a prescription of psychotropic medication provided by the prescribing clinician.17 Monitor Medication Compliance and Effectiveness (17)The client reported that the medication has helped to improve attention, concentration, and impulse control without any side effects, and the benefits of this were reviewed.The client was assigned the exercise “Evaluating Medication Effects” from the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, McInnis, & Bruce).The client reported little to no improvement while taking the medication and was redirected to the prescribing clinician.The client has not complied with taking medication on a regular basis and was redirected to do so.The client and parents were encouraged to report the side effects of the medication to the prescribing clinician.
18 Educate Family About ADHD (18)The client's parents and siblings were educated about the symptoms of ADHD.The therapy session helped the client's parents and siblings gain a greater understanding and appreciation of the symptoms of ADHD.The family members were given the opportunity to express their thoughts and feelings about having a child or sibling with ADHD.
19 Discuss Treatment Options (19)The various treatment options available for ADHD were discussed with the client and/or parents.The options regarding behavioral parent training, classroom-based behavioral management programs, peer-based programs, medication, and cognitive behavioral therapy were reviewed.Pros and cons of each of the various treatment options were reviewed.Risks and benefits of each treatment option were reviewed to assist the parents in making fully informed decisions.The appropriate treatment for the client's developmental age was discussed.
20 Assign Parents to Read ADHD Information (20)The parents were assigned to read information to increase their knowledge about symptoms of ADHD.The client's parents were directed to read Taking Charge of ADHD (Barkley).The parents were directed to read Parenting Children With ADHD: 10 Lessons That Medicine Cannot Teach (Monastra).The parents were assigned to read The Family ADHD Solution: A Scientific Approach to Maximizing Your Child's Attention and Minimizing Parental Stress (Bertin).The parents have read the information about ADHD, and key points were processed.The client's parents have not read the information about ADHD and were redirected to do so.
21 Assign Client to Read About ADHD (21)The client was instructed to read information about ADHD and adolescence.The client was instructed to read ADHD—A Teenager's Guide (Crist) to increase knowledge and understanding of ADHD.The client was instructed to read The ADHD Workbook for Teens: Activities to Help You Gain Motivation and Confidence (Honos-Webb) to increase knowledge about ADHD and ways to manage symptoms.The client was instructed to read Take Control of ADHD: The Ultimate Guide for Teens With ADHD (Spodak & Stephano) to increase knowledge about ADHD and ways to manage symptoms.The client identified several helpful strategies learned from readings assigned to help improve attention span, academic performance, social skills, and impulse control.The client has not read the helpful information on ADHD and teenagers and was redirected to do so.
22 Explain Benefit of Behavioral Interactions (22)Today's session focused on how parent and child behavioral interactions can reduce the frequency of impulsive, disruptive, and negative attention-seeking behaviors and increase desired prosocial behavior.The use of prompting and reinforcing positive behaviors was reviewed.An emphasis was also placed on the use of clear instruction, time-out, and other loss-of-privilege practices for problem behavior.The Kazdin Method for Parenting the Defiant Child (Kazdin) was recommended.Parents and Adolescents Living Together: The Basics (Patterson & Forgatch) was recommended to the parents.
23 Teach Parents to Define Aspects of Situation (23)The parents were taught how to specifically define and identify their child's problem behaviors.The parents were taught how to identify their reactions to their child's behavior, and whether the reaction encourages or discourages the behavior.The parents were assigned “Switching From Defense to Offense” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, McInnis, & Bruce).The parents were taught to generate alternatives to their child's problem behavior.Positive feedback was provided to the parents for their skill at specifically defining and identifying problem behaviors, reactions, outcomes, and alternatives.Parents were provided with remedial feedback as they struggled to correctly identify their child's problem behaviors and their own reactions, responses, and alternatives.
24 Teach About Functions of ADHD Behavior (24)The parents were taught about the possible functions of ADHD behavior.Alternative functions for ADHD behavior, such as avoidance, attention-seeking, gaining a desired object/activity, or regulating sensory stimulation, were reviewed.Parents were assisted in reviewing how to test which function is being served by the behavior.The parents were taught about how to use parent training methods to manage behavior depending on the function it serves.
25 Assign Home Exercises to Implement Parenting Techniques (25)The parents were assigned home exercises in which they implement parenting techniques and record results of the implementation exercises.The parents were assigned “Clear Rules, Positive Reinforcement, Appropriate Consequences” in the Adolescent Psychotherapy Homework Planner (Jongsma, Peterson, McInnis, & Bruce).The parents' implementation of homework exercises was reviewed within the session.Corrective feedback was used to help develop improved, appropriate, and consistent use of skills.The parents have not completed the assigned homework and were redirected to do so.
26 Refer to Parent Management Training Course (26)The parents were referred to a parent management training course.The parents have completed the parent management training course and the key concepts were reviewed.The parents have not used the parent management training course and were redirected to do so.
27 Consult With Teachers (27)Consultation was held with the client's teachers to implement strategies to improve school performance.The client was assigned a seat near the teacher or in a low-distraction work area to help themr remain on task.The client, teacher, and therapist agreed to the use of a prearranged signal to redirect the client to task when attention begins to wander.The client's schedule was modified to allow for breaks between tasks or difficult assignments to help maintain attention and concentration.The teachers were encouraged to obtain and provide frequent feedback to help maintain the client's attention, interest, and motivation.The client was directed to arrange for a listening friend.
28 Institute Behavioral Classroom Management Interventions (28)The parents and pertinent school personnel were consulted in order to implement an age-appropriate behavioral classroom management intervention.The behavioral classroom management interventions were focused on reinforcing appropriate behavior at school and at home, using timeout for undesirable behavior and a daily report card for monitoring progress.The behavioral classroom management program has been used and the benefits were reviewed.The behavioral classroom management program has not been used and problems with this intervention were resolved.
29 Refer for Behavioral Peer Intervention (29)Behavioral peer intervention as described by Pelham et al. in “Summer Treatment Programs for Attention-Deficit Hyperactivity Disorder” was used.Behavioral peer intervention involving brief social skills training, followed by coached group play, was used.Contingency management systems were used as a portion of the behavioral peer intervention, including point systems and timeouts.Objective observations, frequency counts, and adult ratings of social behavior were used as outcome measures.
30 Provide Psychoeducation About ADHD (30)The parents were provided with psychoeducation about ADHD or ADHD and addiction.A rationale for treatment was discussed with the client where the focus will be on improvement of cognitive and behavioral skills, such as organization, planning, adaptive thinking, and reducing distraction and procrastination.The client and parents had a clear understanding of the rationale for treatment, and this was reinforced.The client and parents seemed to struggle with understanding the rationale for treatment and were provided with additional information in this area.
31 Teach Organization and Planning Skills (31)The client was taught organizational and planning skills.The client was taught about tasks such as using a calendar and a daily task list.The client was reinforced for regular use of organizational and
