Since ADHD became a well-known condition, decades ago, much of the research and clinical discourse has focused on youth. In recent years, attention has expanded to the realm of adult ADHD and the havoc it can wreak on many aspects of adult life, including driving safety, financial management, education and employment, and interpersonal difficulties. Adult ADHD-Focused Couple Therapy breaks new ground in explaining and suggesting approaches for treating the range of challenges that ADHD can create within a most important and delicate relationship: the intimate couple.
With the help of contributors who are experts in their specialties, Pera and Robin provide the clinician with a step-by-step, nuts-and-bolts approach to help couples enhance their relationship and improve domestic cooperation. This comprehensive guide includes psychoeducation, medication guidelines, cognitive interventions, co-parenting techniques, habit change and communication strategies, and ADHD-specific clinical suggestions around sexuality, money, and cyber-addictions. More than twenty detailed case studies provide real-life examples of ways to implement the interventions.
Table of Contents
Foreword Barkley Introduction I. Adult ADHD and Relationships 1. Meet the Couples and Their Common Challenges Pera 2. Principles of ADHD-Focused Coupled Therapy Pera II. Clinical Interventions 3. Psychoeducation Robin 4. A CBT Model for ADHD-Challenged Couples Ramsay 5. The Role of Medication Pera and Robin 6. Behavior and Habit Change Robin 7. Imago Relationship Therapy Adapted for ADHD Robbins 8. Co-Parenting Strategies Easterlin III. Special Topics 9. Money Pera 10. Cyber Addictions Roberts 11. Sexual Intimacy Pera Conclusions and Clinical Notes Resources Index
Gina Pera is an award-winning author, workshop leader, and internationally recognized expert on adult ADHD, especially as it affects relationships. She lives in the San Francisco Bay Area.
Arthur L. Robin, PhD, is the director of psychology training at Children’s Hospital of Michigan, a professor of psychiatry and behavioral neuroscience at Wayne State University, and a licensed psychologist in private practice in Bloomfield Hills, Michigan.
Featured Author Profiles
"First came cutting edge theory in Is It You, Me, or Adult A.D.D.?, shining light in the darkness for couples living with the amazing complications of one or both partners having ADHD. Now comes a luminous clinical guide for Adult ADHD-Focused Couple Therapy, helping therapists identify the essential elements of the therapeutic process for successful outcome, including therapy models ranging from medications to cognitive-behavioral to couples therapy. The thoroughness and clarity of the theory and therapy, and the voluminous sources and research citations, make these two books a seminal contribution to the field."
—Harville Hendrix, PhD and Helen LaKelly Hunt, PhD, authors of Getting the Love You Want: A Guide for Couples and Making Marriage Simple
"Couple therapy has moved well beyond interventions for intimate relationship distress. Increasingly, evidence-based extensions of couple therapy have been developed for treating emotional, behavioral, or physical health problems in one or both partners. ADHD presents a critical destabilizing influence on couple relationships that has, heretofore, been largely understudied and undertreated. This book offers a treasure trove of evidence-based interventions for helping partners to cope with this personal and relational challenge.
The chapters are sensitively written by experts in adult ADHD and intimate relationship challenges. Both individual and couple therapists will benefit from the clear exposition of ADHD and its impact on couple relationships, as well as an integrated model for addressing its various adverse relational impacts. Step-by-step guidelines describe effective structured interventions for changing partners’ attributions about ADHD symptoms and for regulating and coping with their adverse consequences. Additional chapters address such critical areas as medication, co-parenting, finances, sexual intimacy, and a variety of compulsive behavior disorders."
—Douglas K. Snyder, PhD, professor of clinical psychology, Texas A&M University, coeditor of Treating Difficult Couples and the Clinical Handbook of Couple Therapy (5th ed.) and coauthor of Getting Past the Affair
"If you work with adults experiencing ADHD, Adult ADHD-Focused Couple Therapy is a must read. Packed with vivid case examples, informed by sound conceptual models, and filled with prescriptive (yet not pedantic) treatment plans and guidelines, this book is a revelation. It takes on controversial issues directly (e.g., internet additions, co-parenting, the potential for abusive relationships) while providing the best synthesis, in existence, of knowledge about ADHD in adulthood plus couple communication styles and issues. Five stars!"
—Stephen P. Hinshaw, PhD, professor of psychology, University of California, Berkeley; professor of psychiatry, University of California, San Francisco; author of The ADHD Explosion
"Living with adult ADHD brings numerous challenges, not only for the ADHD adult, but also for his or her partner. This book offers therapists cutting-edge methods rooted in the latest research. Armed with this book, therapists have at their fingertips practical tools and insights that will allow them to empower couples to thrive with understanding and appreciation for the challenges that ADHD brings to relationships."
