Treatment can be some form of psychotherapy alone or may be a combination of psychotherapy and medication. Cognitive Remediation may be the best option for ADHD and Learning Disorders. Cognitive Training Medication Many medications used to treat depression, anxiety and ADHD can be and are routinely prescribed by family physicians. When medications are necessary, Dr. Smith will be readily available to consult with your physician by phone, letter or email. A Special Note About the Treatment of Conditions like ADHD ADHD, Learning Disabilities and Dyslexia are neurological conditions. That is they are physical conditions and psychotherapy cannot directly treat the condition itself. However, clients and family members often have enormous frustration and confusion about these disorders, which leads to conflicts, poor self-esteem and strained family relationships. These conditions can be treated with psychotherapy. For ADHD, especially, this treatment is usually a combination of individual and family therapy sessions. Medication is usually the primary treatment for ADHD, but medication is often not enough by itself. PSYCHOTHERAPY The Primary Principle of Most Therapies Psychological disturbances result from thoughts, attitudes and feelings that are hidden from conscious awareness, which is a way of coping with painful emotions. This way of coping may once have been consciously chosen, but such decisions are made in an instant and quickly forgotten. Such decisions are usually based on the assumption that there is no other way to deal with this pain. Other components of the train of logic, or rather illogic, for the coping choices are also forgotten. Burying thoughts, attitudes and feelings this way provides immediate relief from the pain, but they continue to actively exert influence over us and cause seemingly inexplicable psychological symptoms. The primary goal of psychotherapy is to bring these hidden thoughts, attitudes and feelings back into conscious awareness as well as consciously examining the original logic for burying them. Psychotherapy accomplishes this by getting the clients to explore themselves through talking. We resist this process because it is at first painful to rediscover the things we think that have been buried. Most psychotherapies work in this way The answer is seldom as simple as a forgotten childhood memory or even some childhood trauma, even when present. What is lost to consciousness is a complex web of faulty assessments of ourselves and the people in our lives. This web of faulty assessments evolves and grows over time. Types of psychotherapy Psychologists have defined and debated the merits of various kinds of psychotherapy for the past 60 years. However, it really does not make any difference. Research has consistently shown that successful vs. unsuccessful therapy is the result of the fit between the therapist's and patient's personalities, not the type of psychotherapy. What counts is not the theoretical orientation or technique, but whether the therapist communicates in ways that get through your resistance and feels right for you at a gut level. The important difference is between good and bad therapists, not between theoretical orientations. There are useful ideas from each of the schools of therapy. Therapists should be flexible, adjusting what they do to fit the person sitting in front of them. Psychotherapy should be a discussion, not a client monologue facing a blank unresponsive therapist. There are two basic types of therapy to choose: Individual and Family Therapy. Individual Therapy Individual Therapy is a 50-60 minute meeting between the therapist and the client.Family TherapyFamily therapy is a 50-60 minute meeting that includes the therapist, the client and other members of the immediate family. The client's problems have an important impact on other family members and other family members have important observations of the client. Sometimes it will be the whole family while at other times it may be deemed necessary or only possible to have one other family member. This form of therapy is especially important with children and adolescents. How long does therapy take? That depends on the nature of the client's problems.Specific clearly defined symptoms often improve sufficiently within 10 to 20 sessions to consider discontinuation of therapy. Clients often see a significant improvement in how they think, feel, and act within 10-20 sessions.Other kinds of problems need more time. A behavior or attitude that is more ingrained and reflects your overall way of getting through life will be more difficult to uproot than a specific symptom in an otherwise comfortable person. Therapy may also go more slowly for clients with important family members or relationships where partners have psychological problems. How Frequently Will We Meet? Frequency of meetings depends on the goals of therapy. Some clients will be seen weekly for an extended period of time. Most clients will be seen weekly at first, but will we may find that meeting every other week or even monthly meets their needs. This is mutually determined by Dr. Smith and the client based on the goals and practical considerations of scheduling and expense. Children and Adolescents Everything about psychotherapy with adults applies to children and adolescents. However, they require some special handling. It is seldom the child or adolescent's idea to enter psychotherapy. Instead, someone around them thinks they need help. Consequently, the resistance is often much higher and may take more sessions to see progress than with an adult. The therapist will need extra patience and frustration tolerance. However, children reject phony appeals and can be less polite about it too. Often what the child or adolescent dishes out to the therapist is just a taste of what the parents have experienced for a long time.
© Robert D. Smith, PhD
Robert D. Smith, PhD Diagnosis of Dyslexia, ADD & Learning Disorders Children & Adults