ADHD Assessment and Therapy
Everywhere you go these days, someone seems to be talking about their ADHD. Previously a little-known disorder, young adults, parents and children alike are now discussing the merits of Ritalin, Wellbutrin and other ADHD drugs.
While ADHD is most often treated effectively with medication, research shows that not everyone gets full benefit from ADHD meds, and longer term efforts have to be put into managing specific challenges such as time blindness, task paralysis, rejection sensitivity, and disorganization without relying fully on medication. .
How Can I Tell If I or a Loved Should Be Assessed for ADHD?
An assessment of ADHD would be appropriate in all the following situations:
Children
Children who can’t sit still, forget instructions, or leave a trail of half-finished work across the house and classroom may benefit from an ADHD assessment. Teachers may say they’re “bright but careless,” and parents are exhausted by having to give them constant reminders.
Teens
Teens who mean to study, but end up scrolling endlessly online can benefit from an ADHD assessment, along with teens who miss deadlines, misjudge how long things will take, or make impulsive choices that blow up friendships, grades, and family trust.
Adults
Many adults with undiagnosed ADHD appear smart and hardworking, yet still miss deadlines, misplace important documents, or live in a cycle of “I’ll do it later” followed by feelings of guilt and repeated burnout. An assessment can bring much needed clarity on the cause of these problems.
How Is ADHD Assessed?
An ADHD assessment at my office is structured, evidence-based but human. The goal is to get a clear picture of attention, activity level, and executive functioning from childhood to present, across home, school, or work.
For children,
This usually includes conversations with parents, feedback from teachers, and standardized questionnaires to pinpoint areas of challenge. To get a more detailed view, ADHD assessments often include IQ tests and school achievement to take a closer look at the child’s learning ability, memory, and problem-solving skills.
For teens
For teens and adults, there is a mix of self-report and input from someone who knows you well (a parent, partner, or close friend), plus focused questions about work, study, daily routines, and history.
Across ages
Across ages, attention is also given to sleep, mood, anxiety, and other factors such as sleep apnea that can mimic or complicate ADHD.
What Happens During Therapy For Adults and Children with ADHD?
Therapy is practical, collaborative, and tailored to an ADHD brain that prefers interest and urgency over rules and obligations
Common areas of focus include:
Making it easier to start and finish tasks
Breaking work into realistic steps, using external structure, and reducing “all-or-nothing” thinking.
Managing time and planning
Learning to estimate time more accurately, using calendars and reminders that actually get used, and setting up routines that are simple enough to stick.
Handling impulsivity and hyperactivity
Instead of demanding sheer willpower, we build in natural pause points, change the environment in helpful ways and give the body and brain appropriate understanding and outlets for the feelings and sensations underlying their hyperactivity and impulsivity
Managing difficult emotions
Feelings often associated with ADHD unfortunately often include shame, frustration, and hopelessness. Therapy helps make sense of the situation and replaces blame and shame with compassionate understanding
Sessions move at a pace that fits short attention spans. Concrete, visual aids are used when helpful, with summaries at the end, and clear “takeaways” to try between sessions.
Stories From the Therapy Room
Details are changed for privacy, but these stories reflect the kind of changes people often experience.
Mia, 9, used to “forget” homework almost every day and melt down when asked to sit and finish it. Together with her parents, a simple after-school routine was created: snack, 10-minute homework “sprint,” short break, then another sprint followed by a small treat (usually a game of cards with her mum or helper). Within a few months, she proudly said, “I don’t lose my homework anymore. I know where it lives. I am not scared to do it because I know I only have to focus for 10 minutes.”
Jordan, 16, failed assignments not because he didn’t care, but because he couldn’t get started until the night before. In therapy, he learned to understand the peculiarities of his ADHD brain, and think about where things typically would go wrong for him. Based on this new understanding, he made his own plan to turn essay writing into a series of tiny, timed steps that he was prompted to complete on his phone with pop-up reminders. His method was unconventional, but it worked. Said Jordan, “I’m still ADHD, but now I’m ADHD with a plan.”
Sam, 38, was constantly late for meetings and overwhelmed by email. It occurred to him that he might have ADHD when he brought his 8-year-old child in to see me and I diagnosed her with ADHD. Her symptoms looked to him to be much like his own. Therapy had to start with the intese grief Sam felt at having unknowingly struggled so deeply with ADHD his whole life. On diagnosis, he began to remember all the pain he felt when teachers complained about him to his parents without understanding his struggle. He ruminated over the opportunities he missed at work because of his disorganisation - opportunities that could have been financially life-changing.
We worked through his grief before then turning our attention to discussing realistic systems that he could implement at work that would work without demanding perfection: Time-blocking the calendar, using alarms, and setting a daily “admin power hour.” Sam later said: “For the first time, my brain and I feel like we’’re on the same team.”
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