Q: How Can I Help a Teen Patient with ADHD Who Needs But Resists Medication?
When a treatment plan falls apart because a teenage patient with ADHD resists medication, ask about their values, and make clear that they’re in control.
Q: “As a clinician, how can I help a teen with ADHD who is resistant to medication?”
Nobody likes taking medicine. So if a teenager doesn’t like taking medicine, I get it, one hundred percent. You can’t force it down their throats. You have to engage with them.
I ask: “What are the things in life that you wish were a little different?” Then I reflect what they communicate back to them: “It sounds like school is a struggle. We have some things that will help with that. Let’s talk about what they are, because we have a variety of treatment options and I want you to help choose one.”
[Read: The Key to Reducing Teens’ Risky Behavior? It Might Be Medication Coverage]
I make it clear that I’m not telling the teenager what to take, and that we’re only going to move forward if they think it helps enough to continue.
So, the key is really shared decision making, where you’re engaging the patient, where they get to be in control. A great example of this is what Maggie Sibley, Ph.D., does in her STAND program. She gives the adolescents in her group therapy a handout, which includes two dozen or so personal values, things like making more friends, passing classes, earning money. Then she asks the teenager, “What’s important to you?” and has them circle their answers on the sheet.
[Read: ADHD in Teens – How Symptoms Manifest as Unique Challenges for Adolescents and Young Adults]
It’s not what’s important to your mom, dad, clinician, psychiatrist, teachers, or therapists, but what’s important to you? Maybe that’s friends, maybe it’s being creative or social, making better grades, becoming a better athlete, feeling better about yourself, being less stressed. The question is: What’s important to you?
When we ask this question, we move away from adults talking at teens and move towards the beginning of a real conversation. It’s a really effective way to engage teens in their ADHD treatment.
Shared Decision Making: Next Steps
- Read: The Teens’ Guide to Making Meds Work
- Watch: ADHD Ages & Stages – Common Challenges and Practical Strategies for Teens and Young Adults with ADHD
- Read: “Stop Trying to Fix Everything!” Scripts for Reflective Listening
The content for this article was derived from a webinar presented by The American Professional Society of ADHD and Related Disorders (APSARD) titled “ADHD Treatment in the Primary Care Setting: The Teenage Years” with Greg Mattingly, M.D., which was broadcast on October 13, 2023.
