Attention Deficit Hyperactive Disorder or ADHD for short is one of the most commonly occurring mental disorders in children and adolescents, with approximately 10% of school age children having a diagnosis. The behavioral disorder is characterised by symptoms including a difficulty in maintaining attention, trouble focusing, a difficulty controlling behavior and hyperactivity.  While many young people occasionally find it difficult to focus on schoolwork, act without thinking whilst playing with a friend or struggle to sit easy for an extended period of time, a young person with a diagnosis of ADHD will demonstrate each of these features in an often consistent manner to the point whereby that individual’s ability to function socially and academically might become impaired. Commonly ADHD can be broken down into three subtypes:

  • An inattentive type.  Most broadly distinguished by difficulties with organization and paying attention.
  • A hyperactive type. Most broadly distinguished by impulsivity and hyperactivity or inability to sit easy.
  • A combined type. A combination of inattentive and hyperactive and is the most common subtype.

Generally the hyperactive symptoms of ADHD tend to ameliorate during adolescence. Despite this, the trials and tribulations as well as the expectations that come along with being an adolescent mean that living with ADHD can be extremely difficult for a young person. With an increase in age, an adolescent faces more complex demands, gaining more responsibilities and losing some of the supervision that they received when they were younger. With this rejigging of structure, an adolescent living with ADHD may struggle to remain organized and motivated which may impact negatively on their continued development. In order to treat symptoms of ADHD in adolescents and promote healthy development, an adolescent will require an effective treatment plan as well as a supportive environment that stimulates a positive treatment response.

A number of psychotherapeutic and medication-based approaches to the treatment of adolescent ADHD have been shown to be effective. Often, a combination of the two is the most effective strategy for treatment. For information regarding the use of medication in the treatment of ADHD, please contact your doctor or a medical professional. The goal of psychotherapeutic approaches is to assist an adolescent in learning to control their behaviors through the development of effective cognitive and behavioral skills or strategies.

One strategy that has shown promise in the treatment of ADHD is the practice of mindfulness. Mindfulness is described as a state of being fully present in the present moment whereby you observe your thoughts and feelings from a distance, without judgement. Mindfulness has been incorporated into the frameworks of several evidence-based psychotherapeutic approaches including dialectical behavior therapy (DBT), Acceptance-Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT).

MBCT includes elements of Cognitive Behavioral Therapy (CBT) with mindfulness-based stress reduction and is typically delivered over 8 weekly group sessions. The overarching aim of MBCT is to increase acceptance, self-compassion and present-moment awareness and to enhance selective attention. MBCT recently emerged as an effective treatment for depression, anxiety and stress. However until recently there was little evidence to support its effectiveness for the treatment of ADHD in adolescence. Guided by evidence supporting the role of mindfulness in the treatment of ADHD, a team of psychologists recently carried out a study examining the effectiveness of MBCT in the treatment of adolescent ADHD. Evidence has highlighted that a supportive environment contributes to ADHD treatment success. As parents are likely to be affected by their child’s diagnosis and also play a crucial part in implementing a supportive environment, they were included in the research programme also.

Jillian Haydicky and her team explored the effectiveness of MyMind, an MBCT intervention developed for the treatment of young people with ADHD and their parents. The programme is delivered to groups of adolescent’s and parents separately. Weekly meditative themes for the adolescents include: distraction and the wandering mind, mindful communication and at home in your body, while weekly meditative themes for the parents include: Responding with awareness, communication and apathy and acceptance and boundaries. During each session, each group may practice meditation, discuss obstacles to the given theme as well their experiences of the meditative practices or participate in psychoeducation.

In terms of findings, Haydicky and her colleagues found was that MyMind appeared to be associated with a number of positive effects for both the adolescents and their parents. Following programme completion, the team found a reduction in overall adolescent inattentiveness and conduct problems, improvements in adolescent peer relations, reductions in parenting stress and increases in parental mindfulness. In terms of both externalizing and internalizing symptoms, a significant proportion of adolescents moved from the clinical to subclinical range which is extremely encouraging. These therapeutic changes may have further positive ramifications for both the adolescents and their parents which may lead to overall better functioning and improved relationships.

For instance if we consider research that suggests that poor peer relations may exacerbate problems associated with ADHD, an individual who learns to behave more effectively with their peers might see a reduction in these problems,  e.g. he or she may become more attentive to their surroundings if they share better relationships with the people around them.

Similarly, an improvement in mindful parenting may have positive consequences for the overall well-being of both the parent and the adolescent. Haydicky and her team describe mindful parenting as “thoughtful and intentional responding rather than automatic reacting to challenging situations”. Such a change in responding may have positive consequences that include a better parent-adolescent relationship which is likely to influence how the adolescent seeks support and ultimately how they behave, thus fostering a supportive environment.

One caveat of these findings is that for the most part, they were based on parental feedback, as often the adolescents did not report as positively. Further research is needed in order to confirm exactly what mechanisms are contributing to these positive treatment outcomes and how best to harness this information to inform future interventions. Nevertheless these findings show significant promise for the treatment of ADHD in adolescents using MBCT. In particular, they draw attention to the act of mindfulness as well as the significance of instilling and maintaining a supportive environment in the treatment of adolescent ADHD. If adopting a more mindful approach to family life can lead to psychotherapeutic gains, it is likely that it can lead to positive effects in all aspects of daily living. Consider how you behave and interact with your children or family members – would your relationship benefit from an improved sense of awareness into the context of daily life? If you are the parent of an adolescent with ADHD, do you identify as a mindful parent? The current research suggests that mindfulness and a supportive environment act congruently to encourage positive outcomes for adolescents experiencing symptoms of ADHD and their parents. If you would like further information on MBCT please see the links below.

 

Some useful links:

Mindfulness based cognitive therapy

http://mbct.com/

ADHD and parenting: 4 mindfulness techniques to curb the stress

http://psychcentral.com/blog/archives/2012/12/06/adhd-parenting-4-mindfulness-techniques-to-curb-stress/

 

Ms. Niamh Allen, M.A. B.Sc.

IS MINDFULNESS THE KEY TO TREATING ADOLESCENTS WITH ADHD?

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