الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
The concept of ADHD coaching is now well-established, however levels of training and experience can vary widely. Coaching can be used as an important adjunct to therapy. A coach can provide brief, frequent contact with the adult client to help them stay on track, working toward their goals between therapy sessions. It is important for the clinician and coach to communicate on a regular basis to compare notes and be sure to work toward the same goals with the client (Rief, 2005).
• Professional Organizing - Disorganization is one of the biggest challenges faced by many adults with (ADHD). Their homes may become so cluttered and disorganized that it becomes more and more difficult to function. Paperwork is often the greatest challenge of all. Often, an adult with (ADHD) needs the hands-on help of a professional organizer to tackle the overwhelming task of getting their home and/or work environment de-cluttered and organized (Rief, 2005).
• Adult ADD Support Groups - The opportunity to meet other adults with (ADHD), to hear their stories and struggles, and to share resources and coping strategies can be highly therapeutic. There is a growing number of adult (ADHD) support groups across the U.S., many of which are sponsored by CHADD, the national (ADHD) advocacy group (Rief, 2005).
Finally, the clinician who wants to successfully treat adults with (ADHD) in psychotherapy needs to develop many skills that are not commonly used in more traditional psychotherapy. Neurocognitive psychotherapy is a treatment model that has been developed, combining aspects of cognitive/behavioral therapy and cognitive rehabilitation that addresses both the neurocognitive and psychological aspects of (ADHD). The astute clinician must always consider multiple factors - psychological issues that result from years of struggle with (ADHD), problems of executive functioning related to (ADHD), and the possibility of multiple comorbid conditions that are common in adults with (ADHD) if treatment is to be really effective (Wender et al., 2001).
Each therapy session needs to address issues on many levels, with the therapist skillfully interweaving interventions that lead to self-awareness and understanding, that explore emotional and interpersonal issues, and that address the many aspects of daily living that become chronic challenges for adults with (ADHD). Clinical experience shows that therapy sessions that provide structure, support, and practical strategies will be most effective in helping the adult with (ADHD) to meet the daily challenges of his life and to move forward toward meeting his true potential and reaching his goals (Wender et al., 2001).
Self-Management Strategies
Adults with ADHD benefit considerably from direct education about the disorder. They can use information about their deficits to develop compensatory strategies. Planning and organization can be improved by encouraging patients to make lists and use computerized schedules. Placing a large calendar with important dates and deadlines in a central location in the home or workplace is a valuable memory aid. Ways to reduce distractions may include having a clutter-free desk, a carrel-style desk or a windowless office. ADHD adults may benefit from going to work early to accomplish tasks before coworkers arrive and phones begin ringing. Most adults are aware of their ”personal clock” and know their prime times for completing intellectually demanding tasks. Task completion can be improved by systematically breaking down large projects into manageable ”chunks,” each with its own deadline (Wender, 1998). Adults with ADHD should be educated about their elevated risk for drug and alcohol dependence and should be encouraged to drink in moderation or practice abstinence.
Psychotherapy and marriage
Marital and individual counseling and self-help groups are often valuable adjuncts to pharmacotherapy and skill training. Among newly diagnosed adults in particular there may be an extended psychologic history of low self-esteem, failure, frequent job changes and relationship problems. Individual psychotherapy that focuses on core issues of self-worth along with ways to improve the patient’s ability to monitor work and social skills can be invaluable (Jensen et al., 1997).
Married patients often have significant relationship conflicts stemming from forgotten commitments, impulsive decisions and emotional outbursts. Working with the couple to enhance communication skills, conflict resolution and problem solving, and educating the patient’s spouse about ADHD can dramatically improve the relationship (Kilcarr, 2002).
Community-based studies using multiple informants, research-based assessment, and diagnostic criteria generally yield good estimates of the need for services for ADHD. However, treatment studies suggest that many individuals do not receive needed services (Surgeon General’s Report, 2001), particularly behavioral and psychosocial interventions.