Rational Emotive Behavior Therapy (REBT; Ellis & MacLaren) provides a
theory for developing a group guidance unit that helps students learn how ADHD
affects learning behaviors and classroom performance. It offers a rationale
for increasing student awareness and the value of practicing school success
skills. The theory assumes that an ADHD student cannot exhibit a behavior that
has not been learned. REBT emphasizes behavioral change and self-regulation
along with the examination and possible modification of thoughts, beliefs,
feelings, and expectations. It is an approach that supports recent treatment
interventions for children with ADHD (Ellis & Wilde; Schweibert et at.).
It is assumed that, while the primary symptoms of the disorder are difficult
to ameliorate, it may be possible to help children develop competencies that
lower the risk of serious secondary difficulties (Braswell). According to Myrick,
this approach also lends itself to brief counseling that is so often used in
The Journey: A Group Counseling Intervention
What follows is a description of a small group counseling intervention that
has been used with ADHD students. The intervention focuses on increased understanding
of the disorder and how it impacts school performance. It was assumed that
students needed to face their disorders and recognize that it is part of
who they are. Further, the disorder by itself wilt not keep them from their
personal, academic, or career goals. To the contrary, many individuals who
have ADHD have made valuable and significant contributions to society. The
secret to success is being able to manage one’s thoughts, feelings,
and behaviors. The intervention consisted of six small group sessions designed
for about six students per group. Each session had a specific objective related
to thoughts, behaviors, and skills that focused on school and personal achievement
and began with a review of the previous session and a check on application
of skills. Sessions ended with tasks for practice and an encouraging summary
statement. The unit culminated with snacks, juice, and talk about the group
experience as well as a review of plans for utilizing strategies. The sessions
were based on the theme of a journey that students might imagine they were
taking. Of course, the journey required preparation and the ability to recognize
certain road signs and to manage the vehicle in such a way that the students
would arrive safely at their final destination. Because the students had
ADHD, they would be a different kind of traveler and, at times, take a different
route than others, although they would eventually arrive at the same destination.
The metaphor of a journey provided opportunities to construct group activities
that were fun and enabled participants to reflect on goals and goal setting,
the influence of personal characteristics on achieving goals, and personal
management skills. As they considered skills needed to move them along on
their imaginary journey, they also thought about how the skills were related
to the academic, personal, social, and career goals shared by all students
Preparing for the Journey
The therapist begins the unit by telling students that they have been selected
for the group because j they have been identified as different kind of learners:
They have ADHD. They are asked, "What do you know about ADHD?" Discussion
and clarification help the students identify ADHD symptoms and how the symptoms
are manifested in school, which often makes them learn in different ways
than others. They are, in one sense, a different traveler in the education
world. It is explained that sometimes they take the same road as others while
learning things and then, at other times, they will go another way, perhaps
taking some detours, even though everyone is trying to get to the same place.
The therapist leads the participants through a series of structured learning
activities. Special efforts are made to focus on what students experience
(their feelings) and how those feelings are related to behaviors (their actions).
Students discuss what they believe to be true about themselves and others,
and how they can manage their thoughts, feelings, and behaviors. Once introductory
activities are completed, the journey begins.
Session One: Our Journey. Participants begin their journey
as they explore a variety of paths to reach a single destination in Map Quest;
they talk about goals and places to go. As they discover the link between an
objective and school success, students realize that not all students must take
the same journey through school; however, they can each achieve success and
arrive at the same destination. Summary statements include: "Having ADHD
doesn’t mean you can’t be successful as a student; however, it
does mean that you might have to find some ways to get there (success) that
will be a little different than the routes others take. You will need to learn
to be a different kind of traveler and do some things to help yourself become
successful. If you do, you will have more control over where you are going
and how you will get there."
Session Two: Pack It Up. Students experience the "messy
bag." The therapist begins the session by rummaging through a bag or
backpack, throwing things left and right and creating havoc. It is a demonstration
of the chaos that comes from being cluttered and disorganized. Students explore
their own bags and the need for organization. Being orderly will probably remain
a difficult task to learn, but students may have more insight as to why others
are continually trying to organize them. Organizational skills are introduced,
demonstrated, and practiced. The session closes with a brief summary statement: "Keeping
things organized is important. It is one way for you to help yourself on your
journey to school success."
Session Three: Stop Lights and Traffic Cops. Students embark
on an imaginary "car ride" to heighten their awareness of the need
to attend and pay attention to the signs around them. As they pretend to drive
a car, signs are flashed in front of them, and they have to navigate obstacles
in the room. They then play the "paying attention" game. A participant
wins the game by keeping his or her eyes focused on an object, a book, or perhaps
a person who is walking around the room such as a teacher might do for various
time intervals. Time intervals are increased from a few seconds until a one-minute
interval is reached. The therapist summarizes by saying, "Having ADHD
makes paying attention and listening more difficult, but it can be done. Learning
and remembering strategies like we practiced today help us notice important
things along the way and let us take control during our journey."
Session Four: Using Road Signs as a Guide. Students identify
familiar road signs (cards) that cue behavior on the road before they identify
signs in their classroom that may help to cue behavior or remember something.
Students each develop their own cue to support increased success in the classroom.
Summarizing remarks include, "Students with ADHD can be successful in
school and get things done —using cues and reminders in your classroom
and making up your own are ways to do it."
Session Five: Road Holes and Detours. Students imagine things
that could go wrong on a road trip, including obstacles to getting to their
destination (construction, detours, holes in the road, etc). Students generate
school situations (many times generated by their own behavior) that create
obstacles to success in school. The therapist teaches and demonstrates selected
cognitive behavioral strategies before giving students an opportunity for practice.
The therapist closes with, "We know there will be holes in the road for
ADHD students. There are holes in the road for all students, but your map is
marked and you can expect them. You are learning ways to get around obstacles
and difficult situations at school and go on with your journey."
Session Six: Roadside Help and Being Your Own Mechanic. Students
explore the idea of breaking down on the road and becoming their own mechanic.
Previously learned skills and attitudes are reviewed as tools they will need
to get back on the road. Sometimes one has to ask for assistance from someone
else when necessary tools are not in the toolbox. However, most of the time,
students will have the tools they need to stay or get back on track. Knowing
that they can fix things and be their own mechanic is an empowering experience.
They are more responsible for managing their own vehicle. The topic of medication
is introduced. Doctors and parents usually determine if medication is an appropriate
intervention. If students have been prescribed medication, they are encouraged
to help themselves by taking the medication, as if it were a tool, and working
on the self-management strategies.
The final session summary includes, "We know that all students
can be successful in school and that not everyone must be the same kind of
traveler or learner. During our sessions we have learned about ADHD and some
of the skills and attitudes that will help us in our travels as we journey
through school. We have talked about the value of being organized, using cues
and strategies to help us remember things, paying attention, and thinking before
we act. We also practiced some skills and tried using them in school and at
home. With the right kind of attitudes and skills, we can reach our destination — school
success." It was found that therapists enjoyed delivering this intervention
to students. The intervention provided the teachers who participated with some
direction, was helpful in their work, and was perceived as impacting student
awareness and perception of self in regard to ADHD.
- Webb, Linda D and Robert
D Myrick; A Group Counseling Intervention for
Children with Attention Deficit/Hyperactivity Disorder; Professional School
Counseling; Dec2003, Vol. 7 Issue 2, p108
Reflection Exercise #11
The preceding section contained information
about "the journey" group intervention technique for children with
three case study examples regarding how you might use the content of this section
in your practice.
According to Webb, what is a group intervention exercise that can help ADHD
children gain insight into the need for organization? Record the letter of the correct answer