Practical ADHD Treatment for the Challenges That Get in the Way

What actually helps when it comes to ADHD treatment?

My philosophy on ADHD treatment, and really on any kind of treatment, is that it takes two to tango.

There has been a lot of discussion around ADHD treatment and what the best treatment is. There are apps, coaches, therapists and all kinds of options. There are many things that can work, but I think one of the most important factors is taking a multifaceted approach.

I tell my patients that you have to do what is best for you. Some people do not want to take medication and prefer behavioral intervention alone. Behavioral interventions can help create structure around symptoms that are difficult to manage.

But we also have to think about the end goal of treatment. ADHD is a neurodevelopmental disorder. It can have ebbs and flows. Symptoms may be more pronounced in certain areas of your life and less pronounced in others. It is something that you learn to work with and manage.

There are different ways people talk about ADHD. Some people describe ADHD as a superpower, while others describe it as debilitating. I tend to fall somewhere in the middle. There can be strengths associated with ADHD, but there can also be consequences. ADHD can impair your life when it is not managed. You can find yourself falling into the same traps repeatedly, and over time that can affect your self-esteem and quality of life.

Medication and behavioral strategies

When people tell me they are just going to take medication, I often think about something a very skilled psychiatrist once told me: “Pills don't teach skills.”

My philosophy is that pharmaceutical intervention and behavioral intervention can work together. When you combine these approaches, you are addressing ADHD from more than one direction.

Behavioral intervention itself can also be multifaceted. One of the challenges with completely unstructured one-on-one therapy is that clinicians naturally want to help with whatever is most pressing in the moment. If something significant happened that week, that can easily become the focus of the session.

That may feel helpful in the moment, but the person can leave without actually developing the tools they originally came to treatment to build.

Why structure matters

That is why we moved away from purely unstructured one-on-one ADHD treatment and toward a more structured, protocol-driven approach.

We want to make sure people first develop the tools they need and learn how to approach the things they are having difficulty with. There can still be room to talk about what is happening in someone's life, but we do not want the development of practical skills to get lost along the way.

We also recognized that people do not always have a lot of time, so part of the treatment became asynchronous. Educational material can be completed through video on your own time.

The challenge, of course, is that ADHD and an open-ended task without a deadline do not always work particularly well together. That is one of the reasons we developed a hybrid approach.

How DRCCH's ADHD treatment approach works

Our hybrid approach combines structured educational material with individual support and accountability.

The individual sessions are not only about accountability. They also give us an opportunity to take strategies that are supported by research and adapt them to the person we are working with.

For example, someone might learn about a strategy such as the Pomodoro method, where you work for a set period and then take a short break. But the standard version of that strategy may not work for everyone.

So the question becomes: How do we adapt this strategy in a way that you will actually use and that can actually work for you?

The strategies themselves are not necessarily complicated or mysterious. Many are evidence-based strategies that people could read about themselves. The goal of treatment is to provide support in actually using those tools, including figuring out how to use them when you initially think a particular strategy will not work for you.

Someone may tell us, “That doesn't work for me.” Our job is to help explore why and determine whether the strategy can be adjusted. We can try something different and continue working together rather than simply giving up on the strategy or the person.

Your participation matters

One of the most important things to understand about ADHD treatment is that you have to participate.

Treatment is not simply something you complete so that you can get it over with. You have to be open to looking at your own patterns and developing greater awareness of what is happening.

One of the challenges with ADHD is that you may not always recognize those patterns while they are happening. You can operate almost automatically, putting out whatever fire is directly in front of you. That is often where the same traps occur.

Once you become aware of those traps, you have an opportunity to ask: What are we going to do about them?

Progress is not always a straight line

People will often tell me, “I tried this and it worked for a little while, but then it stopped working.”

That's part of being human.

I would love for treatment progress to be a straight line upward, but that is generally not what it looks like. Progress has ups and downs.

The important part is continuing to put forth effort, staying aware of your patterns, trying the interventions, recognizing what is working and what is not, and getting back to the strategies when things do not go as planned.

ADHD treatment itself is not going to cure you. It is a collaborative approach. We are here to support, not fix.

DRCCH's ADHD treatment programs

At Durham Region Centre for Cognitive Health, we have different ADHD treatment programs.

One focuses on Emotional Regulation, which addresses the emotional regulation challenges that can be associated with ADHD.

Another focuses on Healthy Habits & Routines, including getting stuck, difficulty following through, procrastination, habit formation and goal setting.

People sometimes ask me which one I recommend starting with. I recommend starting with the area that is causing you the most difficulty. You can then consider the other program afterward, or you may find that one program gives you insight and strategies that help in other areas as well.

If you are interested in learning more about our ADHD treatment programs, please give us a call or send us an email. We're happy to talk with you about it.