OnTrac Program for Teens with ADHD, ages 14-17

For individuals to understand ADHD, they need to know what characteristics affect them and how. ADHD is recognised as a disorder that seldom exists in isolation. It has a list of co-morbid conditions like anxiety, depression as well learning disorders like dyslexia and dyscalculia that can interfere with academic, social awareness and overall achievement. Many individuals have a combination of these characteristics not just impulsivity/hyperactivity or inattention. There is a significant risk for children with ADHD to face several challenges in their academic environments. They may not directly have a learning disability, but the troubles they encounter because of a lag in their executive functioning capacity, may interfere with their academic success. Topics covered include:

• How is ADHD diagnosed
• ADHD is a neurobiological disorder that impairs Executive Functioning (EF) the management system in the brain
• ADHD is a valid diagnosis
• When ADHD is not the only problem
• Treatment options

The focus of this module is to help the children think about problems and challenges in the most adaptive and realistic way possible. This is done by helping the children understand their ADHD-related issues from a CBT perspective. Topics covered include:

• Learning how to identify and dispute negative thoughts
• Learning how to look at situations realistically and make rational choices about the best possible solutions
• Understanding cognitive distortions/thinking traps
• Role of core beliefs in negative thinking
• Values and goals
• Problem-solving

In this module the old CBT view of ADHD, that thoughts don’t play a role in ADHD, and only relevant in cases of co-existing conditions such as anxiety or mood disorders and thus putting the focus of ADHD interventions on changing behaviours, is challenged.

We acknowledge that unlike with depression thoughts do not cause ADHD but experiences of living with ADHD affect thinking and thinking affects ADHD. Negative thinking in ADHD erodes away the pillars of self-esteem and the trust in one’s ability to bring about change in one’s life.

Many studies repeatedly show that emotions play a strong role in ADHD symptoms, suggesting that there is a direct link between negative thinking and ADHD symptoms. In line with the new view of ADHD ‘OnTrac’ gives the Cognitive Component of the intervention as much importance as the psychoeducation and the practical coping skills component.

The CBT model of ADHD suggests that many of the consequences of neurobiological symptoms of ADHD are maintained or exacerbated by a lack of adequate coping skills (Safren, Sprich, Chulvick, & Otto, 2004). Given this the objective of the skills building module is to teach compensatory executive skills such as:

• Time management
• Organisation, impulsivity, and distractibility
• Procrastination
• ADHD and communication
• Bringing about lasting change

Learning these skills at this young age, can facilitate the transition to environments that require greater independence with less supervision from parents, for example from primary to high school, to university or workplace.

Accordingly, in the program we balance the importance of involving parents with an understanding that, developmentally this is a time of increased independence and parenting to protect needs to be balanced with parenting to prepare. The children are taught to rely less on their parents and more on their own cognitive and behavioural ability.