Treating ADHD with Therapy

More than likely, you know someone with ADHD. Or at the very least you know someone who
you suspect might have ADHD. It’s one of the most common behavioral health
diagnoses given to kids today. So let’s say that you walk into an auditorium and you have 100 kids in sitting front of you. On average, how many of them do you think
are diagnosed with ADHD? Go ahead and think about it and when you’re
ready, you can vote up here in the corner. If you answered 11, then you’re right on the
money. About 11 percent of all teens and adolescents have been diagnosed with ADHD. It’s so common that people with ADHD show
up all the time in popular media. Think of a character or somebody who shows
up in TV or in the movies that has ADHD. Just think about one. Okay, most likely, you thought of a male character. That’s probably because boys are two to
three times more likely to be diagnosed with ADHD compared to girls. But why is that? Well, let’s go back to your character. The person that you thought of probably has
the behavioral symptoms of the predominantly hyperactive-impulsive type of ADHD. These include symptoms like fidgeting, tapping,
difficulty staying seated, playing loudly, constantly moving, excessive talking, or interrupting
others. As you can imagine, these symptoms are easier
to observe and, therefore, diagnose. But there’s another kind of ADHD that gets
much less attention and that’s harder to see. The inattentive type. This type of ADHD is characterized by symptoms
like not paying close attention to details, making careless mistakes, having a hard time
staying focused, not listening when spoken to, not following through on instructions,
not finishing tasks, difficulty staying organized, avoiding complicated responsibilities, and
losing things needed for everyday functioning. Okay, now try to think of a character with
the inattentive type ADHD. It’s not as easy, is it. On average, women tend to have a higher rate
of this subtype, which may be a big part of why women are less likely to be diagnosed
with ADHD at all. There’s also the combination subtype, which
is basically a mix of the two kinds. If you find yourself experiencing a bunch
of these symptoms and it causes problems at school, at work, or just in everyday life,
you may have ADHD. Sorry for the sudden change in environment. But I’m having a bit of a tough filming day. The camera just died, so I decided to take
a walk and just keep filming. That’s kind of fitting in honor of ADHD, don’t
you think? Almost 70% of kids diagnosed with ADHD take
medication for it. In Alie’s video on the neuroscience of ADHD,
our friends Cindy and Steve talked about their experience taking the two most common forms
of ADHD medications, which are Adderall and Ritalin. Medication for ADHD can be a polarizing topic. You know, it’s often presented as the only
form of treatment and a lot of parents don’t want to give their kids stimulants. Especially when the media talks about them
being overprescribed or make it seem like an ADHD diagnosis is just a way to control
excitable kids. Now many people wonder if Attention-Deficit/Hyperactivity
Disorder, ADHD, is a real problem. Could children just be overenergetic and/or
naughty? One in every ten male children takes medicine
for the disorder and that number is increasing. So if your mom doesn’t want to go that route,
or if you’re just not feeling it yourself, are you out of luck? Are meds actually the only solution? Well, most likely, if you’re watching this
video, you know the direction that I’m going in. Turns out, therapy can be a very powerful
adjunct or alternative to medication. So, let’s take a look. The most effective form of therapy for ADHD
in children is Behavioral Therapy. This is an umbrella term that refers to a
lot of different kinds of therapy that focus on a person’s unhealthy or unhelpful behaviors
and works to change them. The logic goes that by changing the behavior, you alleviate any mental discomfort that’s associated with it. If you’re dealing with younger kids, then
Behavioral Parent Training is the way to go. Behavioral Parent Training, or BPT, is a type
of therapy that involves providing parents with specific instructions and directions
on how they should interact with their child. There are a lot of programs that use this
model and it’s pretty cool to see it in action. I’ve actually seen it in person and when I’ve
seen it done, it used a two-way mirror where the therapist was on the dark side of the
mirror with a walkie talkie and the parent and child were on the other side in a playroom. They can’t see the therapist, but the parent
wears an earpiece so that they can hear what the therapist is saying to them. So as the child and parent talk and play,
the therapist guides the parent through Child-Directed Interactions. These are essentially skills that teach the
parent how to praise the child and increase appropriate behaviors and focus on relationship
building skills like reflecting, imitating, and describing. These skills make the child feel heard and
understood and supported. Parents are also instructed to provide dedicated
attention to the child. So a common suggestion would be to spend a
few minutes every night showering their child with praise on things that they did well that day. This really reinforces those positive behaviors. On the opposite end, parents also learn how
to reduce problem behaviors by ignoring them or providing consistent consequences, like
timeouts. By practicing all of this in session, then
the parent can then use those same skills at home and they essentially become like a
co-therapist, which is pretty cool. And it’s super effective, too. Now, up to this point, most research on BPT
has focused on younger kids, so it may or may not be effective with teenagers. But in general, 4 to 8 weeks of this therapy
gives clear expectations to the kids and provides a more positive relationship and home atmosphere. And, surprise surprise, adults can benefit
from therapy too. Although the most effective form of treatment for
adults with ADHD is Cognitive Behavioral Therapy. They just snuck in the cognitive part right there. Funny enough, clients can actually use the
same techniques of reinforcement and consequences to change behavior like you would see in BPT. But this time, you’re the one giving yourself
the consequences, which can be tough. Without a parent telling you what to do, it’s
important for the client to examine their cognitive processes and self-defeating thoughts
to better understand and change their behaviors. As you can imagine, when you consistently
fail to complete tasks or have difficulty with your social life as a result of your
ADHD symptoms, that doesn’t make you feel too good and it can really lead to a lot of negative
thoughts. CBT breaks down those barriers and builds
up healthier, more positive thoughts. A lot of ADHD-tailored CBT also focuses on
building skills and routines that help the client with organization, prioritization,
and time management. Essentially, you learn how to adapt your environment
to be more forgiving of ADHD behaviors. For example, if you often forget your keys
or your wallet when you walk out the door, maybe you create a pattern of putting them
into your pants the night before or putting them in your backpack if that’s the thing
that you can’t leave home without. Or if you often forget tasks, you might create a to-do list or write down reminders on your phone. This can vary from person to person and it’s
really all about finding changes that are best suited for that person to make them feel
more capable, calmer, and happier. Alright, sun’s is going down. It’s getting much colder. It’s a very pretty sunset, but let’s go back
inside. I bet the camera’s charged now. There are other kinds of treatments that are
promising for treating ADHD as well. Dialectical Behavior Therapy, which was originally
developed for treating Borderline Personality Disorder, has shown some effectiveness because
it teaches mindfulness, emotion regulation, and interpersonal skill building. Metacognitive Therapy, which essentially asks
clients to examine how their mind works and what they believe about their own thoughts,
also appears to be effective because it teaches new cognitive patterns and addresses maladaptive
beliefs. And specialized skill building in both group
and individual forms seem to be effective as well, which makes sense because it’s
essentially CBT but, ya know, without the C. Now, with all of these therapies, you might
be saying, “Well, that’s not really treating the problem. It’s not curing the ADHD.” And that’s true, I mean, these therapies doesn’t treat the
core symptoms of inattention, hyperactivity, or impulsivity. Instead, they just try to make it easier to
cope with the symptoms. ADHD can’t really be cured, but the symptoms
can be somewhat alleviated with medication. That’s why the most effective treatment
for ADHD is a combination of both therapy and medication. It’s like chocolate and peanut butter in
the same candy. Or archers and infantry on the battlefield. Or a neuroscientist and a therapist explaining
the same topic. But the number of people who have received
therapy for ADHD is horrendously low. Only about 13% of kids diagnosed with ADHD
ever receive therapy for it. Contrast that to the CDC’s report that almost
two thirds of kids with an ADHD diagnosis are taking medications for it. Damn. Ultimately, it’s important for families
and doctors and therapists to consider all options for treating the condition. And using effective, and evidence-based practices,
then people can learn to live with their ADHD. And perhaps, if therapy becomes more popular,
then we can decrease the number of stimulants being prescribed. But that’s just my opinion. I’d actually be curious to hear where you
all fall on this. So if you leave a comment down below, I’d
love to start a conversation about all things therapy and ADHD-related and get your feedback
there too. Anyway, thanks for watching this episode of
Micah Psych on Neuro Transmissions. And until next time, I’m Micah. Think about it. Okay, I think that’s good.


