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EF Therapy ??--Update


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I made an appointment today with a therapist who supposedly works with individuals that have ADHD.  We meet with him next week, so who knows how this will turn out?  I want the guy to help DS work specifically on weak EF using time tested materials and strategies.  DS says he is motivated and willing to try.  I want the therapist to help us put structure in place and establish measurable/quantifiable goals.  I don't know if that is even possible.  Has anyone here used a therapist for helping develop EF?  If so, what was the therapy like and how long was it necessary?  Was the experience good or bad?

 

Thank-you, 

~h

Edited by Heathermomster
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I'm with Lecka.

 

I think it sounds promising. I would definitely want to know how much of it will be talky-talky and how much will be action (and why--it takes time to learn about a person and establish a rapport). You might be expected to be able to articulate what's causing the most difficulties in order for it to be successful as opposed to the therapist having a specific program to go through. He might work exactly the other way around--identifying problems and then creating solutions. Or it might be a combination of both. It would be cool if they have some checklists or something to get a feel for what they target and do.

 

Best wishes!!! Truly.

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I am anxious to hear how it goes and what you think. While all my ADHD kids struggle with regulation and basic EF, my oldest's daydreaming nature compounds that. She's come a long way in the last two-three years, but there's still so much more. You start to worry about things like "is she going to remember to pay her rent in college?" and "if she is still misplacing her pencil what will she do with the car keys?" not to mention "if she doesn't put more effort into reciprocating these overtures of friendship they're just going to stop trying."

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Have you all read Smart But Scattered? (They have one for teens too.) I haven't yet, planning to pick it up as soon as I have more time to read, but I'm hoping it'll help us with some of the issues we're seeing.

 

Smart But Scattered is a very good resource. It's hard to see sometimes where to start though!

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Okay, apparently the therapist is a CBT person.  We met and spoke this afternoon.  I gave the therapist a copy of son's NP report, and he asked me a series of questions.  I took the Linguisystems EF book to the interview, and the therapist borrowed it.  He wants to see my other books too, so I will drop them off next week.  My DS is scheduled to meet with him alone next week.  I was told to expect homework next week but I have no idea what that means.  I guess we just have to wait and see. 

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Well CBT is standard stuff, so that's good.  Definitely can't go wrong with that.  So you think he's going to use your books and help implement them?  Interesting.  

 

Outsourcing can be really good on a lot of levels.  It gets done, the dc gets to see other people notice, the dc gets to hear it from another voice besides Mom...  It's all good.

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The CBT spoke with DS for one hour yesterday and borrowed two more of my Dawson/Guare EF books to look over.  I wasn't present during son's session, but from what I could tell, there was a bunch of thinking about thinking talk.  The counselor told me that he was trying to understand how DS learns and will start giving homework soon.  

 

Something else...Strattera was a complete bust for DS.  If it worked in the beginning, it stopped shorty after, and DS is now off the meds.  I recall the article and thread about behavior therapy first and then meds.  Well, I guess that is what we are doing now.  So there you are,,,

Edited by Heathermomster
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The CBT spoke with DS for one hour yesterday and borrowed two more of my Dawson/Guare EF books to look over.  I wasn't present during son's session, but from what I could tell, there was a bunch of thinking about thinking talk.  The counselor told me that he was trying to understand how DS learns and will start giving homework soon.  

 

Something else...Strattera was a complete bust for DS.  If it worked in the beginning, it stopped shorty after, and DS is now off the meds.  I recall the article and thread about behavior therapy first and then meds.  Well, I guess that is what we are doing now.  So there you are,,,

 

The therapy sounds like it's going in a good direction. Let us know how the books work out. I am encouraged that there is homework.

 

Do you have other meds options to try? (I don't remember if he has a long history with trying various kinds or not.) I am sorry it didn't work out.

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The therapy sounds like it's going in a good direction. Let us know how the books work out. I am encouraged that there is homework.

 

Do you have other meds options to try? (I don't remember if he has a long history with trying various kinds or not.) I am sorry it didn't work out.

DS has only tried Strattera.  The child psych suggested another non-stim medicine but DS is against that.  He wants to try something that will leave his system quickly.  DS was very discouraged by the Starttera.   

