How can I explain cognitive behavior therapy to my child with ADHD?

By engaging her senses, your child with attention deficit hyperactivity disorder (ADHD) will come to see how cognitive behavior therapy (CBT) makes sense and how it can help her. Start by collecting the following items: a detective's hat (any hat that makes your child feel like a detective), a magic wand (available at party or joke stores, or easily made with tape and a pencil (or the cardboard tube from a metal clothes hanger), a stuffed heart (available in card stores or toy stores), and a toy trophy. These items will help externalize inner processes for your child and help her to understand the basics of the CBT approach.

The detective hat will symbolize her ability to discover thoughts that create emotions and behaviors; the magic wand will symbolize her capacity to imagine a better outcome; the stuffed heart will symbolize her feelings; and the trophy will represent her changed behavior. Invite your child to play a game called the "Sherlock Holmes game" or the "detective game." Describe to your child that, like sleuths, you're going to work together to find and uncover the beliefs that cause problems and change those beliefs to create the outcomes that she wants.

Briefly describe CBT theory in a way your child will understand. Explain that thoughts lead to emotions, which lead to behavior. Engage your child by setting up the game so it focuses on a concrete issue that she is struggling with.

To make this fun for her, give her the detective's hat to wear as she tries to find the trail of thinking that has led to problematic feelings and behaviors. Once your child has identified some specific thoughts that are creating problems, you can let her know that now she can pretend to be a wizard. (If your child loves the Harry Potter books, you can ask her to think about Harry Potter rather than just a generic wizard.) Give your child the magic wand, which represents her ability to imagine a better outcome.

Ask her to pretend to be the wizard and tell you what magic she would create with the magic wand's unlimited powers. This is meant to help your child expand her thinking and imagine the most positive alternative outcome possible. Once your child has imagined the best alternative outcome possible, you can show her how the heart symbolizes her feelings and how the trophy symbolizes her successful resolution of the problem.

Invite her to think about how she would feel if she changed her problematic thoughts and how she could achieve the desired outcome.

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