Questions Teens Ask about ADHD

By Edward M. Hallowell, M.D. & John J. Ratey, M.D.

Q: I’m really burned out from school, and I feel I need time off to recharge my batteries. I feel guilty, though, that I’m taking the easy way out. What do you think?

A: There is a difference between taking the easy way out and finding the right way in. If you are going nowhere in school, it may make a great deal of sense for you to take time off.I have treated a large number of high-school and college students who came to me feeling the same way you do. Some of them wanted to leave school. I did not think it was a good idea for all of them to do so. Some of them needed a little encouragement and some redirection to get more out of school.

However, some of them really needed a break. They were lost where they were. They were not keeping up, they were getting more and more depressed, their self-esteem was plummeting, and I was worried they were at risk for more intense depression, or substance abuse, or simply a miserable educational experience.

By leaving school these young people were able to step back and regroup. I was able to set up a thorough neuropsychological evaluation for them, so that we knew exactly what we were dealing with from that standpoint. They were able to sit and talk with me for a while without the pressure of school impinging upon them, so we could begin to sort out what was going on in their emotional lives. I urged them all to get jobs, which they did. This gave them a regular daily activity that brought them both income and the satisfaction of doing work. Some of them found interesting jobs, and some of them found menial jobs, but they all reported they were happier having a job than not. I also required that they pay for a fraction of my bill, rather than letting their parents carry it all. I required they pay a sizable enough fraction that they approached our sessions seriously, wanting to get their money’s worth.

Some also worked on an academic program set up through their school or college in preparation for returning. This was not pressured&emdash;just a short reading list or one session a week with a tutor&emdash;but it was enough to keep their scholastic hand in, so to speak.

Others took trips. Some were vacations, some were unstructured roaming, some were adventures, some were work-related, but all were liberating. These kids needed to stretch their wings and fly. They needed to be free for a while.

For most, the time away from school was about one academic year. Typically, they left school in October or November and returned the following September. Some planned the year off in advance, so they left from June of one year to September of the next. But most had not planned to take a year off. When they arrived in my office exhausted and burned out, as you describe, we decided then that a leave of absence made sense.

These young people returned to school in much better shape than they had left. Some had ADD; some did not. Of those that had ADD, we were able to get treatment stabilized during the year away and set up a good coaching relationship with a person at their school so the next year could be more productive.

A year away from school that is wasted makes no sense. But if the time is wisely spent, under some guidance, it makes all the sense in the world. In fact, it takes courage to leave your friends and leave the mainstream and go off on a program of your own design. It takes courage and creativity. In a subtle way you increase your visibility in your family and your community because you are doing things differently, and this always causes people to look twice. With increased visibility comes increased accountability. So this is no easy way out.

Instead, it can be the right way in. You may need a year to learn about yourself, your learning style, your emotional life, and your long-term goals. You may need some perspective on school. By leaving for a while, you may return in much better shape to make the best use of your time in school.

Q: The shrink I see makes me pay for part of my sessions even though my parents would be willing to pay the whole bill. Why does he do that?

A: I alluded to your question in my previous answer. It makes sense for you to pay as much as you can because you are the one using the services. If you pay, there is a natural human tendency to take the services more seriously, no matter what they are. If your parents pay, you can just show up and pass the time. But if you pay, you’ll be more likely to go into your therapist’s office with an attitude of “I want my money’s worth.” That’s good. It makes for better therapy.Sometimes young people don’t know that there is a fee associated with therapy. I remember a twelve-year-old I was seeing eight or nine years ago. Let’s call him Tommy. One day Tommy said to me, “Does it cost money for me to come here?”

“Yes, it does,” I replied.

“How much?” he asked.

“Seventy-five dollars,” I replied. I’ll never forget his response to that.

“Wow!” Tommy said, wide-eyed. “I could buy two skateboards for that much money.”

Tommy would be shocked to know that my fee has risen to $125 per session today. But so has the price of skateboards, so it is still probably about a two-skateboard transaction.

I urge all my patients to share Tommy’s reaction. For an adult, one session amounts maybe to their monthly telephone bill or the cost of an evening out. For an adolescent, it’s a dozen CD’s or four rock concert tickets. For Tommy, as I’ll always remember, it’s two skateboards. Whatever your age, if you consider the money that is going to your therapist and then imagine where else you could spend it, that will help induce you to make as much of the sessions as you can. Particularly if you have to work to earn the money, and you then have to part with the money for something as apparently trivial as talking to a therapist, you will try very hard to make that therapist work to earn his money. That is good.

 

APA Reference
Psych Central. (2011). Questions Teens Ask about ADHD. Psych Central. Retrieved on December 25, 2014, from http://psychcentral.com/lib/questions-teens-ask-about-adhd/00010491
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.

 

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