College Students With ADHD: Current Issues and Future Directions by Lisa L. Weyandt

Author:Lisa L. Weyandt
Language: eng
Format: mobi
ISBN: 1461453445
Publisher: Springer
Published: 2012-10-27T21:00:00+00:00

Psychosocial Treatment Strategies

63

Fig. 5.1 Typical case conceptualization for cognitive-behavior therapy with college students with ADHD (Adapted from “Cognitive Behavior Therapy for College Students with Attention-De fi cit/

Hyperactivity Disorder” by J.R. Ramsay & A.L. Rostain, 2006,

Journal of College Student

Psychotherapy, 21, pp. 11–12)

emotional, and behavioral rami fi cations of ADHD symptomatology (e.g., procrastination in completing academic assignments). For the purposes of CBT, clinicians must

develop a case conceptualization in order to understand challenges faced by stu-

dents with ADHD from the student perspective. Figure 5.1 displays the key elements of a typical case conceptualization as described by Ramsay and Rostain

( 2006 ) . The combination of ADHD-related dif fi culties and relevant developmental challenges (e.g., increased expectations for organization and time management)

may lead students to adopt maladaptive core beliefs, particularly with respect to

inadequacy (e.g., “I am not a good student”). Maladaptive cognitions, in turn,

increase anxiety and elicit compensatory strategies to reduce anxiety (e.g., procras-

tination of challenging assignments). Over time, this maladaptive cycle may per-

vade thoughts, feelings, and behaviors in daily college life. Thus, the primary goals

of CBT are to help students recognize this cycle and adopt coping, problem-solving

strategies to circumvent this maladaptive process.

Ramsay and Rostain ( 2006 ) provide a detailed overview of CBT for college students with ADHD. Speci fi cally, they outline steps for clinicians to follow in

implementing CBT across an academic semester (see Table 5.1 ). In the early stages

of the semester, clinicians should help students identify relevant goals for therapy

regarding both academic challenges (e.g., increase study time) and other college life

activities (e.g., decrease alcohol use). In formulating goals, it is helpful to consider student motivation for participation in treatment; in particular, the degree to which

students are ready to make changes in their lives will dictate the relative feasi-

bility of possible goals. Students are supported in understanding the linkages

among cognitions, emotions, and behaviors in relation to the challenges they face.

For example, when given a challenging assignment, a student may have maladap-

tive thoughts (“I always fail on dif fi cult, long-term assignments”) that are associ-

ated with unpleasant emotions (e.g., anxiety). Anxiety may lead students to engage

in maladaptive compensatory strategies such as procrastination. Once students

come to recognize such patterns, clinicians guide them in using a coping, problem-

solving approach to making small, feasible changes in their routines and activities.

As students practice the coping, problem-solving approach, clinicians review

the relative success of therapeutic homework and support ongoing use of these

64

5 Psychosocial Treatment and Educational Interventions

Table 5.1 Steps to cognitive-behavior therapy (CBT) for college students with ADHD

Stage of semester CBT steps

Beginning of

1. Identify speci fi c therapy goals for semester related to academic issues

semester

and other aspects of college life (e.g., social activities)

2. Discuss student motivation for participating in therapy

3. Elicit details of cognitive, emotional, and behavioral experiences of

students surrounding common dif fi culties (e.g., procrastination of

assigned tasks)

4. Encourage students to “start small” and make feasible changes in routines

and activities

Middle of

5. Review results from therapeutic homework. If unsuccessful, work with

semester

student to collaboratively problem-solve around dif fi culties

6. Foster balanced, constructive thinking when students encounter

challenges (e.g., midterm exams and projects).

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