role of therapy (talk) with ADHD?

[ceratops]

I haven't posted for a while, maybe a couple of months...

DS (age 12) has had difficulties with school for a number of years, has an ADHD diagnosis as well as some likely LDs, and has an IEP in place for the first time this school year. More details in some previous threads:
millermom.proboards.com/thread/13521/new-appreciate-comments-test-results
millermom.proboards.com/thread/13692/typical-path-exploring-meds

We are trying medication -- started with Metadate CD last November (low dose), switched to Focalin (bad side effects with anger, irritability), took a break from meds for a month or so, and are currently trying Metadate CD again (trying to observe results more systematically than on the first attempt). DS is taking 20mg of Metadate at the moment. We definitely are still in the exploratory phase with medication -- haven't yet settled on a med and dose that clearly helps DS. There are some (small) signs of improvement with the current dose of Metadate, and no really negative side effects, other than some loss of appetite, so we'll keep plugging away.

My question is about concurrent therapy during this stage of the process. DS is seeing a psychiatrist occasionally (mainly for medication management, it seems -- the appointments are quite brief). He was also seeing a therapist, once every two or three weeks on average, just to talk about his/our concerns and problems. The therapist told us, after the most recent appointment, that we don't really need to make any further appointments, as far as she is concerned. My impression was that the problems that DS is experiencing, as well as the stresses within the family, just aren't seen as troublesome enough to warrant further therapy sessions.

I feel sort of adrift at this point. Nice to know that the therapist doesn't see any major pathologies, LOL. And it's true that DS isn't in a crisis situation at the moment.

How common is it for kids with ADHD to do therapy in conjunction with meds, versus meds alone? I thought I had read that the combination leads to better outcomes... For those who have done therapy, what type of therapy did you encounter? Was it helpful, in your opinion? How often/how long did your child see a therapist?

[healthy11]

Ceratops,
When my son first started ADHD medication, he was in 4th grade. It was managed by a child psychiatrist, with visits every few months, but no other "formal" therapy. About a year and a half later, my son ended up being pushed off a slide on the playground by a classroom bully, and my son made a verbal threat back to the kid, resulting in a suspension. At that time, we were so grateful that the psychiatrist had a "group practice," so our son was able to talk to one of the other psychs, to get quickly "reinstated" in school. For a few weeks following that incident, just to be sure there were no lingering aftereffects or ongoing problems, he continued to meet with the psychologist, but there didn't seem to be any reason to continue, especially when school got out for summer break and he wasn't even seeing the other boy any more. (For the record, I found out the bully also had ADHD, so I honestly think the whole incident resulted from two less-than-patient and impulsive kids not being able to exhibit good self-control.)

To tell you the truth, I don't think my son has ever been a very patient or empathetic person; even at home, he would frequently display an arrogant attitude, seldom listening to what I'd say, but by 7-8th grade, it was getting unbearable. He was entering his teen years, and we weren't sure if hormones were to blame, if he needed medication adjusted, or what. My own patience was probably "thinner than usual" because I was dealing with eldercare issues and my mom's passing. My husband was working long hours, too. We basically mentioned the above to our son's psychiatrist, and at that point, he suggested that maybe it would be good to have our son talk to a family therapist again. The guy my son dealt with before, during the bullying incident, had moved, so he started to see a different therapist. (This time, a woman. She said she had two kids of her own: an older son with ADHD, and a daughter.)

The good thing that came of our son's meetings with the therapist were that he had a "3rd party" to "vent to," not always yelling at me, but in retrospect, I think it would have been better for him to have seen a male therapist, simply because the lady seemed like "another mom." He might say he'd try whatever she'd suggest, just to get her to stop talking, but it seemed like he'd forget what he was supposed to work on by the next day. (In one ear, out the other.)

My husband and I did have the woman's email, and generally would send her a short "summary" of what things we'd felt needed to be discussed before visits (which were every 2 or 3 weeks apart) but I'm not sure if our son's sessions with her resulted in any long-term improvements. Sometimes, when we'd take him to the appointments (I think they were scheduled for 45 min.- 1 hr.) the therapist would talk with him for the first half hour or so, then my husband and I would join them for the last portion. Again, as an only child who didn't have many friends, I think the biggest benefit of his "therapy" was just having someone else he could talk to about us, so we didn't have to take the "brunt" of his complaining ourselves. He saw that person for about 2 years, bridging the transition between 8th grade and Freshman year of H.S., after which time it seemed like he was getting involved in some clubs at school, and developing some outside interests and friendships, so maybe he was "venting" to them instead, or maybe he was just starting to "grow up" and things didn't seem quite as bad as they had been when he was in his early teens.

To tell you the truth, Ceratops, if your therapist doesn't think there's a need to have your son continue with his visits now, I'd probably ask your son if he feels like he'd miss their talks. If he says "no," then don't stress about stopping. If he sounds like he still wants to continue, then tell the current therapist. You can always keep the therapist's # handy, and make future appointments if new crises come up.