Attention Deficit Hyperactivity Disorder and Family Interventions

This report presents a comprehensive overview of Attention Deficit Hyperactivity Disorder (ADHD), including its symptoms, diagnostic criteria based on DSM-5, and impact on children and families. A case study of a 7-year-old boy named Ryan with ADHD is introduced, highlighting the challenges faced by the child and his family. The report then delves into the application of Marriage and Family Therapy (MFT), specifically structural family therapy, as an intervention approach. It explains the principles of structural family therapy, its objectives, and the process of intervention, including assessing family dynamics, identifying dysfunctional patterns, and restructuring family interactions. The analysis emphasizes the importance of understanding family rules, coalitions, and boundaries in addressing ADHD-related issues. The report concludes by illustrating how structural family therapy can help families like Ryan's improve communication, establish healthy boundaries, and foster a supportive environment for the child's development. The report is a valuable resource for understanding ADHD and its management through family-centered interventions.

Running head: ATTENTION DEFICIT HYPERACTIVITY DISORDER
ATTENTION DEFICIT HYPERACTIVITY DISORDER
Name of the student:
Name of the university:
Author note:

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Introduction:
Attention-deficit hyperactivity disorders (ADHD) can be described as the brain disorder
that is usually identified by an ongoing pattern of inattention as well as hyperactivity that is seen
to interfere with that of the functioning and development (Clayton et al., 2016). This assignment
will mainly discuss the important suspects of the disorder in children and would also highlight
the different signs and symptoms that remain associated with this disorder. It would also show
how MFT theory can be applied in such scenarios to help families manage their children with
ADHD successfully.
Symptoms and other aspects:
Symptoms as well as signs of ADHD can be classified into three important categories.
The first category is called inattention. Here the child with ADHD is seen to get easily distracted
and they do not follow directions or finish tasks and do not listen attentively. They do not pay
any attention and are often seen to make careless mistakes. They forget about daily activities and
also face problems in organizing daily tasks (Li et al., 2016). They are often found to lose things,
tends to day dream and many other actions. Other category is called hyperactivity where children
are seen to squirm, fidget or bounce when they are sitting, does not stay seated and they also face
trouble in playing quietly. They are always seen to be running or climbing things and they are
also seen to talk excessively. Another important category is the impulsivity which includes
having trouble waiting for his or her turn and blurts out answers and even interrupts others.
For the diagnosis of ADHD under the classification method of DSM-5, an individual
person should be displaying at least six symptoms and those individuals who are over the age 17
must present them with five symptoms from both the categories for Inattention and

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Hyperactivity-Impulsivity. Moreover, the symptoms should be persisting for at least 6 months
and should be also inconsistent with that of the one’s developmental level. In category of
inattention, the symptoms present in DSM V are mainly seen to include not paying close
attention to details and also difficulty in sustaining attention (Lamberti et al., 2016). Other
symptoms are not listening when spoken to directly, not following instructions or finishing
schoolwork, facing difficulty in organizing tasks, avoiding sustained mental effort, losing
important things and being forgetful and easily distracted. Another category under the DSM V is
the hyperactivity- impulsivity. The representing symptoms of the child to be considered to be
suffering from ADHD, are fidgeting, leaving seats, running about, difficulty in playing quietly,
talking excessively blurting out answers before questions being completed, difficulty in waiting
for turn, interrupting and intruding on others (Politte et al., 2018). The diagnosis under DSM V
should be comprising of the different symptoms stated above and should be present before the
age of 12 and should be present across two or more settings like schools and homes. Clinical
impairment also needs to be shown in social, academic as well as occupational functioning.
Case study:
Ryan is a 7 year old boy who is suffering with ADHD. He has become very difficult to
control now because of his hyperactivity as well as impulsivity. The teacher had fixed up a
meeting with the parents where only his mother Pamela had attended. The meeting was mainly
because the teachers wanted to sit together with the family and develop out plans to manage
Ryan at school and both at home as they were failing to handle Ryan. Pamela was seen to
breakdown in front of the teachers stating that she can no more manage Ryan at home. She has
become frustrated and often feels like running away from the house. Ryan never seats calmly at
one place and is often found to run throughout the house. Pamela cannot engage him in any

