The Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out

215 Pages·2014·1.138 MB·English

by  J. Russell Ramsay, Anthony L. Rostain

The Adult ADHD Tool Kit
A central source of frustration for most adults with Attention-Deficit/Hyperactivity Dis-
order (ADHD) is that they know what they need to do, but they have difficulties turning
their intentions into actions. These difficulties also interfere with their ability to use self-
help books and to get the most out of psychosocial treatments that provide coping strat-
egies that promise to improve their functioning. Drs. Ramsay and Rostain are experts
in the assessment and treatment of adult ADHD and are leaders in the development
of effective psychosocial treatments for this group of patients. Their newest book, The
Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out, is a coping guide
for adults living with ADHD, one that does not just present useful coping strategies but
also provides specific tactics designed to help readers implement these skills in their
daily lives and brings them to life in a user-friendly format. The authors discuss many
different settings in which ADHD may cause difficulties, including work, school, matters
of physical health and well-being, and the issue of excessive use of technology. Although
written for consumers, clinicians will find the book to be a clinically useful tool for their
adult patients with ADHD, serving as a companion to the newly updated and expanded
second edition of Drs. Ramsay and Rostain’s professional treatment manual Cognitive-
Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach.
J. Russell Ramsay, PhD, is cofounder and codirector of the Adult ADHD Treatment and
Research Program and an associate professor of clinical psychology in psychiatry in the
University of Pennsylvania’s Perelman School of Medicine. He is cochair of the profes-
sional advisory board for the Attention Deficit Disorder Association.
Anthony L. Rostain, MD, is cofounder and codirector of the Adult ADHD Treatment
and Research Program and a professor of psychiatry and pediatrics in the University of
Pennsylvania’s Perelman School of Medicine, where he is also director of education for
the department of psychiatry. He is currently president of the American Professional
Society of ADHD and Related Disorders (APSARD).
This page intentionally left blank
The Adult ADHD Tool Kit
Using CBT to Facilitate Coping
Inside and Out
J. Russell Ramsay and Anthony L. Rostain
First published 2015
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
27 Church Road, Hove, East Sussex BN3 2FA
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2015 J. Russell Ramsay and Anthony L. Rostain
The right of J. Russell Ramsay and Anthony L. Rostain to be identified as authors of
this work has been asserted by them in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. The purchase of this copyright material confers the right on
the purchasing institution to photocopy pages which bear the photocopy icon and
copyright line at the bottom of the page. No other parts of this book may be reprinted
or reproduced or utilised in any form or by any electronic, mechanical, or other
means, now known or hereafter invented, including photocopying and recording, or
in any information storage or retrieval system, without permission in writing from the
publishers.
Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent to
infringe.
Library of Congress Cataloging in Publication Data
Ramsay, J. Russell, author.
The adult ADHD tool kit : using CBT to facilitate coping inside and out / by J. Russell
Ramsay and Anthony L. Rostain.
p. ; cm.
Complemented by: Cognitive-behavioral therapy for adult ADHD / by J. Russell
Ramsay and Anthony L. Rostain. Second edition. 2015.
Includes bibliographical references and index.
I. Rostain, Anthony L., author. II. Ramsay, J. Russell. Cognitive-behavioral therapy
for adult ADHD. Complemented by (work): III. Title.
