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Monthly NewsNote
December 2003
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Family Counseling and ADD
I believe that several guidance sessions for family and patient after the diagnosis
of ADD and the starting of medication is a good idea. As I often state, ADD
affects not only the ADD patient, it affects the entire family. By the time
the ADD patient is diagnosed and starts treatment, the family has experienced
stress and tension, frequently coupled with worry about the future. Therefore,
medication as the total treatment is often not enough.
Take Marty as an example. Marty was an 11-year-old boy with moderate hyperactivity
and distractibility but with serious impulsive behaviors. He said things without
thinking.
The insulting comments upset his family and alienated his peers, while his disorganization
left rooms a mess and sent Mom scurrying to retrieve forgotten books and other
items. His behavior created tension not only between Marty and others, but also
between his parents, who could not agree on the best way to work with him.
Medication helped Marty a good deal, but the family was still dealing with
many unresolved tensions and questions. Though short-term guidance was strongly
recommended, the family refused.
In Marty’s case, as with many others, I think the total outcome of treatment
is much better when all problems are addressed. Short-term guidance from an
ADD knowledgeable Social Worker, Psychologist, or Psychiatrist can be of great
help. Based on my experience, here is what I think can be accomplished:
Many parents would like to talk about medication. There are often feelings
associated with putting a child on medication, and it is helpful to talk about
them. Sometimes the prescribing physician has discussed medication rapidly and
not left enough time for questions, or perhaps other questions have arisen.
Counseling can help.
Next, those parts of behavior that are ADD-related need to be separated from
behaviors that are not. For example, troubles with a sibling may be unrelated
to ADD. Not clearing the table or avoiding other chores is probably unrelated
to the ADD. Understanding what is ADD and not ADD leads to better methods of
working with the child.
And since no one is medicated for 24 hours a day, this leaves plenty of time
for problems to occur. Help anticipating and dealing with these situations can
make a big difference.
Understanding the ADD in more detail, learning techniques that are helpful
in behavior management, and expressing feelings are helpful to the family and
patient. A few guidance sessions for the family and patient can often accomplish
this and can prove very helpful in dealing with the ADD problems.
Beyond guidance sessions, other helpful activities can include therapy, self
education through reading, or becoming a member of CACLD (838-5010 ) or Smart
Kids with Learning Disabilities (203-226-6831 and attending their programs.
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