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hobbies as he is always in motion of “on the go”. He is seen to talk constantly non-stop and
never listens to his mothers. Pamela said she feel helpless and cannot understand how to manage
Ryan. She stated that she does not get any help from her husband Dan. Dan is also upset about
the situation of the house and does not return home at all. He does not help her in managing
Ryan. In place, he tries to avoid his responsibilities in the name of work at office. His father had
also started taking alcohol because of the stresses at his house because of Ryan. This had made
the teachers consult one MFT therapist to help the family cope with the problem.
Beginning the therapy process including initial assessment using MFT theory:
Marriage and family support also called the MFT is a form of psychotherapy that mainly
helps in addressing the behaviors of all family members. It also addresses the varieties of ways
by which such behaviors that are seen to affect not only each of the individual family members
but also the relationships that are shared between family members as well as the family unit as a
whole. The treatments are mainly seen to be divided between the time allocated for the
individual therapy as well as the time spent on the couple or the family therapy or both when
necessary. Studies have found out that the range of various types of physical and psychological
problems which can be successfully treated by MFT are parent and child conflict, marital and
couple conflict, eating disorders and weight issues sexual dysfunction, alcohol and drug
abuse, grief, distress, and even different types of the children’s behavior problems, and issues
with eldercare, such as coping with a parent’s or grandparent’s dementia (Johnson et al., 2016).
The therapists are also seen to work with different types of mental health issues like depression,
anxiety as well as schizophrenia of the family members that also impact the rest of the family.
Here, the children is suffering from ADHD which is a behavioral disorder suffered by children
that impacts both parents as well as the other families affecting the relationships within each of

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the family member (Tadros et al., 2018). Hence, a proper MFT needs to be applied to the case
study in order to ensure that the child and his family members can live happily with better
quality lives. Structural family therapy will be applied in the case scenario.
Structural family therapy:
Structural family therapy also called SFT is one of the treatment procedures classified
under the MFT. This treatment mainly helps in addressing the different types of pattern of
interaction that have the potential in creating problems within the families (Eilertson et al.,
2018). The therapist following this approach mainly view the mental health issues of signs of a
dysfunctional family and so the focus is mainly placed on the changing the family structure
rather than changing each of the individual family members. The main objectives that are set by
the therapists are improving the communications and even the interactions among the family
members and also to highlight the appropriate boundaries so that a healthier family structure can
be created successfully (Hanna, 2018).
Specific process of intervention:
In case of Ryan and his family, it has been seen that his mother and father do not share an
appropriate relationship anymore that they used to when they got married. Ryan’s father had
started consuming alcohol and rarely stays in home or spends time with the family. These actions
have upset Ryan’s mother Pamela. She remains depressed throughout the day and seems
withdrawn from all the activities. Even she does not take good care of Ryan and rarely shows
him any affection. Dan is of the opinion that he cannot control or manage his son effectively and
cannot get rest for himself after a busy day at work. He states that his wife fails to take good care
of the son and all these disappoint him. Therefore, he does not come back home. Therefore, these

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issues show that the relationships between the family members have worsened because of the
ADHD problems suffered by Ryan. Therefore, in order to help the family overcome the
strenuous phase, it is important for the therapists to understand the family dynamics and
accordingly develop interventions with the help of structural family therapy (Pitula et al., 2017).
In case of Ryan and his family members, the therapist would first observe how the family
members interact among themselves and accordingly they would draw a chart or map of the
entire family structure. This chart would be helpful for the professional attending Ryan’s family
to identify the hierarchy and even the boundaries and subsystems or the sub-relationships within
the family unit like that of relationship between one parent and the child or between the parents.
The therapist would also include this outline and thereby find out where changes are required
and also to find out the various types of interventions that would help the in restructuring family
(Widmer, 2016). Here, the professional attending the case of Ryan can ask the family members
to participate in role-playing a problematic situation. At times, the professional would be taking
sides to help in disrupting a negative pattern within a family sub-system and thereby bringing
changes in the dynamic of the relationship. Experts are of the opinion that most childhood
problems is not within the child but mainly within the family unit (Colapinto et al., 2015). So, in
order to change the behavior of the child, the therapists need to look at the family dynamics and
change them accordingly. The therapist is considered to be the active member of the treatment
groups and thereby they need to get involved in the dynamics between and among the family
members for effectively promoting change and strengthening the family practices (Reiter, 2016).

