View Full Version : Opinions on behavioral therapy?

09-24-09, 03:50 PM
Hey guys, wanted some input. Sorry this is long but bear with me. As a reminder, my son is 7 yrs old diagnosed ADHD/anxiety/depression in June. He takes 40mg Strattera and 10mg Lexapro. The anxiety/depression has improved and his teacher sees no behaviors out of the norm for a 7yo boy. Our psychiatrist (just this past Monday) said he is doing great. Retested him and he improved compared to non-medicated test results. We are to stay at the current med doses and followup in 3 months.

NOW, we have also been seeing a psychologist since May because he was having extreme meltdowns and refusing to go to school and then summer camp. We have worked through a lot of these issues. He is going to school without incident. He still has meltdown issues but they have improved--still quite severe but the frequency has lessened. He still has an aversion to riding a bus without a parent which is an issue for field trips. So the main behavior concerns are the bus issue and still some severe meltdowns.

We are not sure the therapy is helping any. The doctorís suggestions typically were things that we already knew or had already tried. We have been working on the bus issue since May and he will ride with us now but not by himself. We typically go to him every two weeks, they talk, he says he does well and thatís pretty much it.

I know that typically meds + behavioral therapy give the best results, but we just donít see the benefit. I mean, heís 7. Is talk therapy really that beneficial at that age? He has taught my son relaxation breathing (which he wonít do), given him a worry stone (which he keeps in his drawer), they do role playing for things that affect my son and he does well in the office but in practice, my son doesnít seem to be able to use any of these tools.

This particular office doesnít take our insurance so we pay out of pocket for it which is getting to be a financial strain. If the therapy would help, we could move him to another office (like our psychiatrist which DOES take our insurance) but I then there is the issue of building the relationship with the doctor all over again.

We are torn. If we were seeing a benefit, it would be a no brainer, but as it stands right now, we think we should drop the therapy sessions for now. Any input? Personal experiences?


09-24-09, 05:16 PM
There is no evidence that talk therapy with a psychiatrist or psychologist helps with ADHD.

Remember the 30% rule. He has the emotional maturity of a 5 year old. Riding the bus is a typical fear for a 5yo.

09-24-09, 05:27 PM
Talk therapy may not help, but behavioral therapy can help, in the form of behavior analysis (also known as behavior modification).

Behavioral analysis is working on goals and how to deal with the issues through consequences. It will also teach you how to react to his issues (meltdowns, fears, etc) and what consequences might work best.
Perhaps you should look into seeing a behavior analyst. If you want, you can PM me your location and see if I can recommend a person or company.
Behavior modification + medications has been known as the best way to treat ADHD

Lady Lark
09-24-09, 09:03 PM
I personally don't think talk therapy is a good idea for kids. What 7 year old is able to sit and talk for a hour, even if they are NT? My opinion.

I do think that therapy can be a great benefit, even more so when combined with the right medication(s). I would suggest you look into play therapy.

09-24-09, 09:15 PM
Thanks everyone. I guess they do a little more than I stated. He does have a reward chart which included right now: going to school nicely, no meltdowns and being nice to his sister. He earns points for his achievements and he can go "shopping" in their prize closet each week. They role play issues he's having like pretending to ride the bus.

I guess we just don't think the improvements we see have really come from his seeing this therapist but more from us learning how to deal with him. Perhaps, we as parents have gotten more out of it. As for me, the reassurance that when things go badly, it's not my fault and the support to do "tough love" like leaving him at summer camp even when I knew he was going to have a horrible meltdown. Maybe we need family therapy more right now to show us how to deal with these issues and how to parent this type of child. Or maybe he needs social skills classes to learn how to play on a team and how to lose without going off the deep end. I have talked with the psychiatrist's office about play therapy and they didn't feel it would be effective for him.

Thanks again for your inputs! So much to sort out!!!

09-24-09, 09:18 PM
I have taken tons of behavioral psychology courses.
(I have a BA in behavioral psychology.)

How does behavioral therapy help with ADD problems like impaired auditory working memory and impaired executive function?

I do not think it does.


I tend to think stuff like Dr. Mel Levine's "strengthen the strengths" and "management by profile" and Dr. Phil's 'catch them doing something right' make a lot more sense.

e.g. Work with the strengths, don't fight the deficits.

09-30-09, 01:00 PM
It sounds like you are doing everything right, since you are implementing the proper parenting techniques at home. However, things just dont get that much better that quickly. He will need more help than the other kids throughout school. I dont mean to be discouraging, just trying to let you know that even though you might not be seeing the advances you would like to see, you are still probably doing the rigtht things.

When your son gets older, cognitive behavioral therapy can help with anxiety issues. However, I think your son is a bit young for that.