What can be done to help someone who is resistant accept treatment?
How we can best deal with a family member’s resistance to evaluation and treatment varies dependent upon the individual’s age. In younger children, we rarely see resistance. Once they see the positive impact of medication and other strategies on their school experience, social interactions, and home life, most young children are happy and, actually, excited about treatment.
There is much more resistance pre-pubertal children and young adolescents who frequently struggle with the notion that ADD and its treatment make them different from their peers. This is a developmentally appropriate response for children this age who can react intensely to anything that sets them apart . . . a pimple on the forehead, not enough pubic hair, or having to take a pill in order to pay attention. Parents of these children can promote acceptance by being empathetic and providing educational materials that demystify ADD and its treatment. In my experience, however, it is important that parents of the resistant young adolescent take charge by setting clear limits about taking medication and participating in follow-up counseling. Typically, resistance and struggles with acceptance at this age fade relatively quickly as the child matures and begins to appreciate that we are all different in some way.
When dealing with older adolescents and young adults, addressing resistance is often more challenging. We frequently see older adolescents or young adults who have struggled for years, been accused of being lazy or stupid, or been told that they could do it if they just tried harder. After years of failure, many of these young people develop a hard exterior shell, an “I don’t give a damn” attitude to cover up a very low and damaged self-esteem, and intense resistance to help. While educational materials and frank discussions about ADD and its long-term consequences can sometimes help to overcome the resistance, it is often necessary for parents to focus on establishing firm limits and to stop enabling in order to motivate the older adolescent or young adult to comply with treatment. This may mean taking away the car, refusing to provide spending money or, in the case of the young adult, withdrawing the comfort and support of continuing to live at home.
Addressing resistance to evaluation and treatment with an adult, particularly a spouse can be tricky. Adults may have many reasons for not wanting to become involved in treatment. Some may have developed a version of that hardened, self-protective shell and, belligerently proclaim, “I’m just fine the way I am!” Many adults with ADD, as a consequence of their poor self-monitoring, truly do not see the problems that a spouse, close friend or even co-worker sees. When this is the case, it is important for significant others to provide direct feedback when problem behaviors occur and be careful to avoid enabling, co-dependent behaviors that can mask the impact of untreated ADD. Learning to detach, let go, and take care of himself are important steps for the spouse of the adult with ADD.
Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.