Parental Needs Matter: Supporting Teens with ADHD

The New Data - Old Truth

Your teen can indeed learn to hand their homework in on time without you supervising their every move. A pilot study published this year by Margaret Silbey (Parent–Teen Behavior Therapy + Motivational Interviewing for Adolescents with ADHD - 2016), has shown strong evidence that affirming a parent’s needs and motivation, is as important as identifying the student’s goals for themselves. 

This study is exciting to me for many reasons. It provides a model for collaborative parenting which is much needed in the field of ADHD coaching. There has been excellent work done on collaborative problem solving by Ross Greene and ADHD parent education by Russell Barkley, but this is the first time that the two have been put together in a comprehensive program.

For now, it is the role of the parent that I would like to share with you. The data shows that the best outcomes occur when the teen and parent are on a parallel path of self-reflection and change. The work is not about fixing the teen so much as it is about co-creating the conditions for the teen to learn the strategies for effectively managing their ADHD symptoms.

Social science data has shown for some time that healthier parents have healthier children. We also know that parents of teens with ADHD are “on” too many hours of the day organizing, advocating, disciplining, or otherwise being watchful that another failing grade is not around the corner.  This stress can shift the interactions between the child and parent in unhelpful ways. Silbey’s research takes this well-known truth and applies it in her treatment model for teens with ADHD.

STAND

Silbey’s program is called STAND (Supporting Teen’s Autonomy Daily) and focuses on building student self-efficacy, skill rehearsal and practice.  Both the student’s and the parent’s motivation for seeking help in the first place becomes the starting point. Poignantly, after non-judgmental reflection with a skilled facilitator, the parent-teen partners usually discover that they want the very same things: increased control over their own lives, better grades, and peace at home.  This common ground then becomes the motivational engine that drives the work. For example, Mom (or Dad) may say that she needs more time to herself, and her teen wants more autonomy. The pair then agree when, where and how Mom will check in. Mom also agrees that she will not “hover” while the work is getting done – no matter the outcome. The teen also agrees to practice new ways of “getting started” so that the work does actually get done.  Each wins. Needs are met on both sides.

The Importance of Parent Beliefs

To get to this point of collaboration, Silbey confirms that identifying limiting beliefs is key. By the time the parent seeks help, they have typically experienced years of frustration and failure to “make” their child do what he/she is supposed to do. Pressure from the school for a parent to “do” something increases this stress. Over time, these frustrations can harden into fixed beliefs about their child’s abilities. “These beliefs”, Silbey writes, “are powerful determinants of the parent’s behavior and guide their parenting choices.”

What is the Most Effective Parenting Style?

Silbey found three statistically significant patterns to describe parenting styles. One she termed, “broad disengagement” for a lack of supervision or structure at home.  These parents tend to be busy and believe that nothing they do will change anything with their teen.

A second type of parenting style she affectionately terms “personal assistants”, tend to be highly involved in all aspects of the teen’s schoolwork, including actually doing it for them. These parents often believe that if they did not supervise every detail their child would fail and the cost of that failure would be too high to tolerate.

The third type of parenting style is a “warmly collaborative” one.  These parents co-create structures with their teens for placing limits on freedoms and accountability for completing schoolwork. Notably, this group of parents has the highest level of personal well-being. It is this group that has the least conflict with their teens, and the teens have the most success in integrating adaptive strategies into their study habits. The parents in this group have the underlying belief that change is possible.

Building Parent Self-efficacy

So how can parents become warmly collaborative when they are feeling tired, discouraged and confused? They can get help from a professional who can support these changes and show them where their “parent” power is. STAND does this by showing that choosing to spend energy on adapting their own behavior is worthwhile and likely to lead to the “desired rewards”. For example, a parent will be asked to introduce a new strategy and later reflect on the results. Over time, the parent sees that these changes are indeed leading to better outcomes. This reinforces the belief that parents CAN and DO make a difference to their teen’s success. The fact that the teen is engaged in exactly the same process of trying new behaviours followed by reflection, can also be deeply encouraging for a tired parent.

The Payoffs

Successfully re-establishing the partnership between a teen and parent lead to improved outcomes in several areas. Teens recorded their homework more consistently, earned higher grades, and reported a reduction in inattentive and hyperactive/impulsive symptoms. Parents reported lower levels of parenting stress and this gain was maintained six months after the close of the study. In my practice, when these shifts occur, I also see reduced family conflict, increased parent and student resilience, and more space for loving connection. Ultimately, I believe, this last is the payoff everyone is looking for.

