Licensed Marriage and Family Therapist (MFC28729) 
  1635 Solano Avenue 
  Berkeley, CA 94707 
  (510) 526-8208 

  Individual, family, couples,
  counseling and psychotherapy
  for Attention Deficit Hyperactivity Disorder

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Groups for Adults with ADHD

by Melinda White, MFT

Adults with Attention Deficit Hyperactivity Disorder often feel inadequate, defective, and different than their friends and coworkers. A therapy group for adults with ADHD can greatly reduce these feelings. Group members find it supportive and reassuring to know that other people who look normal , are intelligent, and interesting, have the same struggles as they do. It is especially important for someone with ADHD to experience support and validation for what he or she has gone through because most of these adults carry the added burden of past criticism. This burden can be lessened through group treatment.

There are numerous other advantages of group therapy for adults with ADHD. Groups offer the opportunity to receive feedback from a wider range of people about ways to manage ADHD. Group therapy can be both validating and motivating. Reporting back to the group about how she did on a task she had announced she would work on, helps make a group member feel accountable for her actions. It is also validating to get reinforcement from the group for completing tasks that outsiders wouldnt understand the significance of. A group member who gets to work on time every day for a week or remembers to put his keys in a set location will be praised by the group but not very likely by other people in his life.

Over time, a well-run therapy group will give members a sense that they are in an accepting environment where they can be themselves. It will help them learn to laugh about their foibles. They will be aware that they have something to offer others and are probably functioning better in some areas than other group members. It might be the first time some people have ever seen themselves as role models for others. A group can offer the safety for participants to let others know what theyve been afraid to acknowledge out loud before. A great deal of healing can take place when this occurs.

There are a number of ways to run an ADHD group. I have found it most effective to have some time for open-ended discussion and the rest of the time devoted to structured activities that focus on skills the participants want to learn. I begin my groups with a brief check-in time when each person can tell how his week has gone or let others know how he has done on tasks hes been working on. I then move on to a the topic for the week. Each time I run a group, I get input from the members as to which issues are most relevant to them. We then use concrete tasks to focus on ways to make changes that will make life more manageable.

Though the emphasis may differ depending on the particular group members, typically there are certain themes everyone is interested in working on. These include developing organizational strategies to help complete tasks, dealing with distractibility and impulsivity, time management, and communication and social interaction problems. When working with college students, the focus is usually on completing assignments on time without last minute anxiety and cramming. Improving self-esteem and self-acceptance are also stressed.

To deal with task initiation and completion, I ask group members to write down three tasks they wish to complete in the next few weeks. They then break the tasks into small, do-able parts. They pick one of the jobs that they will commit to start working on. I ask each person to then consider what might get in the way of her actually doing that task in the next week. We then discuss methods of overcoming the obstacles that arise.

This assignment will often lead into a discussion of time management. Many of the adults I have worked with mismanage their time because they assume that it will take much less time to complete a task than it does. I often ask each client to estimate how long he thinks it will take to finish a project and then to write down how long it actually took. Most people are quite surprised at how far off their estimates are. Part of the group work, then, is to learn to allot realistic amounts of time for projects. This helps prevent one from always running behind.

When obstacles to task completion do arise, the group provides a safe place to discuss what went wrong and to figure out ways to move on to the next step. It helps break the pattern many adults with ADHD have of constantly berating themselves for perceived failures. It is a place where individuals can begin taking responsibility for times they mess up without condemning themselves for it. Meeting weekly with others who share the same issues, can help one acknowledge her biologically based shortcomings. At the same time, she can develop compensatory strategies for getting things done.

Being able to admit that you have messed up without being defensive about it, can improve relationships with significant others. In the group, we discuss accepting responsibility and letting important people know what you will do now to deal with the situation. When an individual has figured out a plan to prevent another slip-up and presents that to his partner while admitting his mistake, he is more likely to be greeted with forgiveness.

The group also provides an opportunity for each member to receive feedback about her communication style. I ask every person to score herself on a list of communication skills that adults with ADHD are known to have trouble with. She then picks two or three of these issues to focus on improving both in the group and the real world. Examples of communication concerns that my past clients have had include: telling too much to people theyve just met, interrupting, and making impulsive comments that they regret later. In addition, spouses and partners of adults with ADHD often complain that the ADHD adults dont listen to them.

Another essential aspect of any treatment of ADHD is self acceptance. Learning to give yourself credit for your strengths and forgive yourself for your shortcomings is necessary for improving self-esteem. The group setting helps each person focus on his assets and give himself credit for what he has achieved, no matter how small the steps. Group members are quick to point out ways others have grown and remind them of progress they may have forgotten or discounted. Meeting with other adults with ADHD, therefore, can facilitate the process of accepting oneself.

Group therapy has much to offer the adult with Attention Deficit Hyperactivity Disorder in terms of support, practical strategies, and enhanced self-esteem.

(c) 1998, by Melinda White, M.A.