ADHD and behavior therapy

If your child has ADHD, you might be looking into treatment options. One non-medication approach that can be helpful for some kids is behavior therapy for ADHD. The goal of behavior therapy is to replace a child’s negative actions and habits with positive ones. And parents are the ones who lead the process.

Learn more about behavior therapy and how it can help kids with ADHD.

How behavior therapy works

When some people hear the term therapy, they may think of clients sitting with a therapist to talk about emotions and work through problems. Behavior therapy is very different from this, however. It focuses on a person’s actions, not on thoughts and emotions.

Therapists — typically clinical psychologists — work with clients to create a plan to help change behavior. The plan is designed to replace negative habits and actions with positive ones.

Behavior therapy for kids is as much about changing the parents’ behavior as the child’s. Parents can get into the habit of nagging and yelling, which can reinforce their child’s negative actions. A big piece of behavior therapy is coaching parents on how to replace their negative actions with positive ones, too.

What to expect from behavior therapy

So what can you expect from behavior therapy for ADHD? It starts with you, your child and the therapist having a meeting.

Together, you’ll talk about the behaviors that are most challenging at school or at home. Those might be things like talking out of turn, not finishing homework, or having angry outbursts.

The therapist will help you come up with a plan for you and your child to follow that addresses the most troublesome behaviors. The plans are based on a system of rewards and consequences. (That’s why it’s important for your child to be there. You’ll need your child’s help to come up with rewards that are really motivating!)

Next, you’ll create a chart listing the specific actions your child needs to take. These should be clear, concrete, and measurable, so your child knows exactly what the expectations are.

The chart can use pictures or words — or both. It should be posted at home where your child can easily see and use it. The plan is that when kids do what they’re supposed to do, you’ll check it off. Then they earn points toward a reward.

Once you start using the chart, you’ll meet with the psychologist on a weekly basis — without your child. The purpose of those sessions is to talk about how things are going, troubleshoot problems, and adjust the plan as needed. In essence, the therapist will be training you to be the “therapist” at home. Once a month, your child will join you at those sessions.

How behavior therapy can help kids with ADHD

Behavior therapy can be helpful for lots of kids, and for adults, too. But it can be especially helpful for kids with ADHD. Kids with ADHD can struggle with self-control and anger, which can lead to problem behaviors. It’s also not uncommon for kids with ADHD to lie frequently about everyday tasks like chores.

Behavior therapy takes a very businesslike approach to helping kids with ADHD change how they act and respond to situations. One of the goals is to eliminate arguing at home and give kids the motivation to change without parents being so involved.

The point of behavior therapy is to replace negative behaviors with positive ones. So the system of rewards and consequences is very specific. But whatever the reward is, it’s always coupled with praise to reinforce good behavior. (It’s important that your child’s teachers be aware of this plan. Then they can reinforce the behavior at school, too.)

Let’s say one of the behaviors you want to change is putting off starting homework. On the chart, you’ll put the desired behavior: “Start my homework when I’m supposed to.”

You’ll also decide on a reward. It might be: “For every five times I start on time, I’ll get an extra hour of screen time.” So each time your child does homework with only one cue from you, you’ll mark it off and your child will earn points.

Equally important are verbal recognition and praise from you. For instance, you might say, “You did a great job remembering to raise your hand in class. I’m really pleased with how hard you’re trying.”

If kids don’t remember to raise their hand, they simply don’t get a point. But they don’t get in trouble or lose any points. The point is to reward positive behavior and ignore negative behavior.

If this approach isn’t successful, however, you might need to switch to negative consequences like losing points. And if the negative behavior you’re trying to change is aggression, you might have to use negative consequences in that situation, too.

Behavior therapy and school

Sometimes therapy targets in-school behavior. In those cases, teachers have to be part of the process. You’ll need to get your child’s teacher to agree to help enforce the behavior plan. You’ll also need to make sure the plan is simple enough that it won’t eat up too much of the teacher’s time and attention.

It’s important to know that therapy isn’t always enough to help with ADHD symptoms. If your child is still struggling, talk to your child’s health care provider. Together you can discuss whether to consider ADHD medication in addition to or instead of behavior therapy. You may also want to read about different professionals who help kids with ADHD.