  1. Not sure what was going on with my brain, but I messed up on both “Dialectical Behavior Therapy” (I said “behavioral”) and Metacognitive Therapy (I said “metacognition”). The text on screen is correct, but…ya know…wanna cover my bases.

  2. "Behavioural health diagnosis" is a great way of expressing the topic. Thanks for another useful, clearly expressed and interesting clip.

  3. The combination of therapy and medication being the most successful form of treatment is not surprising. I agree wholeheartedly that therapy is a very useful tool and has shown some significant improvements in the quality of life for children, parents and adults who are effected by this. Comments do not seem to be appearing in the comments section. Thanks for sharing your knowledge and wisdom on the topic.

  4. Junior high teacher here, just wanted to say I was nodding along with everything you were saying. Like “yep, seen it, seen that, yep, sounds familiar”

  5. I have the inattentive version of "ADHD". Here in Europe we still call it simply ADD, which I prefer, because I don't have the "H" (outward hyperactivity). Medication has been a life saver. I wouldn't have been able to step up with just behavioural therapy. I have been able to compensate for a very long time in my life, but I can't force myself to remain focused more than I can, when the juice runs out. The medication (Methyl Phenidate) also keeps me in a lighter mood.

  6. The "Do you know someone with ADHD?" question in the sidebar is currently at 100% "Yes" — Interesting!

  7. Iran governmental insurance supports medication treatment so it costs free but counsling therapy is pretty much expensive and not supported by governmental insurance.
    but in Iran, all universities are scholarshiped by the government so something like CBT costs nothing for me as a student , and you know all unis have mental health center and is free for its students so I use it and am under CBT too.

