Articles

ADHD Patients' Social Skills More Likely to Emerge in Group Therapy

Clinical Psychiatry News: Vol. 23, No. 2. 1995.

BOSTON – Group psychotherapy is preferable to individual counseling in helping children and adolescents with the condition of attention-deficit hyperactivity disorder to develop social skills, Richard Dana, Ed.D., said at a conference on living with ADHD, which was sponsored by the Cambridge (Mass.) Hospital.

Although individual therapy can offer intense one-on-one feedback, and unconditional relationship with the therapist, and strong emotional bonding, it is not the best setting for teaching social skills an self-control, said Dr. Dana, instructor in psychology, Harvard Medical School, Boston.

Office-based group therapy offers many more opportunities for role paying, social skills modeling, and emotional support from peers.

Further, the situations, interactions, and behavior arising in the group reflect "real life" better than does the more limited behavioral spectrum seen in individual therapy.

For children with ADHD, the ideal group size is six – a number that allows for paired role-playing as well as larger group interactions. The children should all be within 2 years of each other. Dr. Dana recommended a minimum of 10 weeks.

Social skills building is the cornerstone of group work with ADHD children.

The first step is for the therapist to name and model a particular skill or way of behaving, such as "joining in a kick ball game" or "asking permission for something."

Then, all the group members should act out the demonstrated behavior. In many cases, scripts are useful.

Most kids enjoy role-playing exercises up until preadolescence, when "they pretty universally hate it."

When pairing the children off, make sure they reverse the roles, so each child gets to experience both sides of a particular situation.

Children with ADHD often need a lot of practice before they acquire key social skills. Transfer of gains is critical; otherwise, "they end up being able to do it right in your therapy group, but not in real life."

Group therapy, however valuable, should not stand alone. It must be part of an integrated management strategy that may include medication, special education, and counseling for parents, many of whom have ADHD or social difficulties themselves, Dr. Dana commented.

Social Skills Bibliography

1. How to Talk So Your Kids Will Listen & How to Listen So Your Kids Will Talk

Faber, Adele, Mazlish, Elaine 1982 Avon Books, NY, NY.

2. Skill Streaming the Elementary School Child: A Guide for Teaching Prosocial Skills by: McGinnis and Goldstein. Published by Research Press, Champaign, IL 61821.

3) SSS: Social Skills Strategies Books A&B

A Curriculum for Children and Adolescents. Thinking Publications; Eau Claire, WI,

1989.

4) Daily Communication Strategies for the Language Disordered Adolescent

by: Schwartz, Linda, M.S., McKinley, Nancy L. M.S., 1989, Thinking Publication; A

Division of McKinley Companies, Inc. Eau Claire, WI.

5. Peer Relationships, Self-Esteem, and the Self

by: Grunebaum, Henry, M.D., Solomon, Leonard, Ph.D., Int. J. Group Psychotherapy, 37(4) October 1987.

6. Social Skills Assessment and Training for the Learning Disabled: Who's on First and What's on Second? Part I &II

by: Schumaker, J and Hazel, J., Journal of Learning Disabilities 17(7): 422-431,

19849, 17(8): 492-499 19846.

7. Scripting: Social Communication for Adolescents

By: Waldo, P. and Mayo, P., Thinking Publications, 1986 Eau Claire, WI.

8. Skill Streaming the Adolescent: A Structured Learning Approach To Teaching Prosocial Skills

by: Goldstein, A., Research Press, Champaign, IL 61821.

9) Practical Strategies for Social Skills Training

by: Stephen N. Elliot, Frank M. Gresham- 1991, American Guidance Service.

Circle Pines, Minnesota 55014-1796.

10. Social Skills and Peer Relationship Training

by: Guevremont, David in Attention Deficit Hyperactivity Disorder Handbook

by: Barkley, Russell, Guilford Press 1990.

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