Behavior therapy for ADHD

Behavior therapy for ADHD
(Last Updated On: 2019-11-08)

How does health care practitioners provide behavioural therapy for ADHD ADULTS?

ADHD can be a lifelong condition yet it is difficult to notice symptoms in adults than those in children (ages 6-17), although they are just as significant to identify. Behaviour therapy is an effective treatment for attention-deficit/hyperactivity disorder (ADHD) that can improve a person’s behaviour, self-control, and self-esteem. It is most effective in young children when it is delivered by parents. According to the medical code ICD-9-CM, it is recommended that healthcare practitioners must refer parents of children younger than 12 years old for training in behaviour therapy.  But there are different measures for cognitive behaviour therapy for ADHD adults.[1]

Behavior therapy for ADHD

Symptoms of ADHD

This behavioural disorder can be identified by the appearance of the following symptoms;

  • Inattentive Behavior

There are some behavioural disorders that cause the patients to stay inattentive quite often. They usually go through the following situations;

  1. Careless Attitude:

Patients of this disease often make inconsiderate mistakes and lack the focus to details
Examples: overlooking or not concerning the defined details or doing inaccurate work.

  1. Difficulty in paying attention:

Patients often have difficulty paying attention to the tasks that require a central focus.

Example: difficulty in focusing during lectures, social conversations or lengthy readings.

  1. Difficulty in listening:

ADHD patients feel hindrance to listen and follow the instructions usually i.e. their mind seems attentive elsewhere, even in the absence of real distraction. Therefore, they fail to follow through on instructions, chores, or duties in the workplace or institutes i.e. they usually initiate tasks but quickly lose focus and they can be easily sidetracked.

  1. Disorganized routine:

These patients usually feel difficulty while organizing their routine and setup. They always create a mess around themselves, and have poor time management skills and often fails to meet deadlines.

  1. Reluctant behaviour:

These patients show reluctant behaviour to the tasks that require continues mental effort, and often dislike to handle such tasks. For Example; logistic tasks like preparing reports, completing forms or review lengthy documentation.

  1. Forgetful behaviour:

These patients are usually a victim of forgetful memory. They often lose their things like; tools, wallets, keys, paperwork, eyeglasses and cell phone and can easily be victimized of running errands, returning calls, paying bills, and keeping appointments etc.

  1. Unobvious distraction:

These patients get distracted very easily even there is no obvious reason for distraction, they can’t control useless thoughts in their minds. These uncreative thoughts make their efficiency to drop down dramatically.

 

  • Hyperactivity and impulsivity

ADHD may affect adult persons at home, work or at school or in any social situation. The symptoms like restlessness, excessive exercise or hyperactivity are the common symptoms of impulsivity in adults.

Following are the major symptoms of excessive ADHD in adults;

  1. Restlessness:

The adults that are a victim of this disorder usually feel restlessness, because this disorder makes them do excessive exercise or inappropriate workout that results in a passive situation later.

  1. Reluctant to take part in leisure activities:

The adults usually feel reluctant to participate in activities in their leisure time. It deteriorates their creativity and doesn’t let them adopt any activity as their hobby.

  1. Driven by commands:

They only perform any activity on the get-go and follow other’s orders. They don’t tend to think of the solutions on their own.

  1. Impatient attitude:

These patients show impatient behaviour while waiting for something or standing in a line. They also interrupt the discussions and intrudes on others to take over them and prioritize their own matters.

If the patients feel such symptoms then he/she must visit the health care service, immediately.

Causes of ADHD

It is a neurobiological disorder that is quite common in those children whose mother smoked, used drugs or consumed alcohol during their pregnancy. It may also develop in those children whose relatives had this disorder. This issue also pursues in their adulthood. Most commonly, many adults are diagnosed with ADD (attention deficit disorder) which is similar to ADHD.

ICD-9-CM Code Classification

ADD and ADHD both are classified into ICD-9-CM code which includes predominantly inattentive type or indistinguishable ADD and also includes unspecified ADD. 314.01 code for ADHD is also associated to ADD, so both of the ailments can be cured under the same referral code. This code also includes predominantly hyperactive-impulsive type, the combined hyperactive and inattentive type, and overactivity, not otherwise specified. This code usually applies contingents for the diagnosis and children and adults respectively. Although hyperactivity is reduced in adults the symptoms of inattention and impulsiveness may still be present in adult patients. ADD in adults is diagnosed according to the surveys conducted from the people surrounding that patient like family, friends or colleagues, this survey is recorded in reports.

