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Navneet posted Oct 20, 2022 8:34 PM
Your patient is an eight-year-old male child who is extremely active and not doing well in school. After several visits and using the Conners CBRS, you diagnosed him with ADHD. His parents are divorced, and the father attends with the mother and is against medication but would like to talk about cognitive-behavioral approaches prior to starting medication. What is your approach with this child and his parents? What options would you present and why? If they agreed on a medication but later wanted to try the cognitive-behavioral approach to wean the child off of medication, what types of linear plan would you form, who would you involve in this plan, and how long would you expect this plan to be in place in order to show long-term improvements?
Cognitive–behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people to identify and change destructive or disturbing thought patterns that have a negative influence on their behavior and emotions (Nakao et al., 2021). As the patient’s father wants to discuss cognitive-behavioral approaches prior to starting medication. Cognitive–behavioral therapy (CBT) promotes critical thinking and the ability of a person to cope with stress effectively. It’s essential that parents, teachers, therapists, and psychiatrists all work in a team to establish a supportive therapeutic atmosphere for the child. In reality, cognitive-behavioral therapy (CBT) combined with medication is the most effective and widely used approach to treating ADHD.
After a few months of treatment when the child’s symptoms improve it would be the best idea to decrease the dose of medication and continue behavioral therapy to notice the effectiveness of provided treatment and to wean the child off the medication. If the child stops taking medication like Tenex (Guanfacine) which was originally developed to treat high blood pressure, his blood pressure may rise, and his pulse may speed up, but it shouldn’t be too dangerous levels. Tapering gradually is recommended (Miller, 2021). For the provider to discontinue medication administration it is best to discuss the child’s progress with the behavioral therapist and the parents. Parents, Providers, and behavioral therapists must be advised to use a reward system to encourage the child and to support positive outcomes to motivate the child to encourage the continuation of such actions. Once the behavioral treatment ends the target behavior may no longer be rewarded, or rates of reinforcement may decline, although the general idea is that the learned behavior should persist after the treatmebcint (Oord & Tripp, 2020).
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