How to Treat ADHD with Behavior Therapy

Explore this Article

parts

1Designing a Behavior Modification Program

2Continuing Treatment at Home

3Using Behavior Modification with a Child

Other Sections

Related Articles

References

ADHD is characterized by inattention, difficulty concentrating, difficulty attending to details, problems listening to or attending to instructions, organizational difficulties, fidgeting, and often being “on the go”. Behavior therapy serves to reinforce positive (or desired) behaviors through rewards and praise while decreasing problem behaviors by having consequences and setting limits. People with ADHD often have difficulty monitoring behaviors, accomplishing goals, keeping organized, and staying on task. Although behavioral therapy may not produce results as quickly as medications for ADHD, the results of behavioral therapy are more effective and long-lasting than any improvement that may come from medication. Behavioral therapy reduces impulsive behavior and reinforces good study habits, so it is important to include behavioral therapy in any treatment plan for ADHD.

Steps

Part 1

Part 1 of 3:

Designing a Behavior Modification Program

1. 
   1
   Work with a behavior therapist. A behavior therapist specializes in creating, modifying, and enforcing behavior plans. A behavior therapist can work with you (and/or your child) to create a plan that leads to better outcomes in behavior and productivity. A behavior therapist may work to modify responses to anger, use role playing, social skills modeling, and activities to promote focus. Meet with a behavior therapist to create a behavior plan and track progress over several weeks.

   • For more information, check out How to Get the Most out of Behavioral Therapy.
2. 
   2
   Set specific goals. The therapist will ask what desired behaviors or goals are needed. Think beyond “I want better behavior” or “I want to punish my child less.” Reflect on where the struggles are, such as completing homework or work projects. Then, set small goals. You can set goals for getting work done (“Work for 20 minutes, then I get a break”) or for behavior (“Share toys with your friends” or “decrease impulsivity during playtime.”)

   • Think about what goals you may have, then try to break them into smaller parts. For instance, you may want a clean room. Break this into smaller parts by saying, “All shoes will be put away, all laundry in the basket, toys picked up off the floor, and bed made each day.”
   Advertisement
3. 
   3
   Design a program aimed to create initial success. Work with the therapist to encourage immediate success. Criteria for rewards can become harder as the program continues, but keep motivation high in the beginning to encourage following the program.

   • Have small prizes to begin with, such as a little toy or sweet treat (like an ice cream cone) as a reward for completing basic positive behavior.
4. 
   4
   Provide rewards and consequences. Decide what behaviors to reinforce and which behaviors to not reinforce. Then, brainstorm motivating incentives and/or consequences for completing (or not completing) tasks. Providing rewards or positive reinforcement is motivating and will encourage more positive behaviors.

   • For children, some people use sticker charts, which allow the child to earn a sticker for positive behaviors displayed.
   • Rewards can be small toys or objects (which are good for small children, who respond best to immediate reinforcement), or a point system to save up for larger prizes (good for older children).. For adults or older teens, the reinforcement can be a treat (like an ice cream cone or brownie), or the ability to save up and purchase a desired item. Children may want to choose their own rewards, which can be beneficial in motivation.
   • Consequences can include taking away certain privileges (no tv if homework is not completed), or deducting points if using a point system.
5. 
   5
   Continuously use rewards and consequences. The key to implementing behavior modification systems (like a point system or behavior chart) is consistency. Don’t start the behavior system then gradually forget about it. Be consistent and persist with enforcing the behavior system. A behavior therapist will check in on the system each week during therapy.

   • Respond to positive behaviors as they occur; don’t let time go by without positively reinforcing good behaviors in the moment. The faster you reinforce positive behaviors, the better connection is made to continue positive behavior.
   • Make time each day to go over the day’s behaviors, and discuss what can be improved. For instance, praise a good day filled with many positive behaviors. If one day does not include many good behaviors, discuss what can be improved upon for the next day.
6. 
   6
   Know the signs of unethical behavior therapy. Behavior therapy is a tool, and tools can be abused. Rigid or abusive behavior therapy can leave lasting scars on a child. Nobody should be cruel, coercive, or controlling towards the child.

   • Oppositional therapist behavior like arguing, criticizing, escalating conflicts, depriving the child of chances to rest or calm themselves, approaching therapy as a battle instead of a team effort, etc.
   • Harsh punishments like screaming, hitting, forcing the child to eat vinegar or wasabi, locking a child in a dark closet, etc.
   • Abuse of reinforcers like turning a child's life into a series of tokens and exchanges, depriving a child of any food/drink/toys unless they obey, only letting a child access their favorite things during therapy sessions, etc.
   • Lack of caring like seriously withholding affection, ignoring a child's feelings, refusing to let a child set boundaries, ignoring the reasons why a child does what they do (in favor of forcing them to "act normal"), training them to smile or hug on cue regardless of their feelings, etc.
   • Dishonesty such as lying to the parent, prohibiting the parent from witnessing therapy, minimizing incidents (e.g. saying that screaming is just "tough love"), saying that it is normal for children to hate or fear therapy, claiming that they are the parent's only option, etc.
   Advertisement

Part 2

Part 2 of 3:

Continuing Treatment at Home

1. 
   1
   Use a schedule. Behavior therapy is often useless if it’s only discussed and implemented for one hour each week during therapy. It’s important to bring the learned skills home. Many people with ADHD find it hard to stay on task and complete goals. Distraction is far too easy and before you know it, you’re in the middle of another task. Keep life simplified by having a daily schedule. Know your morning, afternoon, and evening routine, and keep it the same and predictable.

