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Old 11-05-04, 08:07 PM
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Exclamation Need advice about a situation with my "team"

I am wondering if anyone can give me some insight or advice. I was very recently diagnosed with ADD by a psychiatrist to whom my PhD of several months referred me. This was during a crisis in my world - I was first diagnosed by the MD as having "atypical depression." The PhD and I had been working on some problems I was having in relationships, and it was the relationship with my boyfriend that we focused on. (Not here for THOSE details).

So, here is the trouble. My medications from the MD are working well, after some trial and error. I have been reading this forum, other web resources, and already a couple of the prominent books on ADD. I have "retested" myself on a couple of the online tests and they validate (in my mind) the diagnosis. But I am questioning the path that my PhD is taking with me.

She knows of my diagnosis because she works in the same office with the MD and there is only one record. I have told her that the medications are working and I now want to work on strategies to deal with the many issues and emotions I am facing with the new diagnosis. When I told her I was concerned about procrastinating at work, she asked me what my payoff was for doing that!! It seemed like she was ignoring the physical part of ADD and telling me to "just do it".

Ok. So, there might be a little payoff for procrastinating. But the real issue with me is that I get lost, or tired, or really bored. And now that I am medicated, I can concentrate a little better, but I am also dealing with a lot of frustration at the stuff that has piled up and also with (still) some moodiness and that darned neurobiological depression.

Any thoughts or suggestions? Am I misinterpereting that one question and just overreacting??? (no, I never overreact! )

I am going to see her on Monday and will probably ask her some pointed questions about her experience with ADDults. But I am not sure what to look for in her answers.

Please help!!!

Katherine
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  #2  
Old 11-05-04, 08:31 PM
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You might want to find a new therapist, someone whose familiar with adult ADD. Or you could give your therapist a book on adult ADD -- Can anyone recommend a good book to help educate professionals who work with ADDers?
I think NCGI has a book listed on their website
http://www.ncgiadd.org
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  #3  
Old 11-06-04, 03:41 PM
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Katherine I would ask her about her experiance and ask pointedly why she asked what the pay off was. I would have taken it as What are you getting from procrastinating my answer would have been nothing...so how can we work on this. I think the hardest part of being ADD/ADHD is learning to take responsibility for all actions at least it was for myself. It was really hard for me to say ADHD makes it easy for me to become distracted but I did NOTHING to fix my issue, I didn't like having to place the blame on myself.

Also keep in mind that just because your on meds and they are working well for you doesn't mean your going to turn into super woman and be able to fix all your issue's in life in one big swoop. It takes tiny steps to learn how to organize and pin point trouble area's and figure out how to fix them.

Be kind to yourself, give yourself a chance, attack the issue's at work in small steps taking what's important first and working your way down the list. Give yourself rewards it sounds like you have a lot of projects that you need caught up for every two projects done buy yourself lunch out with the girls or whatever you enjoy. Life is already hard we don't need to add to the stress by beating ourselves up all the time. Advice I'm learning to follow thru on myself.

Good luck and big hugs.
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Old 11-07-04, 09:58 AM
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Please check out ......You Mean I'm Not Lazy,Stupid Or Crazy?.......by Kate Kelly & Peg Ramundo. It's an excellent reference for adults who either have just been diagnosed or think they may have ADHD. In addition, please check out Russell Barkley's website for info on diagnosing adults by age referencing (the older you are the fewer symptoms required to meet the diagnostic criteria).Also, keep in mind that the original sample used for the DSM criteria was weighted towards boys and that the oldest person was only 16yrs old. Hence, the need for age referencing. Lastly, the 2 most accurate checklists are the Conners Adult Rating Scale and the ADHD-IV by George DuPaul. They are the ONLY checklists normed on both males & females.
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Old 11-07-04, 10:10 AM
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I'll be terribly honest: the majority of professionals, no matter how familiar with ADHD, will do not much more than that. While psychotherapy is effective in some cases with ADHD, it's not shown to be too terribly useful. Cognitive-behavioral therapy can have some effect, but none of it will be "life changing."

Medication is the standard front-line of ADHD treatment. The medication removes, if only temporarily, most of the impairment from the disorder. After that, the therapist or psychologist is more likely to deal with counseling to help with comorbid disorders or other feelings of inadequacy, etc., rather than try to correct the ADHD.

ADHD has no known cure. Unlike many other disorders, such as unipolar depression or acute anxiety, you can't "cure" ADHD. No amount of medication or psychotherapy can make ADHD "go away." For that reason, it is very rare that a psychologist would even attempt to do those kind of things.

