Structuring the Psychotherapy Session
Not only is it important to introduce structure into the living environment of an individual with ADHD, it is equally important to introduce structure into the therapy session itself. Structure, compensatory strategies,
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and reminders are needed in daily life as well as within the therapy session.
For example, just as unfocused activity rarely helps an individual with ADHD reach a goal, unfocused, rambling interaction during a psychotherapy session is rarely productive. A neuro-cognitive psychotherapy session should be structured to help a client review issues discussed in earlier sessions, review issues related to other treating professionals (medication issues, coaching issues, etc.), set priorities for the focus of the current session, and set goals or tasks to work on between sessions.
Memory difficulties are very common in adults with ADHD. There may be no real sense of continuity from session to session without added structure from the therapist. Audio-taping or note-taking during sessions can be extremely helpful, allowing the client to review issues and goals between sessions. Each session needs to involve setting goals and priorities and then establishing realistic steps to work toward those goals.