The THRIVE Center for Emerging Young Adults

 

ADHD Case Vignettes

The following vignettes show how THRIVE practitioners might apply different approaches to the situations and challenges of specific patients.

Browse through the vignettes and see which ones fit your current situation and challenges. These patients’ stories (names and details changed) will give you a better feel for the ADHD care delivered at THRIVE.

SCHOOL-AGE CHILD: “Christine can’t sit still in class or stop talking.”

Christine was the classic hyperactive kid – disruptive in class, working below grade level, low self-esteem. After a diagnostic evaluation revealed a diagnosis of ADHD, Christine was started on a stimulant medication. Christine’s mom then met with an Executive Function coach to learn techniques to support Christine with her study skills and to discuss the best way to talk to her daughter about the ADHD diagnosis. Christine also spent several session with a psychotherapist to explore the emotional and social impact of her ADHD. Over several months, Christine’s grades improved, her classroom behavior became more appropriate and she began feeling better about herself and her ability to succeed in school.

TEEN: “I have terrible grades and no friends. I’ll never amount to anything.”

Lenny’s ADHD had dealt him a double whammy: he had trouble with age-appropriate social skills; and despite his smarts, he was struggling with his ninth grade classes. The psychiatrist confirmed an earlier diagnosis of ADHD and got Lenny started on medication, as well as helping him set up better sleep and exercise habits. A consult with the nutrition coach gave Lenny the information and encouragement he needed to improve his diet. Participation in the Teen Social Skills Group helped him with social cues and interactions. A year later, Lenny had developed a group of friends, improved his self-care and increased his grades from C’s and D’s to B’s.

YOUNG ADULT: “School, parties, money, work – this is way too much to juggle.”

Peter had been diagnosed with ADD in grade school and had been on medication for years. But this wasn’t enough for him to deal with the challenges of college and his adult responsibilities. Peter met with an executive function coach for study skills and academic support, both in person and in regular phone meetings. Peter began to set specific academic goals, organize his study schedule, apply more effective study techniques, and set up a system for daily money management. He also obtained accommodations from the college. In time, Peter was able to find a better balance between his social and academic life, feel more organized and have more confidence in his life choices.

CAREER ADULT: “I’m 40 years old and I still wonder what I really want to do with my life.”

Steve had never really settled in to one job for a long time. Like many ADD adults, he got bored easily and changed jobs frequently. And he never felt that he had worked up to his potential. After working with the psychiatrist and the work/life coach, Steve began to understand that he had trouble processing auditory information and was much more of a visual thinker. He also had a better appreciation for the role that good sleep and exercise patterns had on his ADHD symptoms and his ability to function at work. When he began to record the conversations with his sales clients in pictures and diagrams, he felt much more able to organize information and tasks. He developed a clearer sense of his life goals and the steps he needed to take to get there. And his regular mountain biking sessions provided him with enough sensory stimulation to help control his inner restlessness and stay on task longer. Steve felt calmer, more directed and more accomplished in his work.

HOMEMAKER: “My family is so angry at me. I can never live up to their expectations.”

Linda struggled with the laundry, struggled with the shopping, struggled with the kids’ homework, struggled with the mounds of paperwork and bills, struggled with getting to appointments on time. She felt incompetent and her kids and husband reinforced this idea. Linda was referred to an Executive Function Coach, who helped her set up systems that got the mess in her household under control. The coach suggested she carry a simple notebook to keep track of tasks; and that she begin each day by setting up a schedule. Visual cues around her house helped her stay on task and on time. Linda also brought her husband in for a meeting with a psychotherapist where he had the opportunity to vent some of his frustrations with Linda and to learn the realistic expectations for an adult with ADHD. The house isn’t perfect yet, but a little calmer, a little more organized – and Linda feels a lot better about herself and being able to take care of her family.

COUPLES AND FAMILIES: “I have three kids at home – two are my children and one is my husband Rob. I’m sick of it – he never follows through on anything I ask. And he has no idea how to stay consistent with the kids.”

Jenn gave her husband an ultimatum: meet with a therapist for couple’s counseling or get a new wife. The therapist helped the couple explore the difficulties of communication in a relationship where one partner has ADHD; and had them establish basic rules for listening and speaking. Several parenting sessions gave Rob some guidelines for how he and Jenn could team up more effectively to support and discipline their children. After meeting with the psychiatrist, Rob also started taking medication and got his sleep, diet and exercise patterns under control. What had felt like a hopeless situation to Jenn now felt like a relationship that could heal and grow, and a family that could stay together.