  8. gimmi gimmi the speed i need i need more life dont need this state to last i want more to burn i want more to break so give me the speed i need.

  9. I see ADHD like diabetes of type 1 and 2. The 1 is a condition you are born with while the 2 have environmental causes. I think most of the ADHD cases are caused by environmental factors, and that the problem reside in an inadequate social environment. Finally, can someone who never felt any of the symptoms mentioned in this vid raise their hand? Those a very generic symptoms, and the grey area in which health professional have to deal to diagnose kids, teens and adults appear huge to me.

  10. 16 yr old junior (girl) in high school here, recently diagnosed over the summer with depression and anxiety. I also identify with practically all the adhd/add symptoms (though more the inattentive one for women and less hyperactivity)and while not formally/officially diagnosed with this disorder, both my sister and brother have it and take medication for it, so my psychiatrist started me on adderall. Adderall was a bust, it made me feel awful and I had all the bad side effects. I’m trying concerta (like Ritalin) now and while it has less uncomfortable side effects I’ve found it really hard to Distinguish wether or not it is helping me. Everyone keeps telling me it’s a fast acting drug so I should be able to tell right away the difference but I just can’t. I don’t know if this boils down to my attention just being awful( I genuinely can only handle watching this video at 1.5 speed!) Or being oblivious to everything or being depressed with my mood being at a constant low, but if there is any positive difference I can’t say I notice it. It’s tough because adderall didn’t work for me but it works for both my siblings, and I have anxiety which maybe my fidgetyness can be attributed to, so I feel really frustrated, like maybe nothing is working because I might not truly have adhd. I do think these issues may help with therapy (along with helping my anxiety/depression) but therapy is so goddamn hard to get. The waiting list for affordable or covered therapy is insane, plus it’s important to get a therapist that fits my needs and understands my situation. So while therapy and medication is probably the best solution, i wish it wasn’t so much harder than advertised.

  11. Thank you for another great video on ADHD. I remember being unwilling to take ADHD medication in part because I thought it would change who I was. What really struck me was that scene in the Simpsons when Bart is given some sort of attention medicine and he ends not doing the things he used to love – basically changed. I know it's just a cartoon but it really felt the same would happen to me.

    I'm glad to say that it didn't happen and in fact, I can be even more myself since I can actually focus on the things I love instead of giving up and feeling dumb so thank you for this great and informative video! It really helps break these misconceptions.

  12. My school sent me to a specialist to figure out why I was disruptive and unattentive in class when I was 6. What they found out was that I was just really bored because everyone else was learning soooooooo slowly

  13. I don't think I have ADHD but i experience some of the symptoms in a weak form. And I figured out the methods of cbt on my own and they work great. Everyone should reflect on themselves from time to time.

  14. I think this is missing a few things, exercise, breathing, diet and mindfulness exercises very important factors in ADHD.
    Diet is especially important in inattentive type ADHD, as many have dietary sensitivities that produce brain fog. For me, I had a gluten sensitivity for many years and had no idea that had caused lethargy and brain fog, wasn't until I had an elimination diet that we had found out that I was sensitive to a variety of foods. Everything improved beyond that.

  15. I wonder what advice you have regarding the different conditions

    I have been diagnosed with Aspergers/PDD, but much of your description of inattentive ADHD feels relevant.

  16. It would be nice if they wouldn't put substances in food and supplements that can lead to attention deficit. I don't know how many times I read that warning on labels. And yeah, I have it too. Or I think I do.

  17. Why is adhd or add considered a disorder in the first place? Especially given the quantity of people diagnosed with it, at what point is something so common that its no longer a deviation from the norm? Knew dozens of kids in grade school that were "diagnosed" with it… at what point is it not a disorder of a child but perhaps a societal disorder?

  18. There's a "notable" gamer out there (won't name for obvious reasons) who seems to mess up a lot in "stupid" ways like completely missing an obvious path in a maze. I guess he has the "obscure" kind of ADHD.

  19. Thank you for your vidéos ! I'm a second year medicine french student (sorry for my english) and I really enjoy loocking at your videos. But I wanted to make an observation. I think that is better to speack about patient instead of client because in that kind of professions you dosen't only do your job to get pay, you do not answer the same kind of service as a restaurant ou a hairdresser. When you are a therapist I think that you'r doing a public service mission and that deserved to use an other word than client
    Anyway thank you for what your are doing and continue like that 🙂

  20. I might consider this. Adderall helps me focus and gets me motivated ,but it also ramps my anxiety up like ten fold, and makes my insomnia worse. like Adderall helps me focus and stay on task 50% of the time, maybe 40%, but the other 50 or 60% of the time it just ramps all my other problems up to an insane degree. Why is my Neuro-Chemistry so twacked?

  21. Hm… Ok, I need you to help me. I am trying to teach Spanish to a 6 y.o. Russian kid, and it's not giving enough results. I am very creative usually, but I'm stuck. I need a psychological formula to teach kids things that they are not interesting in learning, because parents aren't unschoolers sadly.

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