Written by Dr. Inez Van Roy on
July 20, 2021
Written by Dr. Inez Van Roy on:

Medically Reviewed by our Medical Affairs Team

If you’re looking for a way to help your child with ADHD, behavioral therapy may be the answer.

Behavioral therapy is one of the most effective treatments for children with ADHD. It’s also an important part of treatment in many cases.

That’s because behavioral therapy can teach kids how to change their behavior and manage their emotions more effectively, which helps them function better at home and school. And when combined with medication, it can make both therapies even more effective than they are alone.

Behavior modification teaches kids skills that will last a lifetime – like how to control impulses and frustration or how to organize tasks so they get done faster without forgetting anything important along the way.

This type of therapy also focuses on building self-esteem by acknowledging successes as well as teaching new skills that promote independence and responsibility in all areas of life – from managing time wisely to getting along better with siblings or classmates at school.

The best part? You don’t need any special training or expertise; just follow these simple steps every day at home!

This post will go over everything you need to know about behavioral therapy for ADHD.

What is behavioral therapy for ADHD?

Behavioral therapy, also known as behavior modification, aims to change actions. It teaches strategies to improve impulse control, concentration, organization, and other challenging areas. It addresses target behaviors by establishing routines.

Behavioral therapy structures time in different settings and reinforces positive attention. Unlike talk therapy, it focuses on the individual’s actions.

It must be noted that this intervention does not change the actual ADHD symptoms; it trains people to make it much easier to cope with the challenges and succeed at different settings (i.e., home, school, workplace, etc.). It teaches strategies that can help make overwhelming tasks feel easier to deal with.

It is never harmful to use behavioral therapy concepts if you suspect that your child has ADHD. Most children do not get diagnosed until school age. It is helpful to be proactive and reinforce positive behaviors early on.

Some individuals with ADHD use behavioral therapy with medication. Others find that behavioral therapy alone helps them manage their symptoms.

How Does Behavioral Therapy Work for Children with ADHD?

The American Academy of Pediatrics (AAP) recommends that parent training should be the first line of treatment (and not medication) for children with ADHD younger than 6 years old.

Behavioral therapy alone is also preferred by those who are concerned with the side effects of certain medications. Behavioral therapy with medication is one of the recommendations for 6-year-olds and older. 

Behavioral therapy for children with ADHD involves the whole family. It looks into how maladaptive behaviors are being responded to at home. Sometimes, negative behaviors are unintentionally reinforced by family members. For instance, some parents can get into the habit of nagging. This can further reinforce negative behavior.

Parents who undergo training learn skills in assisting their children to succeed. These can not only be useful at home and school but also in their relationships. The behavioral therapist works with the family. He helps look into the goals and the steps to achieve behavioral change.

A child undergoing natural treatment for adhd through play.

What Can We Expect During Parent Training?

Parent training is also known as parent training in behavior management. Others refer to it as parent behavior therapy or behavioral parent training.

According to the Centers for Disease Control and Prevention (CDC), behavioral therapy is most effective in young children when it is facilitated by parents.

Preschoolers are not mature enough to change their behavior on their own. They need their parents’ close supervision. It is ideal for parents to look for therapists who have related certifications.

Parents usually attend at least eight sessions. These may be parent groups or with one family alone. The basic steps being taught include:

Setting Clear Goals

For instance, parents can post chore lists and use specific instructions. For instance, “You need to stand still while I tie your shoelaces.”

Being Consistent With Rewards and Consequences

For example, the parent says “When you finish your dinner, you may watch TV.” The child could only watch if he eats what is on his plate.

Using the consequence system consistently

It is fundamental to always acknowledge good behavior. Employing the rewards and consequences in a long time will yield long-term results.

The parents will then practice with their child between sessions. Experts recommend parents narrow their focus. Even the most basic techniques may seem like a tall order. For instance, it is common to initially have many goals. Parents may want to address finishing homework, being dressed on time, making the bed, etc.

The top priority is then chosen. This will be closely monitored by noticing and complimenting small signs of success. As the child achieves milestones, his confidence increases to tackle the other tasks.

Specific behavioral therapy strategies include the following:

  • Positive Reinforcement

This technique rewards the child for good behavior. For example, the child can use the computer longer for 5 minutes if he was able to do his chores.

  • Token Economy

This method uses symbols or tokens such as stickers. These can then be exchanged for other reinforcers. For instance, a child earns a star sticker every time he goes to bed on time. She can then exchange her well-earned 3 stars for a healthy treat.

  • Response Cost

This strategy uses a negative consequence. This can be a loss of a reward or a privilege in response to negative behavior. For example, the child’s computer time will be shortened if he does not complete his chores.

To ensure improvement, the therapist provides regular support. There may be adjustments to the initial strategies if needed. Hence, parents and caregivers are also taught how to replace their negative actions.

They can develop constructive ways to respond to children with ADHD. The training may also improve family bonds as they work towards a common goal. Many families continue to experience improvement even after the training.

What Can We Expect During Behavioral Therapy for ADHD in Children?

Behavioral therapy sessions empower parents and their children in managing daily tasks. For instance, it can help with completing chores, doing homework, and paying attention.

The behavioral therapist will help in specifying a system of consequences. This may be done by creating a chart that shows the actions that need to be met and the expected rewards. The goals should be concrete, clear, and measurable.