—Andrea Bilbow, OBE, founder and chief executive, The National Attention Deficit Disorder Information and Support Service (ADDISS), London
"Describing ADHD as a disorder of executive functions and self-regulation, this guide creates a framework for clinicians that explains not only adult ADHD but also how to affectively deal with ADHD as it affects couples and their relationships. Presenting models adapted to the needs of couples, this book encourages flexibility while providing guidelines for therapists, including ways to manage and monitor medication for ADHD symptoms, initiate behavior change, improve mindfulness, and help the couple pursue shared goals. A fantastic resource for any therapist working with couples!"
—Patricia O. Quinn, MD, coeditor of Gender Issues and ADHD
"This is an outstanding treatment manual, providing an excellent summary of ADHD in general and a comprehensive framework for working with couples. The authors integrate the latest in ADHD research and describe a combination approach to treatment with an emphasis on neurobiological and cognitive behavioral interventions. This is an extremely practical book, with case examples illustrating applications and exercises that can be used with couples at various phases of treatment, beginning with diagnosis. Many myths and common barriers to reducing ADHD-related impairments are addressed. I recommend this for anyone who works with adults, couples, or families. Thank you, Gina Pera and Arthur Robin!"
—Mark A. Stein, PhD, ABPP, professor of psychiatry and behavioral sciences, University of Washington
"‘A-ha’ moments abound as this book successfully intertwines state of the art scientific knowledge with incredible empathy and insight into the lives of couples affected by ADHD. Emphasizing the pitfalls of a ‘one technique fits all’ approach, the text still clearly lays out practical recommendations for effective counseling of this massively underserved population. A joy to read, and sure to be of great help to therapists and the people they care for."
—Martin L. Kutscher, MD, behavioral neurologist, author of ADHD: Living without Brakes
"Aimed at couples therapy for adult ADHD, this book does so much more. It provides a beautifully written and accurate account of the many difficulties faced by adults with ADHD in their daily lives. The disorder is so often misunderstood, yet here we have a clear description of the symptoms and impairments and how best to support adults with ADHD. The book is a treasure of information and practical advice that makes invaluable reading for both expert and novice alike. It should be read by all those working with adults with ADHD who wish to optimise the success of their treatments and make a real impact on the quality of their lives."
—Philip Asherson, MD, PhD, professor in molecular psychiatry and honorary consultant psychiatrist, King’s College London
"ADHD-Focused Couple Therapy has many strengths. The book indicates in detail how conventional couple therapy needs to be modified to accommodate the fact that one or both members of the couple have ADHD. There are very few books that address this important topic.
The book clearly shows how ADHD symptoms can significantly affect the functioning and relationship of the couple, and how if the ADHD symptoms are not recognized and addressed, couple therapy may not succeed. It has a wealth of clinical examples to illustrate its points. The book is clearly written and well-referenced, both with research and clinically helpful material, such as outlines, rating scales, and resources.
Many of the chapters present clear step-wise approaches to intervention, with case illustrations for each step. A whole chapter is devoted to medication treatment. Other chapters are devoted to particularly important topics that present challenges to couples and need to be addressed, e.g., money issues, cyber-addiction, and sexual intimacy. Co-parenting strategies is also an important chapter as it illustrates how ADHD can impact on parenting skills, particularly if the child also has ADHD."
—Lily Hechtman, MD, FRCP, professor of psychiatry and pediatrics, director of research, division of child psychiatry, McGill University, Montreal Children's Hospital
"Adult ADHD-Focused Couples Therapy is a truly exceptional resource. Up to now, the impact of adult ADHD on couples’ relationships has been surprisingly underappreciated and certainly undertreated. This book eloquently fills the gap. Filled with poignant vignettes, the book brings to life typical day-to-day struggles facing couples with an ADHD partner, including the gamut of ‘hot spots’—from difficulties communicating, sharing responsibilities, and handling finances to coparenting, infidelity, and sexual intimacy.
The chapters are uniformly helpful and complementary, clearly the product of seasoned clinicians. Evidence-based treatment principles are distilled into practical, easy to follow suggestions including clear and often scripted guidelines for educating couples about ADHD and enacting change through a balance of acceptance and accommodation. This book carefully guides clinicians through even the most clinically challenging cases and offers hope. It is a must-read for clinicians, destined to be of enormous benefit for the many couples and families struggling with ADHD.
—Linda Pfiffner, PhD, professor of psychiatry, University of California, San Francisco