 

We will not go back to the child psych until mid-April.  The idea of trying new meds has no appeal to either of us because finals will be in early May.  

Edited by Heathermomster
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Ritalin has a super short half-life.  In our other thread, there was sort of this thought process (suspicion) evolving that the way meds would cycle and lead into some kind of bipolar process was on the 12 hour XR.  For just say a 4 hour Ritalin, you're on, off, no cycling.  It seems to be the XR meds where the effect goes up and down.  Also the evidence is that kids who are flipping on meds had indication before.  But even so, I think there could be a quantifiable difference in risk of problems going with 4 vs. XR.  

 

You could bump your next appt to May after the finals.  You could do the appt earlier in April.  Who knows, might be the new meds would be immediately, noticeably better.

 

Btw, that study about behavior/counseling first was *parent* counseling, not the kids.  That study was not saying CBT first, then meds.  It was saying parenting classes first for behavioral modification, then meds.

Edited by OhElizabeth
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Early Behavior Therapy Found to Aid Children With A.D.H.D. - The New York Times

 

Read it again and see.  Behavioral modification first, with ages 5-12.  The middle of the article lists specifically what they were being taught.  It's a lot like ABA, with rewards (pat on back, affirmations, small rewards) for hitting little targets.  Higher value targets had higher value rewards.  And there was withholding.  But it was all behavior modification and it was taught to the parents and carried over at school.

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Dd had a bad first attempt at medication. She needed a month to be ready to try the next one. She was really apprehensive. But when she tried the next one it worked like a miracle...at first. And that got her over her reluctance. She's now on med number three after developing headaches with the second med which was so wonderful at first.

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Early Behavior Therapy Found to Aid Children With A.D.H.D. - The New York Times

 

Read it again and see.  Behavioral modification first, with ages 5-12.  The middle of the article lists specifically what they were being taught.  It's a lot like ABA, with rewards (pat on back, affirmations, small rewards) for hitting little targets.  Higher value targets had higher value rewards.  And there was withholding.  But it was all behavior modification and it was taught to the parents and carried over at school.

DS is 16yo and primarily inattentive. 

 

I think we agree.  I skipped over the group meetings.  I kinda assumed the parents were involved with their children's care and receiving feedback too.  When dealing with patients at such a young age, therapy with a 5 yo is not completed in a vacuum.  A 5-12yo cannot drive themselves to the places they need to be.  Of course, the parents have directions or instructions for later when at home or school.  Parents/guardians certainly pay for the visit.  

Edited by Heathermomster
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Early Behavior Therapy Found to Aid Children With A.D.H.D. - The New York Times

 

Read it again and see.  Behavioral modification first, with ages 5-12.  The middle of the article lists specifically what they were being taught.  It's a lot like ABA, with rewards (pat on back, affirmations, small rewards) for hitting little targets.  Higher value targets had higher value rewards.  And there was withholding.  But it was all behavior modification and it was taught to the parents and carried over at school.

 

So here I am, rethinking spending the money on therapy. Since we're already using these techniques (and they've been quite successful) is there any reason to spend the big bucks on it at this point? If Anna had self-esteem issues, or ODD issues, or was old enough to be able to absorb skills that an ADHD coach might provide, then I can see how it would be helpful. But she's been quite obedient over the past several months, her main issue is controlling her emotions, so is there anything a therapist could do for us at this point that we're not already doing?

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So here I am, rethinking spending the money on therapy. Since we're already using these techniques (and they've been quite successful) is there any reason to spend the big bucks on it at this point? If Anna had self-esteem issues, or ODD issues, or was old enough to be able to absorb skills that an ADHD coach might provide, then I can see how it would be helpful. But she's been quite obedient over the past several months, her main issue is controlling her emotions, so is there anything a therapist could do for us at this point that we're not already doing?

The article was talking about behavior modification training for improving *attention*.  For the emotional regulation, it would depend on what kind of therapist you want to.  A behaviorist (BCBA, trained in ABA) is going to have more tools for that, yes.  They have more tools than just Zones.  

 

Nuts, you want something wild?  Our music therapist is amazing for emotional regulation.  We get the therapy at the autism charter.  There are more ways to skin the cat.

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