What Is Behavioral Therapy for ADHD?
Parenting a child or teen with Attention-Deficit/Hyperactivity Disorder (ADHD) can be challenging, but effective treatments are available. ADHD is a common neurodevelopmental condition that typically begins in childhood and can have a strong negative effect on the child's ability to succeed in school, interact positively with others, and build confidence and positive self-esteem.1
When diagnosing ADHD, clinicians will look for symptoms of inattention, hyperactivity, and impulsivity that are present in more than 1 setting, such as at home and at school.1
What is behavioral therapy?
The American Academy of Pediatrics (AAP) recommends that treatment for ADHD often involves a combination of medicine and behavioral therapies. Behavioral therapy focuses on equipping the adults in a child's life with strategies to respond effectively when difficulties arise, because they have the greatest influence over the child.1,3
Behavioral therapies do not change the core symptoms of ADHD, but mitigate their negative impact on daily life. A major benefit is that the positive effects of behavioral therapy can last long after the therapy concludes, unlike the effects of medicine.2
For some children, these behavioral approaches can be sufficient to support their success without the need for medicine. For others, a combined approach may be necessary.2
There are 2 main types of behavioral interventions, each addressing different challenges associated with ADHD symptoms:1,3
- Parent Training in Behavior Management (PTBM)
- Skills-based training
Addressing behaviors: Parent Training in Behavior Management (PTBM)
Parent Training in Behavior Management (PTBM) is a well-established type of behavioral therapy specifically designed to address impulsivity and hyperactivity that contribute to disruptive behaviors. Clinicians might suggest PTBM even before a full ADHD diagnosis is confirmed because it has proven to be useful for a wide range of behaviors, regardless of their underlying cause.1
Parents can expect to attend about 8 to 16 individual or group sessions and then practice the learned strategies between sessions. They will then report back to a therapist for further guidance and feedback.3
The goal is to help children learn to manage challenging behaviors while strengthening the parent-child relationship. This therapy trains parents in specific techniques that include:1
- Using praise or positive reinforcement to encourage desired behaviors
- Consistently applying consequences when children do not follow instructions
By providing parents with clear strategies, PTBM can greatly improve family dynamics and reduce stress.
Addressing attention: skills-based training
Children with ADHD often struggle with “executive functions,” the self-management skills needed to accomplish tasks, such as planning, organizing, managing time and materials, and maintaining focus. These difficulties directly impact their ability to manage schoolwork and responsibilities at home.2
Training administered by learning specialists can help. For elementary-aged children, specialists may involve parents in implementing strategies such as:2
- Establishing routines
- Using checklists for multi-step processes
- Setting time limits for parts of larger projects
- Using a planner to address memory challenges
- Using reward charts at home and school
Specialists will work directly with older children to develop personalized systems for managing time and school assignments, which are major challenges for adolescents with ADHD. Learning specialists teach study skills, memorization techniques, note-taking methods, and strategies to achieve their goals.2
Children need to understand the rationale behind strategies
An effective therapist will explain to the child why these strategies are helpful and how they will contribute to their success. Children with attention challenges can be quite pragmatic about putting effort into things they believe will pay off, a concept sometimes referred to as "neuroeconomics.” If children can understand and observe their success as a result of using these new skills, they will be more likely to trust that their time is being used effectively.2
Treatment can make life easier
Ultimately, both types of behavioral therapy – PTBM and skills-based executive function training – are designed to address the real-world impact of ADHD symptoms.
By mitigating setbacks and the negative impact on self-esteem that can accompany ADHD, these interventions can significantly improve outcomes and make life easier for children with ADHD and their families. While they require effort from parents, teachers, and the children themselves, the lasting positive effects make this investment worthwhile.