Your Teen is Entering CEGEP or College?

We are inclined to breathe a sigh of relief when our child graduates high school thinking that reaching this milestone means college will be somehow easier. Amid the celebration, it is important to remember that all transitions can be tricky to navigate for those with ADHD. Being prepared for this reality is the best way to set your child up for success.

What is it about transitioning to CEGEP or College that can be so challenging for teens? Like all transitions, the expectations placed on students are suddenly higher than those in high school. And they are higher precisely in the areas that our children may be having difficulties in, for example knowing how much studying is enough, anticipating what is expected when it is not explicitly said, getting around campus, resisting the temptation to go to the mall rather than classes they may not be interested in. These “executive” skills are mediated by the prefrontal cortex of the brain whose development, in individuals with ADHD, tends to lag behind those of their peers without ADHD. Executive function skills are those that support us in doing the things we know we should be doing, and when we should be doing them. As such, you may find yourself watching your teen choosing to prepare for tests at the last minute, handing in assignments late or not at all, performing poorly on tests, and avoiding asking their teachers for help.

What can parents do about this? Your role is now one of supporting your teen’s growing autonomy, while also expecting that there may be gaps in their ability to follow through, or doing what they should be doing. Start by finding out in advance what support services are available at the college your teen will be attending. Model the core belief in a “Growth Mindset” that learning is about honing abilities and skills, as much as it is about learning content. This creates a love of learning and builds resilience necessary for children to solve problems more flexibly and non-judgmentally. Be prepared to ask your teen questions when you see something they may not be seeing: “Is this a problem for you? How can you know? How are you planning to handle that? What will you do about this?”  Be curious about their experience. Listen. Your relationship with your teen is the best way to ensure you two work productively together if something goes awry.

How to communicate with your teen?  Be prepared that he/she may respond defensively to a question they do not have an answer for. Take this as a sign that they really don’t know and that they don’t like not knowing. Acknowledge their feelings. Let them know that you are there to break the problem down with them when they are ready. If they say, “No, I don’t need your help”, you can ask them, “Is there a person at the college who you would feel comfortable talking to about this?” Hold them accountable for finding a solution. Above all, praise all efforts to find a solution even if the solution is not one you agree with. For example, “I see that you are trying to get a handle on this. It is great you are taking responsibility for it. Is there something else that might also be helpful?”

Is the CEGEP or College the best fit? Set your teen up for success. Find a program your child is truly interested in. High interest is the best way to ensure your teen will be engaged during the program. If they must go into a program they are not thrilled about, it is helpful for them to find some activity at the college, outside their studies, that they truly enjoy. This will support them in staying connected to the school community. Also, ask if the school provides accommodations for exams and/or has tutoring and coaching services available.

How do I know if my teen needs coaching? If your teen is underperforming, appears disorganized, and is not sharing with you, it may be that he/she would be more open to working with a coach. Coaching builds the inner skills necessary for academic success: effective problem solving for better decision making, breaking down tasks, learning to ask for help when needed, building accurate self-awareness, and acquiring resilience in the face of challenges.

Where can parents get answers to their questions? You may benefit from support too. Find a coach who is familiar with ADHD and how to build executive skills. Ask them your questions. Or, better still, find a coach for yourself. Have no doubt. You are a leader and your resilience and level of confidence will impact how you show up to support your child.

Lynda Hoffman, certified ADHD coach

Medipsy Psychological Services

Psychotherapy in Canada: the question is not whether we can afford to make it more accessible, but whether we can afford not to.

The World Health Organization estimates that depression is the leading cause of disability and that it contributes greatly to the global burden of disease. It is also estimated that in Canada, approximately 20% of the population will be affected by a mental disorder, including depression. Such disorders are associated with a marked deterioration in the functioning of individuals, with poorer quality of life and death by suicide, in addition to representing considerable costs both in direct costs for care and in indirect costs related for example to a drop in productivity. Again in Canada, it is estimated that the costs associated with mental health problems amounted to $ 52 Billion in 2006. That's a lot. Can we therefore imagine that we could recuperate the costs of making psychotherapy accessible to all, free of cost or at low cost, which of course means paying more professionals to offer this service?

As a result of our work with Quebec’s National Institute of Health and Social Services (INESSS) following a request from the Minister of Health, we have already established, via a systematic review, that the costs of psychotherapy for treating anxiety and mood disorders is equivalent to that of medication in the short term (and lower when the therapy is given in a group format), and significantly lower than pharmacotherapy in the long run. It's a good start, but can we be more specific?

This is the question that my colleagues H. Vasiliadis, A. Lesage, E. Latimer and myself recently decided to look into. In a socio-economic modeling study that will be released soon, we calculated the consequences –including the financial implications- of depression and its treatment over a 40 year period. Unsurprisingly (others have previously found similar results), out model showed that better access to psychotherapy led to a significant decrease in suffering and to increased health-related quality of life. That in itself should suffice to make the case for greater access to psychotherapy. But let’s imagine for a moment that it is not enough, and that it all comes down to money. Can we expect a return on our investment?

Simply put: yes. IN CANADA, FOR EVERY DOLLAR ($ 1) INVESTED IN PROMOTING GREATER ACCESS TO, AND IN OFFERING PYCHOTHERAPY, OUR MODEL INDICATED THAT THERE WOULD BE ON AVERAGE A $2 SAVING FOR SOCIETY.

Not bad. Obviously, the question is no longer whether we can afford to provide psychotherapy in Canada, but whether we can afford not to.

Dr. Martin Drapeau, Clinical Psychologist
Professor at McGill University

Martin Drapeau is a professor of counselling psychology and psychiatry at McGill University and a clinical psychologist at Medipsy Psychological Services. The opinions expressed here are those of the author only and not necessarily those of Medipsy Psychological Services. Medipsy is  a private psychology clinic located in Westmount, Quebec.