ADHD: Behavioural therapy

A very important treatment component with ADHD is the behavioural therapy which may usually be applied as of school age. It focuses on the reduction of disruptive behaviour patterns in exchange of the acquisition of positive behaviour. It is also an objective to develop and practice strategies together with the child – in order to help it deal better with ADHD in daily life and change problematic behaviour patterns. This may be accompanied by parent counselling and special parent training. Teachers and educators should be included as well.

Basic elements of behavioural therapy

In order to modify the child's behaviour, various elements are used within the scope of a training program. This includes, for example:

• Using positive reinforcements:

  It is of particular importance to reward positive behaviour in children with ADHD. In addition to social reinforcements, such as verbal praise or a smile, small items – such as stickers, smileys or stamps – may be used as positive reinforcements within the scope of a reward system. If positive behaviour is systematically rewarded, the child is inspired to behave correctly.

• Punishing negative behaviour:

  Rewards or privileges can also be revoked again if the child displays negative behaviour patterns or violates the rules. Similar to positive reinforcements, the objective is here as well to provide the child with immediate feedback on its behaviour. In certain cases, it may also mean that misconduct must be made up for: For example, if the child dumps the trash bin, it must sweep the room afterwards.

• Prompting:

  The child learns best to comply with stable behavioural patterns when it has role models. This is why therapists often assume the stance of a first-person narrator when explaining actions in front of the child. The child thus finds out why something is done and which individual steps are necessary. The child thus learns to organise and structure its actions by itself.

• Practising correct behaviour patterns:

  To this end, desired behaviour patterns are applied time and again and used in new situations. The child thus learns to mould and automatise its behaviour.

• Cognitive methods:

  They are used to provide the child with the opportunity to reflect on its actions and to make new decisions. By means of the therapist's appropriate questions, the child is prompted to monitor itself, assess its actions and (re-)evaluate them. Different cognitive methods are differentiated – for example, self-observation, self-assessment, self-control or self-management strategies.

• Training in social competences:

  Training in social competences may prove helpful since children with ADHD frequently have difficulties with social interactions. This not only includes training of cooperative behaviour but also communication and interpersonal skills, as well as reinforcement of the child's self-confidence.

Further possibilities

In addition to the core elements already described, yet other methods may be used in behavioural therapy, thus e.g.:

• Relaxation techniques
• Autogenic training
• Progressive muscle relaxation

These methods not only have an impact on a psychological level, but also on a physical level. Balancing emotion and sensation provides a pleasant feeling. In this manner, the ability to concentrate, attentiveness and awareness are to be improved.