SECTION VI: ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD) Therapists Overview

FROM RECKLESSNESS TO CALCULATED RISKS

GOALS OF THE EXERCISE

1. Maintain a program of recovery from addiction and reduce the negative effects of Attention Deficit/Hyperactivity Disorder (ADHD) on learning, social interaction, and self-esteem. Decrease impulsivity by learning how to stop, think, and plan before acting. Learn the benefits of taking calculated risks rather than acting impulsively. Gain insight into patterns and consequences of reckless behavior and decision making. Learn a method of decision making that leads to more positive outcomes.

2. 3. 4. 5.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Attention Deficit Disorder, Inattentive Type (ADD) Impulsivity Mania/Hypomania

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT

The From Reckless to Calculated Risks activity is for clients with a history of impulsivity. The exercise asks the client to review past impulsive decisions and consequences and then guides him/her through a technique that encourages more calculated/thought-out responses. Follow-up can include having a client describe a series of self-instructions in situations in which he/she has acted out impulsively. Repetition of this process reinforces the internal problem-solving dialogue necessary for taking calculated risks. If the client is unable to generate personal examples, use scenarios and direct him/her to develop self-instructions for the person in the scenarios.

EXERCISE VI.A

FROM RECKLESSNESS TO CALCULATED RISKS

All of us assume risks in everything we do. However, the risks we take in a given situation can be reckless, not thinking through the consequences, or calculated. Taking calculated risks involves a number of things. First, it means avoiding acting too quickly on impulses. Next, it involves thinking a situation through to its conclusion and anticipating the consequences. Finally, it calls for making concrete plans before acting. Addictive behavior and ADHD share traits related to recklessness: wanting instant gratification, acting impulsively, and not thinking situations through to their potential outcomes. If we take calculated risks versus reckless risks, we have the best chance of getting the outcomes we want and avoiding preventable problems. In this exercise youll review your risk-taking patterns and consider changes to give you more control over your life. 1. List some reckless behaviors you have engaged in, the situations in which you did so, and the consequences. Behavior Situation Consequence(s)

2.

For one of the behaviors you listed in question 1, choose a situation with which you continue to struggle. Complete the following formula to learn how to take more calculated risks. a. The situation is:

b. What outcome do you want to achieve?

EXERCISE VI.A

c. What are some things you can say to yourself in this situation to avoid an impulsive response, such as slow down, dont take it personally, or relax and think for a minute?

d. Write out concrete instructions to yourself in the format below. What is the problem?

What am I expected to do?

What are my optionswhat other things can I do?

What do I want to have happen?

The approach that will give me the best chance of the result I want and will minimize difficulty will be. . .

What can I say to myself to help me cope?

To avoid this problem in the future, I need to focus on . . .

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.