Successful New Year’s Resolutions

by Jessica Jeffers

new-years-day-1892263_960_720Another holiday season has come and gone. The decorations are starting to come down, the gifts have been dispensed, and we are turning our attention towards a new year. For many people, that means it’s time to make New Year’s resolutions. Whether we want to lose weight, stop smoking, or start getting organized, January 1 is a popular time to start making changes in our lives and our behavior.

But now we’ve hit the mid-January slump. Unfortunately many people who make New Year’s resolutions give up on their goals before the month is even over. That doesn’t mean we’re doomed to fail, though. It just means we need to approach our resolutions with a game plan meant to encourage success. A 2002 article in the Journal of Clinical Psychology reported that resolvers with a concrete plan were much more likely to have succeeded in sticking to their resolutions at the six-month mark (Norcross et al, 2002).

Abigail Levrini and Frances Prevatt outline one such plan in their book Succeeding with Adult ADHD (2012). Though meant specifically to help adults with ADHD, the basic principles can be generalized to many people looking to make their own behavioral changes.

 

  1.  Set long-term goals

Goals should be measurable, time sensitive, and process-based. What does that mean? You have to be specific when identifying what it is you want to achieve. Your goal should be something that you can empirically demonstrate you have accomplished. But that’s not all. To stay on track, it’s important to give yourself a timeline to define the actions that you will take to reach the goal. It’s not enough to just say that you want to lose weight. Tell yourself “I want to lose 15 pounds by June 1 by going to the gym three times a week and replacing sweet snacks with veggies.”

 

  1.   Create weekly objectives

New-Year_Resolutions_listYou’re not going to reach your goals overnight. Making changes in your life takes time and patience. Get there by identifying steps along the way, so that you practice new behaviors until they become habits. If you want to train for a half marathon, create a schedule in which you start out running just a mile or two and gradually add a little more distance week by week.

 

  1.   Add rewards and consequences to increase motivation

It feels good to cross objectives off your list. But feeling good isn’t always enough to keep some people working steadily towards their resolutions. The concept of rewards and consequences is a basic psychological principle that can help. As you make progress, remember to treat yourself! If your weekly objective was to spend an hour at the gym, kick off those running shoes and catch up on your favorite TV show when you’re done. But remember to hold yourself accountable if you slip-up. These consequences don’t need to be big—if you decide to skip your workout on Wednesday, the consequence can be as simple as also skipping that grande latte on Thursday morning.

 

  1.   Use metacognition to discover what works

Metacognition is defined as the “awareness of one’s own cognitive processes, often involving a conscious attempt to control them” (VandenBos, 2015). In this context, it means thinking about the way you approach your goals, acknowledging what works, and identifying how you can change what doesn’t work. Levrini and Prevatt suggest tracking your progress by keeping a journal. As you notice patterns emerging, you can adjust your weekly objectives, rewards, or consequences accordingly.

 

Committing to long-term change can be difficult, but applying these psychological principles and making a plan can go a long way towards helping you succeed with your New Year’s resolutions.

 

References

Levrini, A., & Prevatt, F. F. (2012). Succeeding With Adult ADHD: Daily Strategies to Help You Achieve Your Goals and Manage Your Life. Washington, D.C.: American Psychological Association.

Norcross, J.C., Mrykalo, M.S., & Blagys, M.D. (2002). Auld Lang Syne: Success Predictors, Change Processes, and Self-Reported Outcomes of New Year’s Resolvers and Nonresolvers. Journal of Clinical Psychology, 58(4), 397-405.

VandenBos, G. R. (Ed.). (2015). APA Dictionary of Psychology (2nd ed.). Washington, DC: American Psychological Association.

A Conversation With Russell A. Barkley, PhD, About Adult ADHD 

 

russell-barkley-photo

Russell A. Barkley, Ph.D., is a Clinical Professor of Psychiatry at the Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center. He holds a Diplomate (board certification) in three specialties: Clinical Psychology, Clinical Child and Adolescent Psychology, and Clinical Neuropsychology.  Dr. Barkley is a clinical scientist, educator, and practitioner whose publications include 22 books, rating scales, and clinical manuals, 7 award-winning DVDs, and more than 260 scientific articles and book chapters related to the nature, assessment, and treatment of ADHD and related disorders.  He is also the founder and Editor of the clinical newsletter, The ADHD Report, now in its 24th year of publication.  Dr. Barkley has presented more than 800 invited addresses internationally and appeared on nationally televised programs such as 60 Minutes, the Today Show, Good Morning America, CBS Sunday Morning, CNN, and many other television and radio programs to disseminate the science about ADHD.  He has received awards from the American Psychological Association, American Academy of Pediatrics, American Board of Professional Psychology, Association for the Advancement of Applied and Preventive Psychology, the Wisconsin Psychological Association, and Children and Adults with ADHD (CHADD) for his career accomplishments, contributions to ADHD research and clinical practice, and for the dissemination of science about ADHD.  His websites are www.russellbarkley.org and ADHDLectures.com. 

shh_headshot-smallBy Susan Herman

Did you know that adults can have ADHD? It’s true—ADHD is not confined to children and teens.

