In my previous email we discussed exactly what is Cognitive Behavioral Therapy (CBT). That doesn’t exactly tell how Cognitive Behavior therapy can be used to help kids with ADHD.
Originally a treatment for mood disorders, the basis of CBT is that it enables you to recognize how the way you think (cognition) affects the way you act (behaviors). The idea is that impulsive thoughts are the spontaneous results of events or aspects from your environment. These impulsive thoughts that fuel your actions can sometimes be misinterpreted. Especially when your brain works differently like ADHD brains and have common ADHD co-conditions like anxiety, low self confidence, depression and more. If you have an unhealthy dialog going on inside your head it is hard to figure out the right pattern to develop positive, productive habits. CBT trys to help you find ways to retrain your brain to stay on task and accomplish your goals, whatever they may be. Through being aware of your cognitive thoughts you can change your thought patterns and develop positive behavior patterns.
How can CBT help ADHD kids?
CBT has been shown to help with ADHD and a lot of ADHD co-existing conditions like anxiety, hypersensitivity and mood disorders. ADHD kids have a tendancy to have an irrational thought pattern that prevents them from staying focused on a task. Rather than letting doubt that you cannot do something good, or that it has to be done in a particularly perfect way, you can change your congitive thoughts which will result in changing your behavior patterns.
For kids will low self confidence who doubt themselves, inattentive and easily distracted kids and kids with anxiety who overthink and worry about everything it can be a great help. For my son he has all three of these attributes and has found CBT tools a great help in his daily life. For my daughter who only has inattentive aspects of ADHD, it has still show tremendous help in her daily workings.
Overall CBT is a problem focused therapy.You look at a particular problem that your child is struggling with and help them figure out what they are having a problem with exactly and then help them figure out ways they can change their behavior.
But how can I use CBT for my ADHD kid?
For my kids mornings were HORRIBLE! Not kidding. All the memes out there about neighbors hearing mom yell at their kids or sitting in the car after drop-off crying was my life. Every morning was horrible, difficult and full of frustrations. It was so bad I felt like not sending them to school at all, just so I didn’t have to have morning stress with my kids. Once I sat down and looked at it critically, I realized my children have no cognition of time, schedules, planning or what they need to get done. I realized we all needed to rethink our mornings and start creating positive behavior patterns if we are going to survive. And this brought me to CBT and tools that would allow my children to create positive thought patterns and positive behaviors.
Some common practises of CBT for ADHD children could be as simple as using a calendar/planner/list. Not everything works for everyone. Many times, life happens and you are so into just getting through the day your best intentions fall to the wayside. If this happens you will not see the benefits of CBT and should look at modifying your task to make it something that will fit within your life. We tried many of the tips listed below and we continue to keep picking back up tools that will help whatever season we are in.
CBT Tools for ADHD Kids
Use a planner
Many ADHDers have found that CBT has helped them with daily struggles with procrastination and disorganization. A planner is a keep tool in helping kids be organized for important appointments and dates. It’s also great for daily tasks. Either ensure your child has a calendar with them every day (like their school agenda), or place it somewhere in your home where you will see it every day. For my son we have a scheduled task list for the morning and for evenings. For going on vacations, we have another list of what to pack. As my son is getting older, we are trying to make him more responsible for tasks so he is responsible for preparing his own bag every week for swimteam. To make this easier we have ‘swimteam’ marked on his calendar in a bright color and we have a laminated list of the items he needs for swimteam inside his bag. We also chose a designated backpack for swimteam so he doesn’t have to keep switching items out of his school backpack every week. It’s on the calendar, so every Friday when he comes home from school, he gets his swim team bag ready so he isn’t rushed or forgets for his Sunday night activity.
