How does the adult with ADD work toward positive behavior change?
In my experience, the journey toward positive behavior change for the ADD adult begins with an experienced professional leading him through the same steps we encourage parents, teachers and childcare providers to use in managing behavior in children with ADD. That is, we help the adult with ADD to do the following:
- Know who he is. It is important that he understand and accept his temperamental characteristics, his skills and abilities, his attentional abilities, his physical abilities, the stresses in his life, his attitudes and beliefs, and his self-esteem. He must understand which of these are changeable and which are not.
- Set realistic expectations for himself. Based upon his understanding of his own unique profile of strengths and weaknesses, he defines behaviors are achievable for him.
- Determine the factors contributing to an unproductive behavior and/or situation when it occurs. In doing this, he asks himself the following questions:
◦ What is the expectation that is not being met?
◦ What are all the contributors to this failure?
◦ What role do I play in this?
◦ What role do factors outside of me play?
◦ What contributing factors are changeable and which are unchangeable or out of my control?
- Develop a plan and put it into action. He refines the expectation as needed, and defines thoughts, actions, words and strategies that address all the factors that are under his control to maximize success at realizing the expectation, and tries it out in the real world.
- Refine the plan when necessary. He reflects upon the success of the plan, and makes changes in the plan by modifying the expectation, the thoughts, words, action, and/or strategies.
In repeatedly guiding the adult with ADD through this sequence, the professional gives the adult progressively more responsibility. Ultimately, the adult becomes an independent problem-solver able to critically evaluate and modify his behavior in nearly any situation. In my experience, my adult patients who are open and committed to learning about themselves and how to effectively solve problems grow wise and become confident in their ability to deal with whatever is thrown their way.
How do limiting setting and use of consequences work with adults?
In adult life, limits and consequences are not generally defined in treatment or by supportive parents and teachers. Usually, it is our employer, our spouse, our friends, the police, the IRS, the bank, etc. who impose them.
Further, the limits are not always clearly defined and the consequences are often very serious. Treatment activities with the ADD adult involve clarifying the reality of the limits, defining strategies that promote success in meeting expectations, supporting and brainstorming plans when consequences do occur, and working with spouses, friends, and parents to help them allow the sometimes serious consequences to occur.
ADD/ADHD creates life challenges unique to each life stage. Seek out care providers who have an appreciation for the challenges specific to adult expectations. For help identifying a qualified care provider in your area, download Dr. Liden’s book, ADD/ADHD Basics 101.