Alternative ADHD Therapies

While reading the book How to ADHD, I came across this interesting idea that DBT and ACT is being used to treat ADHD. I was surprised by this because I thought that DBT is only used for BPD and I’d never heard of ACT. But both of these techniques are useful and relatively simple.

DBT

DBT (Dialectical Behavior Therapy) skills training is a crucial part of DBT and focuses on teaching practical skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills are typically taught in a group setting, similar to a class. Here’s a closer look at each area:

  1. Mindfulness:
    • Objective: To develop an awareness of the present moment and engage fully with what is happening right now.
    • Skills Taught: Observing, describing, and participating in thoughts, sensations, and emotions without judgment. Learning to focus the mind and attention effectively.
  2. Distress Tolerance:
    • Objective: To increase the capacity to withstand negative emotions and stressful situations without reacting impulsively or using harmful behaviors to escape or avoid these feelings.
    • Skills Taught: Techniques for tolerating and surviving crises, and accepting life as it is. Skills include distraction, self-soothing, improving the moment, and considering pros and cons of a situation.
  3. Emotion Regulation:
    • Objective: To recognize, label, and adjust emotions, especially those that are painful or overwhelming.
    • Skills Taught: Understanding and naming emotions, increasing positive emotional events, decreasing vulnerability to emotion mind, and changing emotions by acting opposite to the current emotion.
  4. Interpersonal Effectiveness:
    • Objective: To enhance the ability to communicate effectively and assertively in relationships, maintaining self-respect and strengthening relationships.
    • Skills Taught: Asking for what one needs, saying no, and coping with interpersonal conflict. Balancing priorities versus demands, balancing the ‘wants’ and ‘shoulds’, and building mastery and self-respect.

It’s useful for ADHD in the following ways:

For ADHD, specific areas to focus on within the framework of DBT (Dialectical Behavior Therapy) skills include:

  1. Mindfulness:
    • Focusing Attention: Learn techniques to anchor your attention in the present moment, reducing distractibility.
    • Task Completion: Practice mindfulness to stay engaged with tasks and reduce tendencies to procrastinate or switch tasks frequently.
  2. Distress Tolerance:
    • Impulse Control: Develop strategies to manage impulsive behaviors and decisions, a common challenge in ADHD.
    • Coping with Frustration: Techniques to tolerate and manage frustrations arising from ADHD-related difficulties.
  3. Emotion Regulation:
    • Identifying and Naming Emotions: ADHD can sometimes make it hard to recognize and understand emotions. DBT can help in better identifying and articulating these feelings.
    • Managing Emotional Responses: Learn how to modulate emotional responses that may be more intense or quick due to ADHD.
  4. Interpersonal Effectiveness:
    • Communication Skills: Improve how you communicate needs and boundaries, which can be challenging with ADHD.
    • Building and Maintaining Relationships: Strategies to nurture relationships that might be affected by ADHD symptoms like forgetfulness or inattention.

ACT

Another interesting tool for treating ADHD is Acceptance and Commitment Therapy (ACT, pronounced as the word “act”). ACT is a form of psychotherapy that is part of the third wave of cognitive-behavioral therapies. Developed by Steven C. Hayes in the 1980s, ACT uses acceptance and mindfulness strategies alongside commitment and behavior change strategies to increase psychological flexibility. Here’s a more detailed look at ACT:

Core Principles of ACT

  1. Cognitive Defusion: This involves techniques to reduce the tendency to regard thoughts, images, emotions, and memories as literal representations of reality. Instead, ACT encourages seeing them as what they are — passing, often subjective experiences.
  2. Acceptance: Instead of fighting or feeling guilty about negative thoughts or feelings, ACT teaches the acceptance of these experiences as a normal part of human life, reducing their impact and influence.
  3. Contact with the Present Moment: This is about being fully aware and present in each moment, rather than being lost in thoughts about the past or future. Mindfulness techniques are frequently used to strengthen this skill.
  4. The Observing Self: ACT helps individuals understand the concept of “self-as-context” — the idea that there is a part of them that is unchanging and consistent, which observes and experiences the flow of life without getting entangled in it.
  5. Values Clarification: Clients are guided to identify what is truly important and meaningful to them — their values. This process helps in setting goals and directions in various domains of life.
  6. Committed Action: This involves setting goals according to one’s values and taking actionable steps to achieve these goals, even in the face of obstacles and setbacks.

Using Acceptance and Commitment Therapy (ACT) to address Attention Deficit Hyperactivity Disorder (ADHD) offers significant benefits, focusing on managing the emotional and psychological challenges associated with ADHD. Here’s how ACT can be effectively applied to ADHD:

  • Emphasis on Acceptance: ACT promotes the acceptance of ADHD symptoms such as distractibility and impulsivity as part of one’s experience, reducing the struggle against these symptoms.
  • Cognitive Defusion Techniques: These techniques help individuals with ADHD to distance themselves from negative thoughts, viewing them as transient mental events rather than truths.
  • Mindfulness Practices: Central to ACT, mindfulness aids in managing distractibility and impulsivity, improving focus and reducing impulsiveness.
  • Self-As-Context Concept: This helps individuals with ADHD foster a sense of self that is stable despite fluctuating attention and mood.
  • Values Clarification: Identifying personal values is key for those with ADHD, guiding decision-making and goal-setting.
  • Commitment to Action: ACT assists in developing strategies for organization, time management, or completing tasks, aligned with personal values.
  • Structure and Routine: Implementing structured routines and organizational strategies can help manage ADHD symptoms.
  • Emotional Regulation Focus: ACT addresses emotional dysregulation, a common challenge in ADHD, through acceptance and processing of difficult emotions.
  • Combination with Skill-Building Interventions: ACT can be integrated with interventions like executive function training to address specific ADHD symptoms.
  • Empowerment and Self-Efficacy: ACT encourages a sense of empowerment and self-efficacy, helping individuals with ADHD develop resilience and a positive self-view.