Interventions in multiple settings can be hard
One challenging thing about treating ADHD is that you have to have interventions in multiple settings; usually one single treatment is not effective enough. As a clinician, you need to consult with multiple persons in a child’s life and try to intervene in multiple systems and put supports around the child, as well as to advocate that the parents do the same. As with any other mental health issue, you don’t always have just the mental health issue involved, and that can complicate treatment as well.
Marcus Cherry, PhD, Child and Pediatric Psychologist
Rewarding results
As a clinician, it’s a really great feeling when you see results. An adolescent may say, “You know, I actually used my organizer and my planner and it worked! I was able to finish my homework in two hours and I gave myself three hours– and I had all the rest of the time.” To hear them talk that way on a consistent basis is really rewarding. Or when a little 7 or 8 year old says, “I was able to slow my motor down today in class. I was able to raise my hand a couple of times,” and they can verbalize different things they can do to slow their motors down and control their bodies is rewarding. Having kids and parents work together to problem solve things at home and then going when they come back and see that there was some success at least for that particular time or multiple times, is also quite rewarding.
Marcus Cherry, PhD, Child and Pediatric Psychologist
A total turn around
The rewarding things are if the medication helps and the treatment is helping, it is just a total turn around in the child. When the ADHD is pretty severe kids are impaired socially, emotionally, intellectually, and academically. It really affects all the aspects of their life. When symptoms are under control then they begin to do the work at retrieving those aspects. Friendships improve and they are invited to parties because they are not trashing the whole house, or being impulsive and doing other things. They are doing much better academically in school: they bring home books and papers instead of forgetting them. Parents just can’t believe it; it’s wonderful.
Frances Johnson, Advanced Practice Nurse
When medication doesn’t do its job
It is frustrating for the clinician if the medication doesn’t help. There are some cases where the medicine is not doing its job, it isn’t helping as well as we wanted it to. It’s difficult when you don’t see the progress that you really want to see.
Frances Johnson, Advanced Practice Nurse
The heterogeneity of ADHD
One of the most challenging issues is that ADHD is a heterogeneous disorder and can co-exist with other problems. This heterogeneity can affect what type of outcome will occur. That is probably the biggest frustration for parents and clinicians; namely, that we just don’t have more effective interventions than we currently do. We have significantly better treatments than in the past and we can take care of people better than even five to 10 tears ago. However, if you are a person with ADHD in the subgroup that is either not taking such great care of yourself or not receiving good treatment, then it is very frustrating for you or for families because there isn’t the kind of improvement that you would like to see.
Eugene D’Angelo, PhD, Chief, Division of Psychology