The trademarks of Attention Deficit Hyperactivity Disorder (ADHD) are inattention, combined (for some) with hyperactivity and/or impulsive behaviors. According to the National Institutes of Mental Health, some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors are more severe, occur more often, and interfere with or reduce the quality of how they function socially, at school, or in a job…Children and adults with ADHD need guidance and understanding from their parents, families, and teachers to reach their full potential and to succeed.

Professor, researcher, and clinician Russell A. Barkley recently published a self-help book with APA LifeTools for family members of adults with ADHD, titled When an Adult You Love Has ADHD: Professional Advice for Parents, Partners, and Siblings. You can find more information about the book and purchase it here.

I recently interviewed Dr. Barkley about his work with adults who have ADHD, and how loved ones in their inner circle can support them.

How recently was adult ADHD recognized? 

A German-language textbook published in 1775 has a remarkably accurate description of what we now call ADHD in adults. But, aside from very periodic mentions in the literature—as “minimal brain dysfunction” in the 1950s, and as “hyperkinetic reaction” or “hyperkinetic disorder” in the 1960s—neither the public nor the research community much recognized it. It wasn’t until the 1970s that a series of longitudinal studies was conducted to find out whether ADHD continued beyond childhood. Interest in this picked up throughout the 1980s and 1990s as it was found that half to two-thirds of kids who were diagnosed with ADHD continued to have symptoms into their twenties. This was the first real evidence base that began to show us how ADHD, like mental retardation, dyslexia, and autism, can continue into adulthood.

What would you say has been your greatest contribution to the field of adult ADHD?

In 1991 I started an adult ADHD research clinic at University of Massachusetts Medical School, and the same year my psychiatrist colleague Joe Biederman started one at Massachusetts General Hospital in Boston. We were collecting data on a variety of domains of impairment and symptoms on these adults to see if it was equivalent to the childhood form of the disorder – it clearly was.  Later, Alan Zametkin and colleagues at the NIMH did the first PET scan study showing brain related deficits in functioning in adults with ADHD.  Other studies on never-before-diagnosed adults were done to learn whether they responded to the same types of drugs that children were being given for ADHD.  Results showed that they did so.

In 2008 I published a monograph where I compared results of my own 20-year longitudinal studies on children with ADHD followed to an average age of 27.  Drs. Kevin Murphy and Mariellen Fischer and I compared them with adults diagnosed with ADHD alongside data I’d been collecting in the

clinic from adults who were not diagnosed as ADHD. This was the first time anyone had compared the two groups directly (children with ADHD grown up vs. adults diagnosed with ADHD). The monograph was massive, but I chose that format over journals because with journal articles you have page limitations and you have to peel off tiny bits of your research and present it over multiple, disparate articles. Instead I presented it all at once, and this allowed adult ADHD to really hit the research map. Others followed up my work with various methods of neuroimaging to show differences in brain activity for adults with ADHD.

Why did you decide to focus on parents, siblings, and partners of people with ADHD in your latest book?

Ever since I wrote a self-help book for adults who have ADHD, called Taking Charge of Adult ADHD (in 2010), I’d been wanting to write one for the family members who support them. At the time there was no science-based trade book available for loved ones of people with ADHD. Also, ADHD is in my family. I had been trying to help various of my own family members, get them treatment and offer a safety net, so I knew there were others out there also feeling frustrated after picking up and dusting off their loved one again and again.

I was ready to write the book when my twin brother died. He had ADHD, and I know that it indirectly contributed to his death. He was driving 40 miles per hour on a country road in the Adirondacks. He never wore a seatbelt, and he had a habit of going too fast and drinking while driving. He ran off the road and was killed. I put the book aside while I was grieving him. Not long after my sister, who had physical disabilities, also died. And about three years after that, my deceased brother’s son, who also had ADHD, hanged himself.  So I just “couldn’t go there” for a while due to all this grieving.

Finally, in 2015 the time was right. Several books on how ADHD affects marriage had appeared by that time. Writing about how to love someone with ADHD was cathartic for me. I feared that re-living events would make me feel worse, but actually I felt better.

Thank you for sharing that personal story. I’m glad you decided to include some of it in the book, too. 

adult-adhdLet’s back up a bit and talk about how ADHD can affect adults who have it. Also, how many adults have ADHD—how common is it in the population?

