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ADHD and Executive Dysfunction Treatment - Group Format

Learn why attention issues occur and use evidence‑based, neurodiversity‑affirming systems to build focus, organization and motivation. No diagnosis or medication needed.

Program Overview

It seems like everyone has ADHD nowadays. At least they think they do. The overwhelming rise in attention to ADHD has led to an overwhelming demand for assessment and, due to the lack of universal assessment standards, a visible and massive rise in false positive diagnoses—especially amongst adults diagnosed with ADHD for the first time—has emerged(Harrison & Edwards, 2023; Wakefield, 2015).

A diagnosis of ADHD should never be rendered solely based on the patient’s self-report.Collateral sources of information, such as a thorough review of report cards from grade school, informant interviews and questionnaires (typically filled out by parents), and potentially cognitive testing, should all be included, so as to avoid false-positive diagnoses.

However, there is another significant factor in the massive rise in adults complaining of problems with executive functioning (i.e., attention and focus). This significant factor is the way we live our lives. The near-constant barrage of brief information and simuli, delivered by our computers, tablets, and above all our phones, is changing us. This constant deluge of high intensity stimuli is changing the way we live, behave, feel, and think (Reed, 2023; Fabio et. al., 2022). This is not a novel concept, of course. Observing your own habits, and the habits of those around you, is likely to lead to a similar conclusion: at best, we are massively distracted by our screens. At worst, they are impairing our ability to sustain focus, tolerate boredom, and engage in tasks that promise slower, subtler rewards. As everyone keeps saying: with cell phones and social media, the dopamine’s just too easy to get.

Because of these factors, our clinic has developed a group that we titled “Executive Difficulties Group: for People With ADHD, and People Who Kind of Have ADHD.” We gave our treatment group this winky title because it is open to adults (and adolescents) who have been diagnosed with ADHD, and those who do not have a diagnosis of ADHD, but find themselves struggling with similar difficulties.

This group therapy program was adapted from the best available protocols for cognitive behavioural treatment of ADHD. Our treatment protocol places a strong emphasis on behavioural systems and practices that have been shown to counteract the detrimental impacts of ADHD and other neurological conditions that negatively affect an individual’s executive functioning and task management (such as dementia, cognitive decline, medical conditions, etc.). While each participant will have unique individual goals, the overarching purpose of the group is consistent and clear:

  1. Manage tasks of daily life with greater effectiveness, in both home and work.
  2. Reduce stress and feelings of ‘overwhelm,’ by implementing and embracing a consistent set of systems for: time management, item management, and relationship management.
  3. Control the impulsive behaviour that often accompanies hyperactive-ADHD, and establish skills for effective, intentional decision-making.
  4. Set, work towards, and complete goals that require sustained commitment over time.

This program is neurodiversity-affirming, and primarily utilizes the term “executive difficulties” to denote the types of challenges group participants face (i.e., rather than executive dysfunction). The premise of the group is that each participant is unique, and executive difficulties are due to the alignment, and potentially misalignment, between the individual’s behavioural habits and their environment. As Thom Hartman writes in his book ADHD: A Hunter in a Farmer’s World, people with ADHD should not be pathologized; instead, we are facing a challenge of adaptation: neurodiverse individuals find the demands of their environment challenging to meet, in some ways, so skill and strategies can help with this adaptation.

Desired Outcomes

​The desired outcomes for group participants include:

  • Increased ability to attend to, and process, information accurately (i.e., cognitively filtering extraneous information to capture relevant information), by developing and using mental-filtering skills.
  • Counteract the negative impact of ‘short’ attention span and distractibility by using an effective work method (this involves multiple measures including: reduced environmental distractions, implementing techniques to prioritize and segment work tasks, reducing procrastination, and segmenting work time into more manageable units).
  • Implement regular and routinized behavioural systems and environmental tools to manage items (e.g., even a simple thing, such as a consistent ‘home’ for one’s keys and wallet can be a game changer) and repetitive necessary tasks (e.g., ongoing use of a single, consistent time management tool, with regular required tasks becoming fixed ‘time pillars’ during the day or week).
  • Mitigating the negative impacts of hyperactivity (as relevant), by finding and maintaining appropriate energy outlets.

Overall, both the goals and techniques are intuitive, sensible, and can be adapted for each participant. However, like any process of habituation, they do require sustained effort and commitment over time. As such, the group has three ‘tiers’: beginner, intermediate and advanced. The FAQ table below describes the logistics and structure in more detail.

FAQs

NOTE: we were provided FAQs in a document ADHD_Group_Clinical_Descriptions.docx — however, those FAQs appeared to be meant for the CPT/trauma group, and have been pasted there.

References

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders(5th ed., text rev.)
  • Fabio, R. A., Stracuzzi, A., & Lo Faro, R. (2022). Problematic Smartphone Use Leads to Behavioral and Cognitive Self-Control Deficits. International Journal of Environmental Research and Public Health, 19(12), 7445. https://doi.org/10.3390/ijerph19127445
  • Harrison, A. G., & Edwards, M. J. (2023). The Ability of Self-Report Methods to Accurately Diagnose Attention Deficit Hyperactivity Disorder: A Systematic Review. Journal of Attention Disorders, 27(12), 1343-1359. https://doi.org/10.1177/10870547231177470 (Original work published 2023)
  • Reed, P. (2023). Impact of social media use on executive function. Computers in Human Behavior, 141, 107652.
  • Wakefield JC. DSM-5, psychiatric epidemiology and the false positives problem. Epidemiology and Psychiatric Sciences. 2015;24(3):188-196. doi:10.1017/S2045796015000116