directions twice, rechecking work; see Test-Taking Strategies by Kesselman-Turkel & Peterson).
Cite instances in which instant gratification was delayed in favor of achieving meaningful long-term goals. (40, 41)
Teach the client mediational and self-control strategies (e.g. “stop, look, listen, and think”) to delay the need for instant gratification and inhibit impulses to achieve more meaningful, long-term goals (or supplement with “Problem Solving Exercise” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce).
Assist the parents in increasing structure to help the client learn to delay gratification for longer-term goals (e.g. completing homework or chores before playing basketball).
Identify what social skills were implemented to reduce anxiety and build confidence in social interactions. (42, 43, 44)
Use instruction, modeling, and role-playing to build the client's general social and/or communication skills.
Work with the parents and assign exercises that facilitate the client's use of social skills in various everyday situations.
Assign the client to read about general social and/or communication skills in books or treatment manuals on building social skills (e.g. Your Perfect Right by Alberti & Emmons; Conversationally Speaking by Garner); or supplement with “Social Skills Exercise” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce.
Identify and implement effective problem-solving strategies. (45, 46)
Teach the client effective problem-solving skills (e.g. identifying the problem, brainstorming alternative solutions, selecting an option, implementing a course of action, and evaluating the results).
Use role-playing and modeling to teach the client how to implement effective problem-solving techniques in his/her/their daily life; work with the parents and assign exercises that facilitate the client's use of problem solving in various everyday situations.
Cite which constructive coping strategies were implemented when the negative emotions associated with failure were a potential trigger for addiction. (47, 48)
Review specific instances of failure to learn and the negative emotions associated with the experience; focus on how addictive behavior was used to escape from negative emotions.
Role-play and model constructive alternative coping behaviors to use in failure-to-learn situations (e.g. cognitive focusing, deep breathing, make lists, reduce distractions, shorten learning sessions, repeat instructions verbally).
Report instances when relaxation techniques reduced tension and frustration while increasing focus in a learning situation. (49, 50)
Using techniques like progressive relaxation, guided imagery, or biofeedback, teach the client how to relax completely; assign him/her/them to relax twice per day for 10 to 20 min per session.
Encourage the client to incorporate relaxation skills as a coping and focusing mechanism when feeling tense and frustrated by a learning situation or urge to use substances; review implementation; reinforce success and problem-solve obstacles.
Develop and implement an exercise program that includes exercising at a training heart rate for at least 20 min at least three times per week. (51)
Help the client develop an exercise program; increase the exercise by 10% each week until the client is exercising at a training heart rate for at least 20 min, at least three times a week.
Develop an aftercare program that includes regular attendance at recovery group meetings, getting a sponsor, and continuing the therapy necessary to bring ADHD and addiction under control. (52)
Help the client to develop an aftercare program that includes regular attendance at recovery group meetings, getting a sponsor, and continuing the therapy necessary to bring ADHD and addictive behavior under control (or supplement with “Aftercare Plan Components” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce).
Complete a survey to assess the degree of satisfaction with treatment. (53)
Administer a survey to assess the client's degree of satisfaction with treatment.
1 Childhood history of Attention Deficit/Hyperactivity Disorder (ADHD) – primarily inattentive, primarily hyperactive/combined that was diagnosed during childhood or based on a history of symptoms meeting criteria.