Medical Treatment for ADHD

Cognitive Behavior Therapy:

CBT is a concerned therapy that targets the dysfunctional thoughts and emotions that prevent you from accomplishing time management, completing projects and scheduling your life productively with ADHD. This therapy is an umbrella term for a cluster of mediations used to cure disorders like anxiety, PTSD, and more. The way CBT is used to treat this condition varies, but all CBT focuses on cognitions, thoughts and behaviours. It’s a short-term, goal-oriented form of psychotherapy that purposes to change negative patterns of thinking and change the way the patients have emotions about themselves, their abilities, and their future. This ADHD therapy requires that the patient must keep up with their thoughts and feelings to learn how to change their behaviour when they’re dysfunctional.

Behavior therapy for ADHD

Cognitive-behavioural therapy is based on the recognition that cognitive or automatic thoughts, lead to emotional complications. Automatic thoughts are impulsive interpretations of life events. These impressions are vulnerable to distortion i.e. unfounded assumptions about yourself (or others), an occurrence of a particular situation, or the future. An unhealthy internal dialogue could prevent an individual from working toward an ambitious goal, obstruct working to develop productive new habits, or generally lead the patient to take calculated risks.

For adults with ADHD, cognitive or thoughtful behaviour, and emotional responses are addressed relate to the self-instruction that the patients can decide while beginning a task. This includes their thoughts on how to organize, prioritize, and plan. The behaviours addressed include; physical skills and habits. For example, learning how to use a planner and time management etc.

The procrastinating behaviour of the patients can be modified, by practising this therapy consistently, then a positive change can be observed in no time. Unnecessary stress, missing deadlines and other dysfunctional attitudes can be cured easily.

By virtue of their life experiences, many adults with ADHD can also have coexisting anxiety or hypersensitivity. CBT makes it possible to solve other critical issues that affect ADHD patients like; co-existing mood, anxiety disorders, hyper-focus on technology and gaming, a job search, or overall disrupting lifestyle habits. For example; sleep, exercise, and excessive self-esteem. This therapy is used to treat each condition separately, so it may be motivating for you and your therapist to focus on each one symptom individually before moving to the next one. Remember, none of these conditions can be cured overnight. They all require consistent practice, develop awareness, and challenge negative beliefs.[2]

Medication:

ADHD/ADD is mainly cured with medications, commonly the following psychostimulants:

  • Methylphenidate (Ritalin, Concerta, Daytrana)
  • Dextroamphetamine-amphetamine (Adderall)
  • Dextroamphetamine (Dexedrine).

The use of psychostimulants is short term and must be regularly monitored.

Coding and sequencing for ADHD/ADD are dependent on

  • The physician’s documentation in the medical record
  • The application of the Official Coding Guidelines for inpatient care.

Also, medical billers also use particular AHA Coding Clinic for ICD-9-CM and the American Medical Association CPT Assistant references to make sure complete and accurate coding.

Behaviour therapy for ADHD adults

This disorder can also be treated at home by patients themselves, only motivation and consistent engagement with their positive thoughts is required for therapy practice at home.

Following are the essential practices that you can perform at home to cure this disease.

Prepare Daily Planner:

Patients should strive to manage negative expectations and emotions. They must overcome unwinding behavioural patterns that can interfere with their strategy. They should make a daily planner for the execution of daily tasks and robustly determine to accomplish these tasks. It is an important factor that each task must be mentioned in the planner, if the task is not there in the planner, then it doesn’t exist in your life.  If the patient won’t try to comply with his/her planner then he/she will experience no change in their lives.

Planner Commandments:

As it is already mentioned that each task must be already mentioned in the planner, then your home chores, office tasks and hobbies must be mentioned in the planner. As the planner is fully prepared then the patient must keep up with that routine, a trustworthy partner can also help the patient to remind the tasks to the patients and play a constructive role in their lives. This will help them to prevent the inattentive or hyperactive symptoms of this attitude instead of spending a lot of time putting out fires.

Useful resources about ADHD

  • https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878
  • https://www.health.harvard.edu/newsletter_article/recognizing-and-managing-adhd-in-adults
  • https://www.rcpsych.ac.uk/mental-health/problems-disorders/adhd-in-adultshttps://www.additudemag.com/adhd-in-adults/
  • https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd
  • https://my.clevelandclinic.org/health/diseases/15253-attention-deficit-disorder-without-hyperactivity-add-in-adults
  • https://chadd.org/for-adults/overview/
  • https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html
  • https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/add-adhd/adhd-and-behavior-therapy-what-you-need-to-know

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