ADHD OVERVIEW ADHD TREATMENT
The Hallowell Method
A Positive, Strengths-Based Approach to ADHD
The Hallowell method favors a comprehensive approach that addresses the totality of the child or adult who comes to us for help. Well-rounded treatment can include steps to alter first, the physical elements of what’s going on through medication, exercise, nutrition, sleep habits, prayer or meditation, as well as alternative treatments like neurofeedback and cerebellar stimulation; second, the behavioral elements of the issue through interventions like cognitive behavioral therapy, behavioral modification plans, coaching, lifestyle changes, and parent counseling; and third, the psychological elements of the issue through individual therapy, couples or family therapy, or other therapies all aimed at promoting strengths and talents. Beyond that, we look at the milieu or system in which the individual lives and try to determine the best school, or the best job, or the best camp, or the best living situation, again always with the goal in mind of promoting talents and strengths.
The following is from Delivered From Distraction, my book on the treatment of ADHD, specifically the chapter “The Treatment of ADD: What Works Best”:
Whether for children or adults, the treatment of ADD should be comprehensive and include a wide range of possible interventions, certainly more than medication or some other single step. Assistance should also be provided over the long-term, as ADD generally does not go away. The person being treated may not need to go see the doctor very often, but he should always know that help is just one telephone call away.
I divide a comprehensive plan into the following eight steps. Each step need not be implemented, but each step should be considered.
1. Diagnosis, which should include identification of talents and strengths. Make sure the diagnosis is both accurate and complete, taking into account the likelihood of coexisting problems.
2. Implementation of a five-step plan that promotes talents and strengths (detailed elsewhere in the book, this is too long to recap here, but is in a chapter called “How to Find the Buried Treasures: Five Steps that Lead to Lasting Joy)
3. Education – you need to learn what ADD is and what it isn’t as well as teach members of your family about it. You also need to explain it to teachers and all others who deal with your child or whomever has ADD. See the resource section of this web site and the appendix in Delivered From Distraction for more educational information about ADD.
4. Changes in lifestyle. Taking care of yourself has a huge impact on your brain and your ADD. You need to get enough sleep (critical!), eat right, exercise (which is actually one of the best treatments for ADD), calm your mind daily through prayer or meditation, stay connected with other people.
5. Structure – find external ways to create structure (there are a number of web sites that offer this type of help)
6. Counseling of some kind, such as coaching, psychotherapy, career counseling, couples therapy, family therapy
7. Various other therapies that can augment the effectiveness of medication or replace the use of medication altogether, such as an exercise program that stimulates the cerebellum, targeted tutoring, general physical exercise, nutritional interventions, and occupational therapy. Again, there is a great deal of information about this in Delivered From Distraction.
8. Medication (only if desired)
When medication works, it works as safely and dramatically as eyeglasses. Medication helps about 80% of the time in the treatment of ADD. Make sure you work with a doctor who can explain the issues around medication to you clearly. Most people do not realize how safe and effective stimulant medications truly are, when they are used properly. Make sure you work with a doctor who has plenty of experience with these medications. The stimulants include medications like Ritalin, Concerta, Adderall, Vyvanse, Focalin, and others. As long as you take them under proper medical supervision, they can help you immensely.
Psychology Today Interview with Dr. Hallowell About Ritalin, Scare Tactics, and Medications for Kids with ADHD
Non-Medicinal and Alternative Treatments
Alternative treatments for ADD is a catch-all phrase that refers to non-medication interventions.Here is a list of such treatments that I endorse.
I have found the following to be helpful in all patients:
- Love sustained over time.By far, the most important treatment for ADD.
- Using the “cycle of excellence.”See SuperParenting for ADD for a description of this reliable 5-step method.
- Daily physical exercise.As my friend John Ratey has shown in his book, Spark! The Revolutionary New Science of Exercise and the Brain, physical exercise may be the single most powerful somatic treatment for ADD that we have.
- Good sleep.Many people with ADD have sleep problems.See Delivered From Distraction for more on this.
- Proper nutrition.Eat whole foods.Avoid too much sugar or additives.I also suggest a supplement of omega-3 fatty acids.See the chapter in Delivered from Distraction for more on this.
- Mindfulness training, meditation, or prayer.See Delivered From Distraction for more, or see the outstanding research from Sue Smalley, a professor at UCLA.
- Daily doses of positive human contact.See my book Connect for more on this.
I also endorse the following treatments, but I have found that they are not beneficial to all patients, meaning they work for some and not for others:
- The movement and sound program developed by Integrated Listening Systems (iLs). This program stimulates parts of the brain and body which play a role in self-regulation and sensory processing. It is used by many top clinics in the U.S. and is now available direct. iLs is a pleasant therapy, has good research to back up its efficacy, and the program is only 2-4 months in length. Effective for processing, learning and attention issues.
- Cerebellar stimulation. Learning Breakthrough, the original physical exercise program to stimulate the cerebellum can be helpful in treating both ADD and dyslexia. “I have seen firsthand the extraordinary power of the various physical exercises Dr. Frank Belgau developed in improving concentration, memory, reading, verbal fluency, and mental dexterity, as well as confidence… I am happy to join in that effort.” –Dr. Edward Hallowell. See both Delivered from Distraction and SuperParenting for ADD for more on this.
Watch Dr. Hallowell Interview on: Treat ADHD, Dyslexia, and CAPD with Learning Breakthrough.
- Educational counseling and specialized tutoring – The right tutor or counselor can make a huge difference. Ask through your school.
- Coaching – I introduced coaching for ADD back in 1994 in Driven to Distraction. You can read about my HOPE model of coaching in that book. Now, there are many books about coaching, including an excellent one by Nancy Ratey called The Disorganized Mind.Coaching can help a great deal, as long as the person being coached wants to be coached.
- LENS, a special form of neurofeedback – See SuperParenting for ADD for more on this.
- Cogmed, a computer game that improves active working memory – Developed by scientists in Sweden, the research here is solid.Google Cogmed to learn more
- Kolbe therapy - Go to SuperParenting for ADD for two chapters on the remarkable work of Kathy Kolbe and her breakthrough treatments.
- Other nutritional interventions – You can read about these in Delivered From Distraction.
Whatever works, as long as it is safe and it is legal. I put this last item in because I know there are many interventions that can be useful that I either do not know about or have no experience with Chiropractic, acupuncture, homeopathy, and many more I haven’t even heard of no doubt have helped some, if not many people. It is important to keep an open mind. Just be sure you consider the proven interventions first.