[DNLM: 1. Attention Deficit Disorder with Hyperactivity—psychology.
2. Attention Deficit Disorder with Hyperactivity—therapy. 3. Adult—psychology.
4. Cognitive Therapy—methods. WM 165]
RC394.A85
616.85'89—dc23
2014014783
ISBN: 978-0-415-81588-8 (hbk)
ISBN: 978-0-415-81589-5 (pbk)
ISBN: 978-0-203-44166-4 (ebk)
Typeset in Minion
by Apex CoVantage, LLC
JRR dedicates this book, as always, to my daughters, Abigail and Brynn.
ALR dedicates this book to my amazing wife, Michele, and to my wonderful
kids, Isabelle, Julian, Sam, and Gen who have taught me what it really means
to be a dad.
This page intentionally left blank
Contents
Preface xiii
Acknowledgments xix
1 Introduction 1
Why Should I Expect That This Tool Kit Is Going to Help Me? 1
Adult ADHD Background 3
Development of the Adult ADHD Tool Kit 5
2 What Do You Have to Do? The To-Do List 9
Planning Time to Plan 10
Comprehensive To-Do List 12
Daily To-Do List 14
“Enter the Room with a Plan” 16
3 How Do You Spend Yourself? The Daily Planner 19
Choosing a Daily Planner 19
(Over)use It or Lose It 22
Self-Care Activities 22
Err on the Side of Underscheduling 22
Define Start and End Times for Tasks 23
4 Define, Prioritize, and Choreograph What You Do:
Time and Task Management 25
Review the Daily Planner—Early and Often 25
Write Down All of Your Existing Obligations 26
Define Tasks for Your Daily To-Do List 28
Breaking Down a Task into Its Steps 28
Commuting and Other Buffer Times 31
Scheduling Unstructured, Discretionary, and Downtime 31
Choreography and Realistic Expectations 32
viii Contents
Make Adjustments, as Needed 34
Do It Now 34
5 Putting the Plan into Motion (or “Once I Get Started . . .”) 35
Define Tasks in Specific, Behavioral Terms 35
Define the Smallest Step of Behavioral Engagement 36
Implementation Plans 39
The 10-Minute Rule 39
Be Aware of Your Escape Behaviors 40
Procrastination Thoughts 42
Change the Negative-to-Positive Anticipation Ratio 44
Identify and Accept Discomfort 45
6 Keeping the Plan Going (Part 1): Motivation, Emotions,
and Energy 48
Renewing the Plan 48
Manufacture “Enough” Motivation 49
Behavioral Scripts 50
Reframe Time 52
Managing Energy 54
Setting Up Rewards 56
Accepting and Retraining Emotions 56
7 Keeping the Plan Going (Part 2): Attitudes, Beliefs, and Self-Esteem 60
Catching Your Automatic Thoughts 61
Thinking Errors 63
Changing Your Thoughts: Consulting Your Defense Attorney 65
Method Acting Approach 69
Values and Commitment 71
Changing Your View of Yourself 73
8 Outsourcing Coping Skills 76
Setting Up Automated Payments 76
Setting Up Automatic Reminders 77
Hiring and Bartering 78
Find Good Tools, but Avoid “Fool’s Gold” 79
9 Data Management: Recording, Organizing,
and Managing Information 82
The Daily Planner, Again 82
Electronic Backup 82
Contents ix
Going Paperless (Other Than Your Daily Planner) 83
Assertiveness and Information Management 84
Workplace Information 86
Classroom Information 88
10 Materials Management: Organizing and Managing Your “Stuff” 91
Do You Need It? 91
Finding a Place for Your Stuff 93
Tools of Daily Life 93
Keeping Up with Mail 94
Staying Organized 96
11 Environmental Engineering: Managing Your Surroundings 98
Your Work Station at Home 98
Stimulus Control 99
Alternative Work Stations 100
Your Work Station at Work 100
Your Sleep Station 102
12 Problem Management: Putting Skills Together
to Navigate the World 103
Problem Management Template 103
Decision-Making Template 105
Facing Uncertainty 107
13 Managing College with ADHD 108
Readiness and Setting the Stage for College 108
Managing the Demands of College 111
Dorm Life (or Living at Home while Attending School) 111
Reserving Time for Studying 111
Reading, Writing, and Arithmetic 112
Asking for Help and Self-advocacy 116
Self-care 117
Dealing with Technology 118
14 Managing the Workplace with ADHD 119
Goodness of Fit 119
Planning, Organizing, and Getting Started 120
Accommodations: Coping with an Imperfect Fit 121
Assertiveness and Negotiation 123
Do I Tell My Employer That I Have ADHD? 125