybe if I tell her these guidelines, I’ll actually be able to stick to the punishments." (Phelan 105)

Do you have a client like Jill with an ADHD teenager who might benefit from using the Four Steps for dealing with an ADHD teenager’s social and behavioral problems? Would your Jill find the "Three Category System" useful?

In this section... we have discussed the Four Steps for dealing with an ADHD teenager’s social and behavioral problems. The Four Steps to use in dealing with an ADHD teenager’s social and behavioral problems are 1. Doing nothing, 2. Consulting, 3. Negotiating, and 4. Taking Charge.

In the next section, we will discuss the Four Points of Arguing. The Four Points of Arguing are that arguing doesn’t work, arguing usually escalates, each person controls 50 percent of the problem, and teens love to bait parents. We will also discuss the Two Steps to Avoiding and Stopping Arguments. These two steps are to stop talking, and to be prepared for the ADHD teen’s next move.

Peer-Reviewed Journal Article References:
Courrégé, S. C., Skeel, R. L., Feder, A. H., & Boress, K. S. (2019). The ADHD Symptom Infrequency Scale (ASIS): A novel measure designed to detect adult ADHD simulators. Psychological Assessment, 31(7), 851–860.

Helseth, S. A., Waschbusch, D. A., Gnagy, E. M., Onyango, A. N., Burrows-MacLean, L., Fabiano, G. A., Coles, E. K., Chacko, A., Wymbs, B. T., Walker, K. S., Wymbs, F. A., Garefino, A., Massetti, G. M., Robb Mazzant, J., Hoffman, M. T., Waxmonsky, J. G., Nichols-Lopez, K., & Pelham, W. E., Jr. (2015). Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls. Journal of Consulting and Clinical Psychology, 83(2), 280–292.

Kane, L., Bahl, N., & Ouimet, A. J. (2018). Just tell me it’s going to be OK! Fear of negative evaluation may be more important than fear of positive evaluation in predicting excessive reassurance seeking. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 50(4), 217–225.

Karalunas, S. L., Gustafsson, H. C., Fair, D., Musser, E. D., & Nigg, J. T. (2019). Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychological Assessment, 31(2), 236–247.

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.

“Meta-analysis of cognitive-behavioral treatments for adult ADHD”: Correction to Knouse, Teller, and Brooks (2017) (2017). Journal of Consulting and Clinical Psychology, 85(9), 882.

Pfiffner, L. J., Villodas, M., Kaiser, N., Rooney, M., & McBurnett, K. (2013). Educational outcomes of a collaborative school–home behavioral intervention for ADHD. School Psychology Quarterly, 28(1), 25–36.

What are the Four Steps for dealing with an ADHD teenager’s social and behavioral problems? To select and enter your answer go to Test

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