Lynda Hoffman, Certified coach 

Medipsy Psychological Services

Parental Needs Matter: Supporting Teens with ADHD

The New Data - Old Truth

Your teen can indeed learn to hand their homework in on time without you supervising their every move. A pilot study published this year by Margaret Silbey (Parent–Teen Behavior Therapy + Motivational Interviewing for Adolescents with ADHD - 2016), has shown strong evidence that affirming a parent’s needs and motivation, is as important as identifying the student’s goals for themselves. 

This study is exciting to me for many reasons. It provides a model for collaborative parenting which is much needed in the field of ADHD coaching. There has been excellent work done on collaborative problem solving by Ross Greene and ADHD parent education by Russell Barkley, but this is the first time that the two have been put together in a comprehensive program.

For now, it is the role of the parent that I would like to share with you. The data shows that the best outcomes occur when the teen and parent are on a parallel path of self-reflection and change. The work is not about fixing the teen so much as it is about co-creating the conditions for the teen to learn the strategies for effectively managing their ADHD symptoms.

Social science data has shown for some time that healthier parents have healthier children. We also know that parents of teens with ADHD are “on” too many hours of the day organizing, advocating, disciplining, or otherwise being watchful that another failing grade is not around the corner.  This stress can shift the interactions between the child and parent in unhelpful ways. Silbey’s research takes this well-known truth and applies it in her treatment model for teens with ADHD.

STAND

Silbey’s program is called STAND (Supporting Teen’s Autonomy Daily) and focuses on building student self-efficacy, skill rehearsal and practice.  Both the student’s and the parent’s motivation for seeking help in the first place becomes the starting point. Poignantly, after non-judgmental reflection with a skilled facilitator, the parent-teen partners usually discover that they want the very same things: increased control over their own lives, better grades, and peace at home.  This common ground then becomes the motivational engine that drives the work. For example, Mom (or Dad) may say that she needs more time to herself, and her teen wants more autonomy. The pair then agree when, where and how Mom will check in. Mom also agrees that she will not “hover” while the work is getting done – no matter the outcome. The teen also agrees to practice new ways of “getting started” so that the work does actually get done.  Each wins. Needs are met on both sides.

The Importance of Parent Beliefs

To get to this point of collaboration, Silbey confirms that identifying limiting beliefs is key. By the time the parent seeks help, they have typically experienced years of frustration and failure to “make” their child do what he/she is supposed to do. Pressure from the school for a parent to “do” something increases this stress. Over time, these frustrations can harden into fixed beliefs about their child’s abilities. “These beliefs”, Silbey writes, “are powerful determinants of the parent’s behavior and guide their parenting choices.”

What is the Most Effective Parenting Style?

Silbey found three statistically significant patterns to describe parenting styles. One she termed, “broad disengagement” for a lack of supervision or structure at home.  These parents tend to be busy and believe that nothing they do will change anything with their teen.

A second type of parenting style she affectionately terms “personal assistants”, tend to be highly involved in all aspects of the teen’s schoolwork, including actually doing it for them. These parents often believe that if they did not supervise every detail their child would fail and the cost of that failure would be too high to tolerate.

The third type of parenting style is a “warmly collaborative” one.  These parents co-create structures with their teens for placing limits on freedoms and accountability for completing schoolwork. Notably, this group of parents has the highest level of personal well-being. It is this group that has the least conflict with their teens, and the teens have the most success in integrating adaptive strategies into their study habits. The parents in this group have the underlying belief that change is possible.

Building Parent Self-efficacy

So how can parents become warmly collaborative when they are feeling tired, discouraged and confused? They can get help from a professional who can support these changes and show them where their “parent” power is. STAND does this by showing that choosing to spend energy on adapting their own behavior is worthwhile and likely to lead to the “desired rewards”. For example, a parent will be asked to introduce a new strategy and later reflect on the results. Over time, the parent sees that these changes are indeed leading to better outcomes. This reinforces the belief that parents CAN and DO make a difference to their teen’s success. The fact that the teen is engaged in exactly the same process of trying new behaviours followed by reflection, can also be deeply encouraging for a tired parent.

The Payoffs

Successfully re-establishing the partnership between a teen and parent lead to improved outcomes in several areas. Teens recorded their homework more consistently, earned higher grades, and reported a reduction in inattentive and hyperactive/impulsive symptoms. Parents reported lower levels of parenting stress and this gain was maintained six months after the close of the study. In my practice, when these shifts occur, I also see reduced family conflict, increased parent and student resilience, and more space for loving connection. Ultimately, I believe, this last is the payoff everyone is looking for.

