Complete a peer-based treatment program focused on improving social interaction skills. (29)
Conduct or refer the client to a Behavioral Peer Intervention (e.g. Summer Treatment Program or after school/weekend version) that involves brief social skills training followed by coached group play in recreational activities guided by contingency management systems (e.g. point system, time-out) and utilizing objective observations, frequency counts, and adult ratings of social behaviors as outcome measures (see Summer Treatment Programs for Attention-Deficit Hyperactivity Disorder by Pelham, et al.).
Identify and implement tactics, strategies, and skills for maximizing focused productivity and minimizing interference bought on by ADHD vulnerabilities. (30, 31, 32, 33, 34, 35)
Provide psychoeducation about ADHD or ADHD and addiction and orient the adolescent client to the CBT model and its rationale including cognitive and behavioral skills such as organization, planning, adaptive thinking, while reducing distraction and procrastination to improve focused productivity (see Cognitive-Behavioral Therapy for Adolescents by Sprich & Burbridge; Substance Use in Adolescents with ADHD by Kennedy et al.; Substance Use chapter in this Planner).
Teach organizing and planning skills including the creation of a centralized and prioritized task list.
Teach distraction delay and cue-controlled techniques that respectively involve writing down distractions while working and coming back to them after a set amount of time and instructing the client to check in with him or herself regularly (e.g. every 30 min) to assess if he or she was still working on the task at hand or if he or she had gotten distracted.
Use cognitive restructuring to teach adaptive thinking skills and respond adaptively to task-interfering thinking including anxious, depressive, or overly positive thinking that does not recognize the effects of attentional deficits.
Teach skills to reduce procrastination including scheduling tasks, breaking them down into manageable steps, learning to set realistic goals for completing tasks, and rethinking beliefs about perfectionism.
Conduct relapse prevention in which all skills are reviewed, continued use is encouraged, and coping with potential future difficulties are rehearsed; ask client to schedule a self-check-in one month after the last treatment session.
Parents develop and utilize an organized system to keep track of the client's school assignments, chores, and household responsibilities. (36)
Assist the parents in developing and implementing an organizational system to increase the client's on-task behaviors and completion of school assignments, chores, or household responsibilities using calendars, charts, notebooks, and class syllabi (or supplement with “Getting It Done” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce).
Increase frequency of completion of school assignments, chores, and household responsibilities. (37, 38)
Assist the parents in developing a routine schedule to increase the client's compliance with school, household, or work-related responsibilities.
Encourage the parents and teachers to utilize a school contract and reward system to reinforce completion of the client's assignments (or supplement with “Getting It Done” program in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce).
Identify and implement effective test-taking strategies on a consistent basis to improve academic performance. (39)
Teach the client more effective test-taking strategies (e.g. reviewing material regularly, reading directions twice, rechecking work; see Test-Taking Strategies by Kesselman-Turkel & Peterson).
Cite instances in which instant gratification was delayed in favor of achieving meaningful long-term goals. (40, 41)
Teach the client mediational and self-control strategies (e.g. “stop, look, listen, and think”) to delay the need for instant gratification and inhibit impulses to achieve more meaningful, long-term goals (or supplement with “Problem Solving Exercise” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce).
Assist the parents in increasing structure to help the client learn to delay gratification for longer-term goals (e.g. completing homework or chores before playing basketball).
Identify what social skills were implemented to reduce anxiety and build confidence in social interactions. (42, 43, 44)
Use instruction, modeling, and role-playing to build the client's general social and/or communication skills.
Work with the parents and assign exercises that facilitate the client's use of social skills in various everyday situations.
Assign the client to read about general social and/or communication skills in books or treatment manuals on building social skills (e.g. Your Perfect Right by Alberti & Emmons; Conversationally Speaking by Garner); or supplement with “Social Skills Exercise” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce.
Identify and implement effective problem-solving strategies. (45, 46)
Teach the client effective problem-solving skills (e.g. identifying the problem, brainstorming alternative solutions, selecting an option, implementing a course of action, and evaluating the results).
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