It is necessary for the child to have a clear understanding of the expected behavior. It is important for the child to help come up with rewards that are motivating. For instance, a child has difficulties with fixing his toys.

The chart may then be set up so that the child gets a point or a sticker after putting his toys in his toy box. It may then be established that having five stars earns him more playtime in the park.

Parents are reminded to consistently compliment completed tasks. They should not shame or punish children for incomplete ones. Not earning a point is already a consequence. It is best to couple rewards with praise to further strengthen positive actions.

Verbal recognitions should specify the reinforced behavior and acknowledge their efforts. Rewarding the hard work toward positive change leads to the full new behavior. One example could be, “You did a great job in finishing your homework on time. I am pleased with how hard you are really trying”.

The goal is to reward positive behavior and ignore negative ones. The meetings with the therapist, without the child, are usually done once a week.

The main aim is to discuss progress on the chart and how certain issues may be better managed. The child also usually has monthly visits with the therapist. The sessions strengthen strategies on managing intense feelings, accomplishing goals, and self-control.

A parent reinforcing positive behavior on his child.

How is behavioral therapy done in schools?

Consistency in all settings is vital to foster change. AAP recommendations include involving schools through behavioral classroom interventions and school supports. It is helpful to clue the teacher what has been practiced at home.

Thus, developing a good communication system with teachers and school psychologists is fundamental. It is key in coordinating efforts and monitoring progress. It is also beneficial to involve teachers in creating the plan. This way, they can track and report back school-related behaviors.

Behavioral classroom management supports learners’ positive behaviors. This is done while preventing negative ones in the classroom. In this type of evidence-based therapy, student academic engagement is increased. This is implemented with the teacher’s participation in treatment delivery.

Some children with ADHD may perform better with the help of school-chart systems. Considering teachers’ time and workload, the plan must be simple enough. For instance, the teacher will mark if certain tasks were accomplished. The earned points will then be equated with positive consequences at home.

Moreover, teachers keep in mind to praise positive behaviors. They may also remove common triggers of bad behavior. For instance, the teacher may reassign the child to another seat. This may be an option if his seatmate triggers negative behaviors.

For older kids, private communication during classes may be done through hand signals. Other adjustments may include having different locations for tests and longer test-taking times. They may have modified activities depending on their respective conditions.

Behavioral peer interventions may also be considered. It involves one or more of the child’s peers providing help. The teacher will train the peers to reinforce the child’s positive actions. Pertinent academic and social support strategies will be employed.

Is Behavioral Therapy Working for My Child?

CDC says that behavioral therapy is helpful in reducing children’s ADHD symptoms. Seeing progress on the chart shows that the therapy is helpful. You may also observe an improvement in handling frustrating situations and self-confidence.

Otherwise, the system may be better changed. For instance, the adjusted plan will involve the introduction of negative consequences. An earned point will be removed when a particular task is not completed.

Keep in mind that behavioral therapy is not a cure (like medication which is also a tool). Learning and practicing behavioral therapy takes time and effort. Behavior improvements may be initially slow. But, with persistence and teamwork, things should get better.

Behavioral therapy provides tools for managing symptoms. It teaches life skills, such as empowerment and self-control. These can make huge impacts on future success as adults.

It must be noted that therapy is not always enough to help manage ADHD symptoms. It is important to talk to your healthcare provider if you see no improvements. You may discuss other alternatives if your child is still struggling. You may consider medication with behavioral therapy.

The National Institute of Mental Health (NIMH) conducted a Multimodal Treatment Study of Children with ADHD. They found out that the combination of medication and behavioral therapy had the best results. This approach decreased ADHD-related oppositional behaviors.

It also worked well in improving communications with parents and school. Medication works on a neurological level to regulate irregular brain waves. This may further help achieve behavioral therapy’s aims to address specific behaviors.

Other options that may be considered include nutritional intervention, supplements, and consulting other professionals.

A child with adhd reading, undergoing behavioral therapy.

How does behavior therapy for ADHD work for adults?

Cognitive Behavioral Therapy (CBT) can help adults with ADHD. It aims to help adults reframe their thoughts to have more control over their symptoms. It guides individuals in recognizing how their mindset can affect their actions.

Also, CBT helps in analyzing how previous challenges could have been better managed. This kind of therapy prepares the client for similar situations in the future.

The other benefits include figuring out behavioral patterns and having healthier self-esteem. They may also learn to cope better with stressors by being able to set aside personal time for self-care and other techniques.

CBT programs can be specifically designed for adults with ADHD. For instance, a study on CBT for adults with ADHD featured modules on the following:

– psychoeducation and organizing

-coping with distractibility

-adaptive thinking

-addressing procrastination

-involvement of a partner

The therapy sessions may focus on time management, organizing, and planning. They also address impulse control and stress management.

CBT may help individuals better deal with their responsibilities and look into strategies to complete tasks on time. The adults with ADHD may then be able to pay bills promptly, keep appointments, and manage expectations. Therapists may use follow-up check-ins and reminders to address challenges between sessions. 

A 2016 study demonstrated the initial efficacy of CBT. It was helpful for adolescents who showed persistent ADHD symptoms despite taking medications.

A related study reflected that the participants showed marked improvements after CBT. The benefits included improved reports on self-esteem and academic progress. The participants also had better family functioning and a decrease in inattentive symptoms.

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