   • This goes for children, too. Have a morning and after-school schedule in place so that the child knows what to expect. Keep motivations in the schedule, like setting aside 30 minutes of tv time once homework is completed.
   • The more predictable the day is, the better someone with ADHD will follow through and accomplish goals.
2. 
   2
   Keep things organized. If you find it hard to keep things in order or notice that your child leaves things around the house, have a place for everything. Use bins, storage containers, baskets, or anything else that keeps you organized. If you constantly lose certain items (such as your keys or your cell phone), have a place for them in your home where they always go. For a child, have toy bins that help your child to know which toys go where. Sort clothes so that it’s easy to put them away.

   • For more information, check out How to Organize Your Life.
3. 
   3
   Use timers. Place clocks throughout the house so that you (or your child) can stay aware of how much time is left to get ready or to finish homework before dinner. Use a timer to motivate work getting done, such as homework or projects. Set the timer, and provide a small reward when the timer goes off.

   • If a task seems to big to manage, break it down into smaller parts. Use a timer to work for 20 minutes, then take a break for five minutes.
4. 
   4
   Have a quiet workspace. If work or homework is done at home, provide a quiet workspace. This helps keep out distractions and allows for better concentration. Turn off the tv and have the workspace in a room away from noise or other people. If music is wanted, keep it with minimal or no lyrics, but something relaxing and not distracting.
   Advertisement

Part 3

Part 3 of 3:

Using Behavior Modification with a Child

1. 
   1
   Communicate clearly. If you have a request for your child, make it clear that you are directing it to them. Say the request clearly and simply. It’s not enough to ask your child to “be good”; be specific in your speech and make sure that they understand your expectations. If you aren't sure how to do this, you can discuss it with a behavior therapist, and get some practice.

   • "Aaron, please stand next to me."
   • "Please keep your hands to yourself."
   • "Sheila, please pick that up. It's okay to touch the groceries, as long as you pick them up if you knock them over."
   • "Use your inside voice, please. Mommy is working and she needs quiet so she can focus."
2. 
   2
   Use “when/then” statements. When a child wants something, like to watch TV or play with toys while in the middle of homework, gently remind that the child that they must complete the task at hand first. Then, once the task is completed, they can have the reward. Be firm and communicate simply with the child, then drop the discussion so they understand that this is non-negotiable.

   • "Yes, you can play your dinosaurs when you finish your homework."
   • "First we'll finish putting away your toys, and then you can have dessert."
   • "When we are done in the grocery store, then you can run around in the field a little before we get into the car."
3. 
   3
   Model target behavior. If you want a child to behave a certain way, model the appropriate behavior for your child. If your child has a difficult time monitoring aggression during interactions, show your child what kind and non-aggressive interactions look like. If you want a child to be less messy, model picking up your things before moving on to a different activity.

   • If the child has siblings, have them model good behaviors as well. If you’re working on your child putting their shoes away, have everyone in the family put shoes away in a quick and organized fashion.
   • If you’re struggling to model target behavior, ask the behavior therapist to model it for you.
4. 
   4
   Adjust the system with development. A behavior modification system designed for a 3 year old will not work as effectively once the child is 5. Adjust the system as the child grows. Modify rewards and also target behaviors. Make sure the system continues to motivate the child to working toward positive behaviors.

   • Younger children often respond well to immediate rewards and feedback, like a small toy. If your child begins to lose interest, ask for input on rewards. As the child gets older, they may want larger prizes, which can be earned with points.
   • The therapist will monitor progress and see if adjustments need to be made.
5. 
   5
   Use behavior modification at home and school. Children respond to consistency in their environment. Talk to your child’s school teacher and inquire whether a behavior system is used at school, and if not, how you can help your child succeed in school by using a behavior system. Especially if your child struggles to complete assignments at school or has difficulty with impulsivity or social skills, a behavior system can help. The more it aligns with the system at home, the more consistent and predictable the plan, and the better the child can adhere.

   • Ask a behavior therapist what recommendations they may have for following a behavior modification program at school. It may include reinforcing when the child raises their hand versus blurting answers out, waiting patiently in line, or not rushing through tests but taking one’s time.
   Advertisement

Expert Q&A

Search

Add New Question

Ask a Question

200 characters left

Include your email address to get a message when this question is answered.

Submit

Advertisement

You Might Also Like

The Truth About Mental Health: Separating Myth from Fact

How to

Survive a Heart Attack when Alone

How to

Get Rid of Parasites

How to

Do Savasana (Corpse Pose)

How to

Recover from a Bone Fracture

How to

Become a Sterile Processing Technician

How to

Discuss an Unplanned Pregnancy With Your Spouse

What Is Adrenaline? How an Adrenaline Rush Affects Your Body & More

How to

Encourage Big Kids to Wear Diapers

How to

Identify Pathological Demand Avoidance in Autistic Children

How to

Fix Strawberry Legs

How to

Treat Dry Eyes Naturally

How to

Take Shilajit

How to

Go on a Ketogenic Diet

Advertisement