Lynda Hoffman, Certified coach 

Medipsy Psychological Services

6 Steps to Successful (ADHD) Coaching

6 Steps to Successful (ADHD) Coaching

New clients often ask, "What can I expect from coaching?" This is particularly true for adults with ADHD who are already feeling overwhelmed. They want to change their lives for the better, but they want to do less - not more.

So, how do you get the best results? What leads to improved work performance, healthy relationships, and financial stability? As it turns out, the best results occur when clients are prepared to do things differently, rather than more of the same. Consider the following 6 steps:

Get to know your ADHD

Getting a diagnosis is important to your success. (By the way, getting a diagnosis is doing something differently rather than continuing with the status quo). There are three sub-types of ADHD, and many possible comorbid disorders that may be complicating matters. Once you know exactly which type you have, problem areas can be targeted more effectively. A diagnosis will also dispel the myth that your habits are a result of a character flaw (ADHD is a neurobiological disorder, not laziness). With a diagnosis, you will know definitively why you have not been able to focus at will like other people. You will learn that you did not cause your ADHD symptoms and you are not to blame.

Be committed to your stretch  zone

Being just out of your comfort zone is how you will make the changes in your life. Being slightly uncomfortable as you take risks with new behaviours will result in personal growth, new habits and increased self-confidence. This is because some anxiety is useful to the learning process. It keeps us on our toes and tends to mobilize us. The idea is to feel the stretch, take the action anyway, and celebrate. Your coach will support you in finding the balance between trepidation and effective learning.

Be in your neutrality

To go to your stretch zone repeatedly, you will need to respond to setbacks with neutrality. Responding to failure with non-judgment will support you in persevering until you reach your goals. When we decide to live bravely and tolerate some discomfort as a natural part of the learning process, these feelings diminish over time and we are more motivated to practice our new skills. Remember, failures are not personal. They are merely learning opportunities that are rich with Information about what we can do differently next time.

Set reasonable expectations for yourself

Learn to set goals that are achievable. Many people with ADHD take on too much at one time, become overwhelmed, and then stop. One of my clients had this experience when he decided it was time to become more efficient at work and streamline his paperwork. When we first met, he said he was feeling overwhelmed. When he thought about what it would take to reduce the amount of paper and set up systems so he would know where everything was, he quickly became overwhelmed. In his mind, it as one mammoth sized task. For him, the first step to success was a mini goal: purchase a scanner. Once he saw the purchase of the scanner as one small step in a series and paced himself throughout, he experienced improved feelings of control and self-confidence about making further changes.

Take action

Be prepared to take action in order to change your life. For people with ADHD, this is often very difficult to do because they tend to get sidetracked. Set the intention to take action and you will see results. Although your coach will support you in learning how to follow through on your plans, the most important work takes place between coaching sessions. Be mindful every day that doing something different is where the change occurs. This is when you will create new and more adaptive habits. Remember, whether you succeed with a new behavior the first time you try is not important. What is highly predictive of success is that you took action in the first place.  Action creates momentum. Once you get started, you are more likely to continue moving ahead. Remember too, that the quality of your action can always be modified later.

Consider all parts of your life

Be willing to explore all areas of your life. For example, if you make a plan with your coach for improved time management and do not share that you have a wedding scheduled in the middle of your peak work period, the plan is likely to fail. Be open to sharing what is going on in your life, even if it does not seem relevant. The best way to put the pieces of the puzzle together is to first throw them all on the floor. You can sort through them afterward.

Remember, coaching is a partnership to improve your life.   Decide to show up consistently, with openness and curiosity and you will find the success you are looking for.

For more information on coaching for ADHD, visit the Medipsy website, or visit www.adhd-tdah.ca for helpful resources. The Medipsy YouTube Chanel also includes helpful videos on ADHD. 

Lynda Hoffman

Certified Professional & Personal Coach

Medipsy Psychological Services

Services Psychologiques Medipsy

“If I know how to do it, why don’t I do it?”

Steve, threw up his hands in frustration saying, “Why don’t I do it? I learned from the best how to get organized, but I just don’t do it!” For adults with ADHD, repeatedly failing to do what they know very well how to do is very frustrating.