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Analysis of the theory:
In this therapy, family rules can be defined as the invisible sets of different types of
functional demands that persistently participate in the organization of the interaction in the
family. The therapist should follow the rules of studying the coalitions, boundaries as well as
power hierarchies between the subsystems. The structure of the family remains based on the
models of organization and subsystems (Clossey et al., 2018). This is seen to include interaction
between individuals with different assigned roles as well as expectations. Families that can
establish rules can begin recognizing how interaction would manifest ultimately into different
redundant patterns of communication (Gladding, 2015). Members of the family them start to
taken on specific roles and include the level of authority as well as boundaries that are set forth
during the development of the family structure. The main objective of the families should be to
understand how members of the family structure can later in solving problems with great
understanding of the interaction. In case of Ryan’s families, it can be seen that both Dan and
Pamela were trying the avoid the situation they were facing regarding their son and no one were
willing to take the responsible action and fulfill their roles in the family to set rules and
boundaries for the families to make it close knit. Their family had no set rules and they were
blaming the opposite persons for the situation without taking charge of responsibility of the
situation. They did not engage in effective communication regarding their son that had
aggravated the symptoms of ADHD in their son.
In the specified family, it can be seen that having a child with ADHD had affected the
relationship between the family members. Many unspoken emotions like that sadness, fear, loss
as well as grief can have strained the relationships between Dan and Pamela. In such case,
education alone would not be able to resolve these complex emotions as well as relationship

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difficulties. The therapist should be playing a key role in sorting through the family concerns as
well as different related emotions (Sexton et al., 2015). The therapist would be helping the
family to build as well as strengthen the positive relationships. Experts are of the opinion that
strong and healthy family relationships are extremely important as it can take several years from
that of the time of initial diagnosis to that of the significant improvement.
Anticipated outcomes and termination of therapy:
It is a gradual procedure. Structural family therapy can help in the reduction of the family
tensions that arise while raising a child with that of ADHD. This therapy is also seen to provide a
safe environment for the caregivers as well as the children in discussing topics that might have
become extremely volatile issues. Therapists would also support Dan and Pamela as well as
Ryan in the process of reaching fair as well as equitable solutions. After addressing the
emotional issues of the family, they would then focus on the practical concerns of teaching
parents the strategies by which they can successfully manage their children and help them to
overcome the issues (Tadros et al., 2018). The termination of the therapy would be marked by
development of positive relationship between Dana and Pamela along with the resolution of
emotional tensions between them. The termination of the therapy would also mark equal
dedication of both the caregivers in taking responsibility of Ryan and guiding and supporting
him to overcome his symptoms of ADHD successfully. After termination of the therapy, both the
caregivers should try to seek further help with behavioraltherapy of symptoms of ADHD are still
not brought control (Horigian et al., 2016).
Ethical concerns:

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One of the most important ethical concerns is maintaining privacy as well as
confidentiality. Privacy is mainly seen to refer to the right of an individual for keeping his or her
health information private. Confidentiality can be explained as the duty of the healthcare
professionals to preserve the health information for keeping the informational private (Das et al.,
2017). While interacting with the patients, the professionals often would need to know much
personal information. It is the ethical responsibility of the healthcare professionals to preserve
such information shared by each of the parents of Ryan and do not discuss them or reveal them
to the others. This might lead to breach of this ethical principle and would affect the trust and
belief of the service users on the professionals resulting in disruption of the care therapy.
Another important ethical concern is maintaining autonomy and dignity (Negash et al., 2016). It
is the responsibility of the healthcare professionals to respect the choices and wishes of the
patients and design care planning process that includes their wishes and aligns with their
expectations. Therefore, while interacting with the caregivers of Ryan, professionals would
respect the autonomy and dignity of the caregivers and include them in the decision-making
process.
Collaboration:
The marriage and family therapist should collaborate with other child behavioral
therapist. Both of them would attend the child as well as his parents to provide a collaborative
care service to the service users (Fishman et al., 2017). The MFT therapists would mainly focus
on overcoming the emotional tensions among the relationships and dynamics of the families
whereas the behavioral therapists would mainly try to engage Ryan in activities that would help
in changing the restless behaviors of the child helping him to overcome the symptoms of ADHD.
In these ways, better outcomes can be achieved for Ryan as well as for Dan and Pamela. The

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healthcare professionals should also work with teachers attending Ryan as well as. They should
also include the teacher as well as the parents of Ryan in the decision making process as well as
the care planning process to provide family centered care to the patient. Each of the members
would have valuable information about Ryan, which would help in developing best care strategy
for him. Peer support workers can be also included in the care planning where the parents can
reach for support and discuss their experiences. Peer workers can help by providing moral
support to the parents as they describe their own experiences that encourage the parents and
make them develop the strength to handle the strenuous situations successfully.
Conclusion:
ADHD is a brain disorders that affects both children and adults. Symptoms include
inattention, hyperactivity as well as impulsivity. Parents are often affected and suffer from
mental and emotional issues while managing children with ADHD. Hence, MFT like structural
family therapy can be applied to help the family manage not only their child with ADHD but
also develop their family bonding better.

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