ADHD is a common childhood disorder characterized by difficulties with attention, hyperactivity, and impulsivity. For many, symptoms associated with Adhd can continue through adolescence and adulthood. Adults can experience impairment in various areas of their lives due to ADHD symptoms, including their work, relationships, finances, emotion regulation, and overall daily responsibilities.

The average age of onset for ADHD is 6 years old. The National Institute of Mental Health has indicated that over 65% of children living with ADHD were taking medications to manage their symptoms. When we look at the prevalence of ADHD among adults, we see a rate of 4.4% in the U.S., with rates higher among men when compared to females.

Treatment approaches for ADHD typically include the use of psychotropic medications, including methylphenidate-based stimulants or amphetamine-based stimulants, and psychotherapy. Therapy and counseling can focus on fostering the development of time management and organizational skills, behavioral interventions, education, emotional support, and improving interpersonal skills such as communication and conflict resolution. 

Setting Goals and Objectives With Clients in Your ADHD Treatment Plan

Developing a treatment plan for ADHD requires that you gain insight into the level of impairment your client experiences, and the different ways that their lives are affected. ADHD symptoms can affect individuals in varying ways, which would have a direct impact on what you focus your treatment on. With children, you may have information from clinical observations in various settings, which can provide you with insight into how the child’s symptoms affect their behaviors.

Therapy approaches that are used for individuals living with ADHD are often tailored to their unique needs, age, and symptoms. Many individuals respond well to the combination of therapy and medication management for managing their ADHD symptoms. Examples of commonly used therapeutic approaches for ADHD include:

• Cognitive-Behavioral Therapy
• Behavior Therapy
• Psychoeducation
• Mindfulness-Based Interventions
• Parent-Training
• Family Therapy

What to Include in a Treatment Plan for ADHD + Example

As we move through the different components included in ADHD treatment plans, we will be referencing the following case example of an individual who is living with ADHD. This will allow us to discuss details within our ADHD treatment plan in the following example.

John is a 20-year-old college student who has come to counseling because he has been having a hard time in college. John shared that the first two years had mostly introductory courses, which were easier to manage compared to his current caseload, which has higher-level and specialized courses. John was diagnosed with ADHD when he was in elementary school and has worked diligently to use behavioral strategies to manage symptoms and improve his level of functioning. John reported that he has been taking Adderall for years, and is comfortable with his current medication regimen. He began working with a psychiatrist in his college counseling center two years ago when he began his studies. John has been struggling with focusing and procrastination, which has led to incomplete and late assignments, which are now at risk of affecting his GPA. He has been marked on assignments for careless mistakes that he later recognizes. John indicated that he also interrupts others when they’re talking, which he feels pushes people away. He also blurts out answers in class rather than waiting his turn and gets “antsy” waiting in lines. John reported that he is easily distracted and cannot do schoolwork in the library unless he is in a soundproof, private room. He noted that he is known for misplacing his keys and wallet, more days than not. John explained that he engaged in mental health counseling when he was younger and that he found it helpful because he learned to cope with his symptoms. John currently lives on campus with 2 roommates whom he considers close friends.

In this example, you work as a mental health professional within his college counseling center for students, which is equipped with a multidisciplinary team including social workers, mental health counselors, psychologists, and psychiatrists. 

Agencies Involved and Plans for Care Coordination

 In John’s case, it is appropriate to be in contact with the Psychiatrist within the counseling center to ensure that all of his healthcare providers have a complete picture of his symptoms and level of impairment in functioning.

Example for John:

Other Agency: College Counseling Center

Plan to Coordinate Services: Speak with J.’s prescribing Psychiatrist about his current symptoms and inform him that J. has begun mental health counseling

Other Agency: None at this time

Plan to Coordinate Services: N/A

Clinical Diagnoses

Based on the information provided, John’s symptoms align with ADHD. He has previously received his diagnosis and has been taking psychotropic medications to help in the management of his symptoms. He expressed concerns with maintaining his focus and concentration and being easily distracted.

Since he is engaging in treatment with a pre-existing diagnosis and is receiving medications for this concern from a psychiatrist, it is unlikely that you would be doing diagnostic testing and screening, unless there was reason to suspect his diagnosis should be modified. This diagnosis should be listed on his treatment plan.

Examples of assessments that are commonly used during evaluations and assessments for diagnostic purposes of ADHD include:

• ADHD Rating Scale-5
• Conners Comprehensive Behavior Rating Scale
• Vanderbilt ADHD Diagnostic Parent Rating Scale
• Brown Attention-Deficit Disorder Scales
• Continuous Performance Test
• Behavioral Assessment System for Children

Example for John:

Attention Deficit Hyperactive Disorder, combined presentation, 314.01

Supporting Assessments: N/A

Current Medications and Responses

John indicated that he has been taking Adderall to manage his ADHD symptoms and is actively working with a psychiatrist. You may list details associated with his medication, including dosage and frequency, in this area of your ADHD treatment plan.

Example for John:

Adderall, 5 mg, taken twice per day

Presenting Problem and Related Symptoms

Your presenting problem and related symptoms section will give a detailed account of John’s current concerns, from a clinical perspective. This should be detailed enough to provide a snapshot of his symptoms, impairment, level of distress, and overall level of functioning.

Example for John:

John’s difficulties primarily revolve around his academic work and social interactions. He often finds it challenging to concentrate on his work by frequently becoming distracted by his thoughts or external stimuli. As a result, he struggles to complete assignments on time. Despite his interest in the subject, he frequently procrastinates and struggles to initiate tasks, leading to a pattern of missed deadlines and incomplete coursework.