Steve loved people and people loved Steve. He was smart, charming, and creative. He was welcomed onto committees and he volunteered enthusiastically to take on important tasks. His input was valued and trusted, until it became clear that he was not doing what he said he was going to do. This pattern caused Steve deep embarrassment and eventually he decided to stop volunteering altogether. He was also failing to keep a job, or complete any task that required more than a few steps. He was in a tender place with his family who begged him to explain what was going on.  But he could not enlighten them any more than he could enlighten himself. Years of relative unproductivity eventually led to a growing sense of inadequacy. By the time I first met him, he was suffering with severe anxiety and he despaired that he could ever change this pattern of behaviour.  So, he asked me, “Why am I not doing what I said I would do?”

The short answer to his question was “ADHD”. This disorder is by definition an impairment of the self-management system, which includes the ability to modulate focus, and start and complete tasks. A patient once remarked to Dr. Thomas E. Brown, Assistant Clinical Professor of Psychiatry at the Yale University School of Medicine and Associate Director of the Yale Clinic for Attention and Related Disorders, that having ADHD, “is like having erectile dysfunction of the mind.” You do not have conscious control over performing on demand. Imminent threat or reward, however, will change the brain’s chemistry and mobilize the person to action.

What does this mean for you if you need to follow through more reliably and you have ADHD?  Certainly, you do not want to live under threat in order to produce work and you know that you cannot count on will power to change your behaviour. The answer lies in using what you do have control over.  High interest and emotional pleasure are powerful motivators and, as such, they create the right brain chemistry for action.  For people with ADHD, finding what interests them can be used as a strategy, rather than a distraction. When you know your passion, and live it, you will be more likely to be complete work and persevere through tedious tasks.

On a deeper level, knowing what you dream of for yourself, and what you truly want out of your life, can powerfully draw you forward. Getting in touch with what matters to you, coming to know it, see it, visualize it, sense it, and breathe life into it, is a good way to change your brain chemistry. I have repeatedly been surprised by how much a client with ADHD can get done, or overcome, when sufficiently motivated.  The fact is, none of us knows, what we can accomplish in our lives when we allow ourselves to breathe in possibility. Likewise, the limits in front of us are often of our own making, If you believe that you must find success by doing things the same way was everyone else, and doing the boring tasks that you find difficult to do, you may be limiting your potential.  By focusing on what is not working, you inadvertently create a box for yourself. This brings more of what you don’t want: avoidance, withdrawal, and self-judgment. I would suggest doing the opposite. Set the intention to create what you want for your life.   You will be giving yourself the gift of energy and motivation to learn the skills of DOING what you know how to DO.  You can then learn to notice without judgment that “oops, I’m off track. My trip to the Amalfi coast is out there. Oh, the colours, the smells, and textures. Ok, time to get back to work.”

Lynda Hoffman, certified ADHD coach

Medipsy Psychological Services

The Path to ADHD Coaching

The best things in life have a way of coming after many disappointments and false starts. This is also true for people with ADHD. The stories I hear from clients about how they eventually come to coaching are very similar: “Once I received the diagnosis, I then worked with someone to help me follow through, but they told me it wasn’t working because I couldn’t follow through.” Years of trial and error with various professionals to learn efficient self-management skills can feel tortuous. The words I hear most are: “despair, lack of effort, I failed because of me," and “I want to be in charge of my own life!"

The good news is that these experiences, while not immediately providing the change clients are seeking, form a rich body of learning about what does and does not work for them. This self-knowledge is key to any successful coaching work in which they will eventually engage.

When clients arrive at a coaching session with a diagnosis and a history of trying many different ways to change things for themselves, they are ready -- truly and fully ready -- to embark on a productive, life-changing experience. Their desire for change is at an all-time high, while their despair can be at an all-time low. Ironically, these are the conditions that sustain clients best when they might otherwise avoid sessions or tasks that feel challenging. This history forms the motivational foundation from which clients will take more risks, tolerate uncertainty, and experiment with how to BE differently in their lives.

The best news of all is that these experiences are merely one aspect of the whole person. And this is what sets coaching apart from other modalities. There is the assumption that all of us are whole, just the way we are. Coaching – even ADHD Coaching - is about growing, learning and becoming. The purpose is to empower, illuminate the essential health of the client, and embrace all parts of themselves.

As Carl R. Rogers said, “The curious paradox is that when I accept myself just as I am, then I can change.”

P.S.: Don't forget to take a look at our videos on ADHD on YouTube!

Lynda Hoffman

Certified Professional & Personal Coach

Medipsy Psychological Services