With the recent call for stronger FDA warnings be placed on some common ADHD medications, many parents are turning to other kinds of treatments to supplement or replace drugs as the primary choice of treatment. It’s not clear that this is a growing trend, or just a blip on the treatment radar. But combined therapies — medications plus certain types of behavioral treatments — usually offer the best course of treatment (best outcomes combined with the quickest result). The Washington Post highlights this growing trend in an article today:

“There’s so much lip service paid to [combined] treatments, but a lot of people just rely on medication alone,” said William L. Coleman, a developmental pediatrician at the University of North Carolina who is chairman of the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. “We are a quick-fix society and we want results. There’s a lot of time pressure on parents and on teachers.”

Many Americans want and expect a “quick fix” to their problems. While people often pay lip service to self-improvement, all too often the demands of the real world take precedence over the desires of our ideal selves. Competing priorities often complicate the picture — “Sure, I’d love to take little Jimmy into therapy once a week, but then he wouldn’t have time for his soccer practice!” Parents feel badly when their children can’t do everything that want to do, so it’s easier to purchase the medications than to tell little Jimmy that therapy is important too (even if little Jimmy can’t understand that at his age).

Parents need to play the role of parents, not their child’s best friend. That sometimes means saying “No” when you want to say “Yes,” and sometimes it means explaining to your children why they can’t always do everything they want to do (and have to do some things they’d rather not do).

Common Behavioral Techniques for ADHD Treatment

Like most psychotherapy techniques, behavioral treatments are best tried in the context of an ongoing psychotherapeutic relationship with a child therapist or child psychologist. While you can purchase a self-help book that will help walk you through these in greater detail, an experienced therapist will be more than a teacher or resource, they will be an important aid in helping you find examples that will work best for your situation.

Positive reinforcement
Providing rewards or privileges contingent on the child’s performance.
Example: Child completes an assignment and is permitted to play on the computer.

Time-out
Removing access to positive reinforcement contingent on performance of unwanted or problem behavior.
Example: Child hits sibling impulsively and is required to sit for 5 minutes in the corner of the room.

Response cost
Withdrawing rewards or privileges contingent on the performance of unwanted or problem behavior.
Example: Child loses free time privileges for not completing homework.

Token economy
Combining positive reinforcement and response cost. The child earns rewards and privileges contingent on performing desired behaviors and loses the rewards and privileges based on undesirable behavior.
Example: Child earns stars for completing assignments and loses stars for getting out of seat. The child cashes in the sum of stars at the end of the week for a prize.

Taking an active role in your child’s well-being and development means taking care of their health and mental health concerns as well. This is not always easy, and sometimes the confusing array of choices available to parents makes the task seem overwhelming. When some doctors act more as paternal authoritarians rather than helpful guides in your child’s care, it doesn’t help any. Find a doctor who will listen and help you find a therapist that can be a part of the treatment team for your child. Because it doesn’t just take a village to raise a child, it also takes an invested parent and experienced professionals, all of whom are looking out for the child’s best interests.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 2 May 2006
    Published on PsychCentral.com. All rights reserved.