The First Professional Guide For Helping ADHD-Challenged Couples

Endorsed by leading experts in the field of couple therapy and in Adult ADHD

four book covers

"Therapy that fails to recognize ADHD  risks making a bad situation worse, adversely affecting the couple and their children for years to come—and leaving clinicians feeling befuddled and bereft."

Gina Pera, Author of :
—Is It You, Me, or Adult A.D.D.?
—Adult ADHD-Focused Couple Therapy: Clinical Interventions,
—Adult ADHD and Sex

—"Counseling Couples with ADHD" in Dr. Russel Barkely's Clinical Guide

Professional Endorsements

Harville Hendrix, PhD Getting the Love You Want , co-developer of Imago Therapy

"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."

Russell A. Barkley, PhD., Clinical Professor of Psychiatry, Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center, Richmond, VA.

Excerpted from the foreword:

"The counseling of couples in which at least one member has ADHD has received scant research attention. Fortunately, this book draws together not only what is known, but also what methods of treatment are likely to address these relationship issues.

"Here we find experts in various approaches to treatment contributing to create the first book of its kind, one that provides a thorough review across a diverse array of modalities as well as detailed guidance on implementing them for the ADHD-affected couple.

"Congratulations on having the good sense to read it."

Stephen P. Hinshaw, Ph.D., Professor of Psychology, University of California, Berkeley; Professor of Psychiatry, University of California, San Francisco

"If you work with adults experiencing ADHD, Adult ADHD-Focused Couple Therapy: Clinical Interventions 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!"

Douglas K. Snyder, Ph.D., Professor of Clinical Psychology, Texas A&M University, Co-editor of the Clinical Handbook of Couple Therapy (5th ed.) and co-author of Getting Past the Affair

"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."

See all endorsements

We are grateful to receive endorsements for our book from preeminent experts in the fields of couple therapy and of Adult ADHD:

Professional Endorsements — for ADHD-Focused Couple TherapyHarville Hendrix, PhD and Helen LaKelly Hunt, PhDGetting the Love You Want and Making Marriage Simple

"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."

 

 

Barkley, Russ 2010Russell A. Barkley, PhD.,Clinical Professor of Psychiatry, Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center, Richmond, VA. 

Excerpted from the foreword:

"The counseling of couples in which at least one member has ADHD has received scant research attention. Fortunately, this book draws together not only what is known, but also what methods of treatment are likely to address these relationship issues.

"Here we find experts in various approaches to treatment contributing to create the first book of its kind, one that provides a thorough review across a diverse array of modalities as well as detailed guidance on implementing them for the ADHD-affected couple. Congratulations on having the good sense to read it."

 

Stephen HinshawStephen P. Hinshaw, Ph.D., Professor of Psychology, University of California, Berkeley; Professor of Psychiatry, University of California, San Francisco"

If you work with adults experiencing ADHD, Adult ADHD-Focused Couple Therapy: Clinical Interventions 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!"

Professional Endorsements — for ADHD-Focused Couple TherapyDouglas K. Snyder, Ph.D., Professor of Clinical Psychology, Texas A&M University, Co-editor of Treating Difficult Couples and the Clinical Handbook of Couple Therapy (5th ed.) and co-author of Getting Past the Affair

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."

Professional Endorsements — for ADHD-Focused Couple TherapyPhilip Asherson, MD, PhD, Professor in Molecular Psychiatry and Honorary Consultant Psychiatrist, King’s College London

"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."

 

patricia-quinnPatricia Quinn, MD,  Co-editor of Gender Issues and ADHD and co-author of Understanding Girls With ADHD

"Describing ADHD as a disorder of executive functions and self-regulation, this guide creates a framework forclinicians thatt explains not only Adult ADHD but also how to effectively 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!"

linda p

Linda Pfiffner, PhD, Professor of Psychiatry, University of California, San Francisco

"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 co-parenting, 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."

Mark A. Stein, PhDMark A. Stein, PhD, ABPP, Professor of Psychiatry & Behavioral Science Pediatrics University of Washington

"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!"

Martin Kutscher, MDMartin L. Kutscher, MD, behavioral neurologist, author of ADHD: Living without Brakes

"'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."

Lily Hechtman, MDLily Hechtman M.D. F.R.C.P. Professor of Psychiatry and Pediatrics, Director of Research, Division of Child Psychiatry, McGill University, Montreal Children's Hospital

"ADHD-Focused Couple Therapy: Clinical Interventions 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."

Andrea Bilbow OBE, Founder & Chief Executive ADDISS, London

Andrea Bilbow, OBE, ADDISS Founder and Director

"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."