Prioritize tasks
If you have an ADHD kid you know that EVERYTHING is important to them and must be done right away. If they are like my impulsive son they will then begin obsessing on the task until it is completed. For example, he wanted to call a friend for a playdate, but we were in the middle of his doctors appointment and he continued to asked if he could call his friend every 5 minutes during the entire 45 minutes appointment. This takes a lot of patience from parents. The reality is my son is not trying to be rude and always be interrupting, it’s that he feels immense pressure in that moment for what he feels needs to be addressed. Again, this is a task of patience, discussions and communication. You need to realize that although it’s 10 p.m. and your son is non-stop asking to go visit his friend, he doesn’t understand that it’s not a good time. Or when he keeps waking up on Saturday at 7 a.m. and sneaking out of the house to go next door to ring their doorbell and ask his friend to play, he is only focusing on the fact that he is excited to see his friend. He doesn’t realize that not everyone wants to be woken up at 7 a.m. We needed to help him understand that there is a time and place for everything. It’s not that he can’t play with his friend, it’s just that he has to think of a better time and exercise patience so that it is good for everyone. Instead in the morning he learned that he can get up and play legos or watch a movie until it’s an appropriate time to go next door. Better yet he can do his homework, so when he wants to play with his friend that is already done.
Wear a watch
Time management can be a difficult task for ADHDers to grasp. One way it has helped my son is wearing a watch and be aware of what time things happen. We put up a bright note in the kitchen that has the time he has to leave for the schoolbus. He consults that note every morning the entire school year. It doesn’t mean he still didn’t miss the bus. The other reality is that when he says he’s going out to play basketball for five minutes and then will do his homework, it can be 2 hours later and he will still throw a fit he has to come in because in his mind it still hasn’t been the five minutes.
We started breaking down the time in the day for him. We tried a few different ways from just morning and evening charts to the entire day. This helped but he still was not aware of time so we got him a watch so he could be in control of his time. With a watch I could tell him at 5:30 you need to come in and do homework. He will set a timer and at 5:30 the time will go off and he will come in. ADHD moms, don’t fool yourself… my son is on his 5th watch due to being lost, broken or him taking it apart… but it’s still worth it!
Break down complex steps into smaller manageable tasks
If you tell my son to clean his room he will go up, spend an hour there and come back down saying it’s cleaned. The reality is he went into his room and likely got overwhelmed by what he had to do, so laid on his bed and stared at the wall. Instead I send him with only 1-3 tasks. For example, 1) clear off your bed 2) make your bed and 3) put the books that were in your bed back on your bookshelf. Then those are done he will come back for more tasks which involve putting away clothes, cleaning under his bed, etc. ‘Clean your room’ is too big of a task with too many variables. It helps too if I write down the broken down list for him and of course yell out reminders to make sure he stays on task.
Emotional sensitivity
For my son this was one of the harder tasks for him to work on. He has always been emotional and empathetic. This translates to my sons ADHD making him feel everything, on a big scale, ALL THE TIME! With the ADHD cousins of anxiety and low self confidence he always assumes that every situation will turn out badly and that he will mess everything up.
This is probably the hardest for ADHD kids to deal with and sometimes for the parents too. My husband isn’t that in tune with his emotions and this is difficult for him to relate to our son. Dealing with emotions is the same as dealing with children not being aware of time or tasks. You follow the same steps with all CBT tasks.
- Identify what it is that is causing upset.
- Become aware of how you feel and what you are thinking about those thoughts.
- Recognize where the negative or inaccurate thoughts are.
- Reshape your thinking that is a positive/productive outlook.
I know it sounds simple right. Just figure out your thoughts and change them. But with kids this isn’t always straightforward. Who am I kidding, even as adults this might not be an easy task. It will take a lot of patience and talking. My sons low self esteem makes him think everyone will not like him and he will mess up everything he does. It takes constant reminders that he is great and that how he sees things in his mind is not how things always are in reality. Sometimes I forget to remind him of this and it can get out of control, but after a few key phrases ‘you are a great kid and people like you’, he can get his negativity under control. The only thing is you have to live through the outbursts and actions that spill into all the other aspects of his life and work it out down to what is actually bothering him that takes the time. Another helpful tool was drawing and journaling. In the modern age we live most kids don’t know how to journal or try to express themselves with pen and paper. It’s easier if your kids are younger if you get them to try and create a cartoon like Captain Underpants or Nate books that are popular in schools.
It is important to note that this story is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment before undertaking a new health regime, and never disregard professional medical advice or delay inseeking it because of something you have read on this website. This article is just mean to share what I have learned in the hopes that it may help you too.
Have your tried CBT for your ADHD kid? Let us know what worked for you.