Four to five percent of adults in the USA have ADHD. The percentage is closer to 3-4% worldwide. It’s higher in Western countries because of longer life expectancy and better access to care. In children the ratio of boys to girls with ADHD is three to one; for adults there’s less of a split; it’s closer to 1.4 to 1 male to female. It’s been great seeing more women come out of the woodwork to talk about ADHD. I recently consulted on articles in Elle, Glamour, and Cosmopolitan magazines about adult ADHD.

ADHD is genetic in about two thirds of all cases; in about one third it is acquired either prenatally or after birth because of head trauma or environmental conditions that affect the brain’s frontal lobe development.

Adults who have ADHD typically achieve a lower level of education than they are capable of, and they have problems in the workplace with boring tasks that require sustained attention. Adults with ADHD tend to do well in non-traditional careers, often those that involve performing, music, athletics, police work, and the military. There are people with ADHD in law and medicine, but fewer than you’ll find in the more physically active careers.

Money management is a challenge for many people who have ADHD, as is driving. Adults with ADHD are 2-3 times more likely to be dead by age 46 from accidental injuries, many of which involve driving. About one third of adults with ADHD exhibit antisocial behavior and may even get involved with crime.

New research areas in adult ADHD include risky sexual behavior, along with marriage and parenting problems. ADHD is really one of the most impairing outpatient disorders there is—I would venture to say it’s even more impairing than depression—because it affects so many diverse areas of life. Clinical care and family counseling for adult ADHD exists and is increasingly available but is far from where it needs to be. As of ten years ago, only about one in ten adults with ADHD was diagnosed. The percentage is better now but there is still much progress to be made.

What do family members and partners need to understand about ADHD to best support their loved one who has it?

It’s important to adopt a biologically-based view of ADHD. ADHD is a neuro-genetic disorder. You can’t attribute your loved one’s behaviors to personality quirks, defective morality, laziness, or poor lifestyle choices or say they deserve whatever they get. You can’t be a good support person if you keep thinking, “My loved one could change if they wanted to, but they don’t want to.” People in the inner circle are their loved one’s best safety net and closest influence, but they can’t step up as stakeholders if they don’t adopt a more compassionate outlook about ADHD.

What kinds of support can family members provide to an adult who has ADHD? 

In my clinical work I walk through six steps with adults who have ADHD and their families. Step One is to get a thorough mental health evaluation to document not only ADHD, but any other disorders that the person might also have. Eighty percent of adults with ADHD have an additional disorder, and about half have two additional disorders. These might be anxiety, depression, a learning disability, bipolar, or something else. Detecting secondary disorders affects the course of ADHD treatment. Psychologists, psychiatrists, and behavioral neurologists can diagnose ADHD.

So the support person might offer to set up various appointments for their loved one and help them follow through getting to the specialist’s office.

Yes.

Step Two is to help the patient “own” their ADHD as a part of their identity. It’s easier to accept a diagnosis intellectually than it is to incorporate it as a part of your own view of yourself. Treatment will be superficial if the person doesn’t accept ADHD as a part of their self-view. When the patient starts to grieve their old self-image, that’s when we know we are getting through. Accepting the new you is also a positive thing because it means you’re giving up the old view of yourself as stupid, lazy, or immoral.

Step Three is to read widely and educate yourself about ADHD. I like to say that “truth is an assembled thing.” You can’t just depend on one source for all your information. Jeff Copper’s podcast, Attention Talk Radio, is a great resource, and I offer many more in the book. Think about it: if you’re diabetic, you have to understand how diet plays into your condition, and hygiene [for blood tests and insulin monitoring], and a host of other things. Because ADHD is a chronic disease I sometimes refer to it as the diabetes of psychiatric conditions.

Step Four is to get on medication. Medication is the best treatment for ADHD. And I’m saying this as a psychologist—there is no longer any “us versus them” going on between psychologists [who typically do not prescribe medication] and psychiatrists when it comes to ADHD treatment. Medication is two to three times more effective than behavioral methods alone for treating ADHD. Most adults with ADHD, 80-90%, need medication as part of the treatment package. Family members can help their loved one remember to take their ADHD medication regularly.

Step Five is behavior modification. Cognitive behavioral therapy (CBT) boosts the benefits of ADHD medication for self-control and executive functioning. Outside of formal therapy, there’s a lot family members can do to encourage their loved one to adopt exercise routines and other healthy habits. Often times people with ADHD need to get additional treatment to cut back or eliminate their use of alcohol, tobacco, and marijuana.