In addition to academic challenges, John’s ADHD symptoms also impact his social interactions and personal relationships. He frequently interrupts others during conversations, struggles to use active listening skills, and has difficulty waiting his turn to speak. His impulsivity often leads to social blunders and misunderstandings, causing strain in his friendships and extracurricular activities.

Goals and Objectives

Treatment plan goals for ADHD should be specific, realistic, and attainable. Each goal should have several objectives that can be used as shorter goals that work towards larger goals that align with his presenting problem. Counseling sessions should work towards supporting your clients as they progress towards these goals, with the use of appropriate treatment modalities and interventions.

Example for John:

Goal1: Problem/Symptom – Difficulty with organization, time management, and planning, which leads to missed deadlines, forgetfulness, and disorganization in daily tasks

Long-Term Goal – Improve executive skills

• Objective 1: J. The client will use a digital calendar app to schedule and organize daily tasks and assignments.
• Objective 2: J. will create a weekly planner to prioritize tasks and allocate time for studying classwork, and other activities.
• Objective 3: J. will implement a system of reminders and alarms to prompt task initiation and completion.

Goal 2:  Problem/Symptom – Academic underachievement due to challenges with sustaining attention, staying organized, and managing time effectively, resulting in poor grades and academic struggles.

Long-Term Goal – Improve Academic Performance

• Objective 1: J. will attend all classes regularly and participate actively in class discussions and activities.
• Objective 2: J. will dedicate a specific block of time each day to studying and completing assignments in a quiet, distraction-free environment.
• Objective 3: J. will seek assistance from professors or academic advisors when encountering difficulties with course material.

Goal 3: Problem/Symptom – Emotional dysregulation, impulsivity, and difficulty managing frustration and stress, leading to interpersonal conflicts, mood swings, and heightened anxiety levels.

Long-Term Goal – Develop Coping Strategies for Emotional Regulation

• Objective 1: J. will practice deep breathing exercises and mindfulness techniques to reduce stress and promote emotional stability during challenging situations.
• Objective 2: J. will keep a journal to track emotional triggers, identify patterns of behavior, and develop strategies for managing impulsivity and regulating emotions. 
• Objective 3: J.  will keep a journal to track emotional triggers, identify patterns of behavior, and develop strategies for managing impulsivity and regulating emotions.

Specific Interventions to Be Used

It is important to be mindful of the therapeutic approach and interventions that are being used. Mental health concerns are highly individualistic, which means that two people living with the same mental health disorder can experience different symptoms, and have different levels of functioning. Several things go into this, including the presence of co-occurring disorders, previous counseling and therapy experiences, and the presence of medical health concerns. In John’s case, we will be using cognitive-behavioral therapy (CBT).

Example for John:

• Intervention/Action: Psychoeducation
  • Responsible Person: Counselor A
• Intervention/Action: Cognitive Restructuring
  • Responsible Person: Counselor A
• Intervention/Action: Organizational Skills Training
  • Responsible Person: John and Counselor A
• Intervention/Action: Introduction and Use of Mindfulness and Relaxation Practices
  • Responsible Person: Counselor A and John
• Intervention/Action: Relaxation Techniques Including, But Not Limited To, Deep Breathing, Progressive Muscle Relaxation, And Guided Imagery
  • Responsible Person: Counselor A

Family Involvement

Social support can be an important component of emotional wellness for individuals experiencing various mental health conditions. With ADHD, we often see parents, guardians, and family members participate in therapy so that they can learn more about ADHD, emotion regulation skills, and how to better support the child in their life. In John’s case, he has not mentioned family involvement, nor does he live at home with family. Should he choose to include his family in his treatment down the road, appropriate modifications can be made to his treatment plan.

Example for John:

• At this time, John does not wish to involve his family in his treatment

Additional Services and Interventions

Additional services can be used to enhance an individual’s treatment experience, ensuring comprehensive treatment. This can include referrals to community resources, support groups, and peer-led support groups.

Examples for John:

• Provide referral for student support group
• Encourage J. to speak with his academic advisor about possible aides or accommodations (i.e. scheduling a private room at consistent times during the week for school work)

Estimation for Completion

The keyword for this section is “estimation”. When you are thinking of a possible completion date, several factors can come into play, some of which we cannot control. While this may be straightforward when using modalities that use a structured, and scheduled format, that is not the case in John’s example. For this case, we will aim for completion after 12 sessions or 3 months of treatment. This date is flexible and can be adjusted to meet John’s needs.

Example for John:

• 12 weeks; to be adjusted as needed

Aftercare Plans

Aftercare plans are something that we begin thinking about when our clients begin treatment. There is always a possibility that they can terminate counseling early, and it is better to be prepared with a plan, should this happen. Similar to other sections of your treatment plan, this can be adjusted as you progress through treatment.

Example for John:

Aftercare Plans:

• Referral to local Psychologist for continued medication support
• Local resources for college students
• Community mental health treatment facilities

Final Thoughts On Creating a Treatment Plan for PTSD

ADHD treatment plans should be comprehensive, and tailored to each individual, ensuring that they receive whole-person care. Oftentimes, individuals with ADHD can effectively manage their symptoms and improve their overall functioning with evidence-based practices. With ongoing monitoring and support, individuals living with ADHD can thrive in all areas of their lives.

For more information on crafting a counseling treatment plan, or other  ADHD aides and worksheets, we encourage you to browse available resources on TherapyByPro. 

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Resources:

“Attention-Deficit/Hyperactivity Disorder (ADHD).” National Institute of Mental Health. Accessed April 11, 2024. https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.  

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