ADHD is a permanent condition, and so any kind of assistance is geared towards coping, not curing. And the best coping mechanisms are those that we develop ourselves, so long as they end in an effective result.
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Old 11-07-04, 10:32 AM
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Since I work with children, I'll focus on that aspect.The ONLY therapy ( outside of meds) known to work effectively for Hyperactive-Impulsive and Combined types is behavior modification.That does not hold true for Inattentive type.Therefore, I now do mostly Family therapy with hyperactive kids and use it as a vehicle to teach behavior management techniques.

There's an old saying that I've qouted before and will do so again;" Good therapist's are born more than educated." In other words some people have natural talents and apptitude for communication, instincts and empathy.In terms of effectiveness of therapy, research has consistently shown that the rapport/relationship between the client & therapist is the most important single variable for success (however that is measured on a case by case basis).

I do believe that therapy can play an important part in treating ADHD in terms of helping the client with organization skills, ways to combat negative thinking(which is a huge problem for those of us with ADHD),learning new problem solving skills, journaling, behavior change strategies,etc. Years of negative thoughts, pessimistic belief systems and self defeating behaviors are not automatically wiped out with the sudden clarity from a successful med trial.

The other way that therapy can help is to address any comorbid conditions like depression, social anxiety,etc.

Please remember that you are the consumer here and have a perfect right to ask questions and challenge assumptions.
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Old 03-12-05, 11:01 PM
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I'm going to assume you meant to put "It is my view that" or "It is my understanding that" or "It is my strong opinion that" before your "The ONLY therapy..." comment.

Do you have any evidence to back up your statement.

Chrys

Quote:
Originally Posted by mctavish23
Since I work with children, I'll focus on that aspect.The ONLY therapy ( outside of meds) known to work effectively for Hyperactive-Impulsive and Combined types is behavior modification.That does not hold true for Inattentive type.Therefore, I now do mostly Family therapy with hyperactive kids and use it as a vehicle to teach behavior management techniques.

There's an old saying that I've qouted before and will do so again;" Good therapist's are born more than educated." In other words some people have natural talents and apptitude for communication, instincts and empathy.In terms of effectiveness of therapy, research has consistently shown that the rapport/relationship between the client & therapist is the most important single variable for success (however that is measured on a case by case basis).

I do believe that therapy can play an important part in treating ADHD in terms of helping the client with organization skills, ways to combat negative thinking(which is a huge problem for those of us with ADHD),learning new problem solving skills, journaling, behavior change strategies,etc. Years of negative thoughts, pessimistic belief systems and self defeating behaviors are not automatically wiped out with the sudden clarity from a successful med trial.

The other way that therapy can help is to address any comorbid conditions like depression, social anxiety,etc.

Please remember that you are the consumer here and have a perfect right to ask questions and challenge assumptions.
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Last edited by KnittingJunkie; 03-12-05 at 11:26 PM..
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Old 03-14-05, 01:24 PM
mctavish23 mctavish23 is offline
 

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Im qouting Russell Barkley directly from the Medical College of Wisconsin's 17th Annual Door County Summer Institute held on 8/4/03 to 8/803, which I was fortunate enough to attend. Dr.Barkley is widely regarded as the world's leading authority on ADHD.

The qoute isn't about one research study. It is an overview of the last 14 yrs. For example, he edited 2 huge volumes of works on Child Psychopathology and the Treatment of Childhood Disorders; both of which I have in my office (I'm at home right now). Recently, I presented an inservice workshop to our Children's Day Treatment staff where I work. During that presentation, I covered ethical practice efficacy, which means licensed mental health providers are ethically obligated to use therapeutic techniques that are safe and effective. In addition, we are also obligated to change what we're doing if research doesn't support it working any longer.One of the studies I referred to was from The Treatment of Childhood Disorders text which showed that Social Skills Training for hyperactive kids doesn't work.This is something that Children's Day Treatment programs have done for years. I believe the original reference dated back to 1991 or 1992. My point is that this is one specific example of what I'm talking about. Dr. Barkley also discusses the reasons behind this in his 1997 book ADHD and the Nature of Self Control. It goes back to some other posts I've made regarding ADHD being a disorder of self-regulation and inhibition. Another excellent source would be The ADHD Book of Lists by Sandra Rief (2003).

I appreciate your question and I'm glad you asked it.Most, if not all graduate programs in clinical psychology train their students as scientist practitioners.That basically means that our methods and techniques are empirically derived and found to be safe and effective.It also means that research is what drives our practice(s) and that we must keep up with it to stay on top of what is going on in the profession. So, when I said ONLY, I meant exactly that.
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