Step Six is accommodation. This means altering the environment so the person with ADHD is more likely to succeed. It might mean dedicating one computer for work only and another one for games and social networking. Family members can help their loved one find and download software that blocks distracting content. At home and on the job, adults with ADHD can advocate for themselves by finding support people to keep them accountable for changes they want to make and goals they want to accomplish.

A new type of accommodation that’s becoming more popular is called ADHD coaching. An ADHD coach makes daily contact via text or other channels to help the person stay organized, cope with frustration, and/or work through social problems. The field of ADHD coaching is still developing and is beginning to police itself. Some people are coming to ADHD coaching from financial planning or life coaching and are not currently held to a specific standard of knowledge or experience within psychology or behavior modification. I expect within five years certification requirements and accreditation for ADHD coaching will be in place.

 

Note: The opinions expressed in this interview are those of the author and should not be taken to represent the official views or policies of the American Psychological Association.

 

September Releases From APA Books!

adults with adhdNEW FROM APA LIFETOOLS®

When an Adult You Love Has ADHD 

Professional Advice for Parents, Partners, and Siblings

by Russell A. Barkley, PhD

In this book ADHD expert Russell Barkley explains the science behind ADHD and how you can tell if your spouse, partner, friend, adult child, or sibling may have it. He shows how to guide your loved one toward the right treatment, and what to do if he or she doesn’t want treatment. Adults with ADHD can be successful, achieve their goals, and live out big dreams—and you can help. You can set boundaries to manage your own emotional and financial stress, too. Here you will learn practical steps for helping your loved one accept and manage their disorder, and pursue paths in life where ADHD might not pose such a big problem.

 

community psychAPA Handbook of Community Psychology

Volume 1: Theoretical Foundations, Core Concepts, and Emerging Challenges

Volume 2: Methods for Community Research and Action for Diverse Groups and Issues

Editors-in-Chief Meg A. Bond, Irma Serrano-García, and Christopher B. Keys

This two-volume handbook summarizes and makes sense of exciting intellectual developments in the field of community psychology. As a discipline that is considered a half-century old in the United States, community psychology has grown in the sophistication and reach of theories and research. Reviewing the chapters of the APA Handbook of Community Psychology, the reader will readily notice several themes emerge: Community psychology’s ideas are becoming increasingly elaborated; its theory, research and interventions more situated; and its reach in both thought and action, more expansive. Ideas that may have seemed much simpler when first proposed—for example, community, prevention, and empowerment—have come to pose challenges, contradictions, and opportunities initially unspecified and perhaps unimagined.

 

career pathsCareer Paths in Psychology

Where Your Degree Can Take You

THIRD EDITION

Edited by Robert J. Sternberg

Now in its third edition, this bestselling volume has set the standard for students seeking to find an exciting career in psychology. Its comprehensive coverage spans more careers than ever, with the vast majority of chapters new to this edition. An advanced degree in psychology offers an extremely wide range of rewarding and well-compensated career opportunities. Amidst all the choices, this book will help future psychologists find their optimal career path. The chapters describe 30 exciting graduate-level careers in academia, clinical and counseling psychology, and specialized settings such as for-profit businesses, nonprofits, the military, and schools.

 

sexual orientation and gender diversityHandbook of Sexual Orientation and Gender Diversity in Counseling and Psychotherapy

Edited by Kurt A. DeBord, Ann R. Fischer, Kathleen J. Bieschke, and Ruperto M. Perez

This timely volume explores the unique challenges faced by SM and TGNC clients today.  Experts in the field examine how the concepts of gender and sexual orientation are both socioculturally-constructed and can be informed by biologically-focused research, thus setting the stage for flexible, affirmative mental health services.  Chapters cover a range of practice-focused as well as theory-based topics, including complexity in identity, minority stress, and stigma management.  With concise summaries of research findings and detailed case studies, contributors provide an intersectional understanding of how practitioners can work within rapidly-changing political and legal contexts to uncover and affirm clients’ multiple social identities, and build resilience.

 

supervision competency-basedSupervision Essentials for the Practice of Competency-Based Supervision

by Carol A. Falender and Edward P. Shafranske

This concise text describes a trans-theoretical approach that has been the gold standard in supervisory practice for nearly two decades.  The authors show readers how to identify, assess, and track the knowledge, specific skills, broad attitudes, and human values that undergird a series of professional competencies spanning the breadth of clinical practice.  Case examples illuminate the supervisory give-and-take as trainees develop competence in areas such as professional values, sensitivity to individual and cultural differences, ethical and legal standards, self-care, scientific knowledge and methods, applying evidence-based practice, and more.  From practicum, to internship and general practice, the competency-based approach offers clear training goals that organize and focus the supervisor’s attention where it’s needed most.