Additional Information

About the Editors

Dr. Arthur L. Robin and Gina Pera

Dr. Arthur L. Robin and Gina Pera

The co-editors of Adult ADHD-Focused Couple Therapy met many years ago, when Gina attended one of Dr. Arthur Robin's presentations, on Adult ADHD and relationships. 

Thereafter, Gina sought Arthur's advice to incorporate in her 2008 award-winning book, Is It You, Me, or Adult A.D.D.?

A few years later, they began regularly co-presenting at conferences to mental-health professionals, on the topic of ADHD and relationships.

This book is a natural outgrowth of their shared mission to elevate the clinical treatment standards for Adult ADHD.

Please see their individual biographies below.

Gina Pera

 

Gina Pera_Headshot_retouchGina Pera

Gina Pera is an author, workshop leader, private Adult ADHD consultant, and international speaker on Adult ADHD, especially as it affects relationships. She was a veteran award-winning print journalist when, in 1999, her 37-year-old husband was diagnosed with ADHD. The couple learned of the possibility not from their repeated attempts at couple therapy but by Pera’s chance reading of a neurobiology book that touched upon Adult ADHD.

This discovery—and the positive difference it made in her husband’s life, her life, and their marriage—launched her desire to educate the public on this poorly recognized condition. She began by organizing guest lectures and launching support groups for both adults with ADHD and their partners in the San Francisco Bay Area, all free and open to the public.

In 2004-2005, she conducted an extensive survey among the partners of adults with ADHD. These activities, combined with in-depth interviews of preeminent experts and investigation into the literature, informed her book, Is It You, Me, or Adult A.D.D.?: Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder (1201 Alarm Press, 2008).

Translated now into Turkish and Spanish, the book garnered four national awards, including ForeWord Magazine’s Psychology Book of the Year. Pera was also invited to contribute the first-ever chapter on couple therapy to a leading ADHD clinical guide: Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (Fourth Edition), edited by Russell Barkley (Guilford Press, 2014).

Pera has been featured in several documentaries about ADHD as well as numerous news programs and articles, and she serves as resident ADHD expert at WebMD. She also writes the blog ADHD Roller Coaster (ADHDRollerCoaster.org) and provides online instruction at ADHDSuccessTraining.

By invitation, she has presented to public and professional groups worldwide, including as plenary speaker for the 2013 International Congress on Psychopharmacology in Antalya, Turkey.

For many years, she and Dr. Robin have co-presented at national conferences to clinicians on relationships and ADHD. As a volunteer, Pera has served as coordinator of CHADD Silicon Valley for more than a decade and was named CHADD 2007 National Volunteer of the Year.

In her previous career as a print journalist, her work for USA Weekend Magazine won both the prestigious Best Magazine Edition Award from The Association for Women in Communications and a Unity Award in Media, recognizing accurate exposure of issues affecting minorities and disabled persons. She holds a BS in Mass Communications (summa cum laude) from the University of Tennessee. 

Dr. Arthur L. Robin

Robin, Arthur-2011web2Arthur L. Robin, PhD

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. He obtained his doctoral degree in clinical psychology from the State University of New York at Stony Brook in 1975, was on the faculty of the University of Maryland, Baltimore County, from 1975 to 1979, and has been at Children’s Hospital of Michigan and Wayne State University in Detroit since 1979.

In addition to functioning as a pediatric psychologist at Children’s Hospital of Michigan, Dr. Robin has devoted his 37-year career as a clinician, educator, and researcher to children, adolescents, and adults with ADHD and related problems.

Along with many articles, chapters, and grants, he has authored ADHD in Adolescents: Diagnosis and Treatment (Guilford Press, 1998) and has co-authored three books: Negotiating Parent-Adolescent Conflict: A Behavioral Family Systems Approach (Guilford Press, 1998); Defiant Teens: A Clinician’s Manual for Assessment and Family Intervention (Guilford Press, 2014; and Your Defiant Teen (Guilford Press, 2014). The last two books were co-authored with Russell Barkley, PhD, a preeminent expert on ADHD. Dr. Robin is also the primary author of the published assessment instrument, the Parent Adolescent Relationship Questionnaire (PARQ).

Over the past three decades, as the children and adolescents with whom he worked grew up and married, Dr. Robin came to see the adverse impact of ADHD on their adult relationships. Trained in Cognitive Behavior Therapy and family systems therapy, it was natural for Dr. Robin to innovate in combining these techniques to help these couples. Thus, for the past decade Dr. Robin has been treating couples where one or both individuals have ADHD. In 1989, Dr. Robin was himself diagnosed with ADHD and has had personal experience in his own marriage coping with ADHD; this personal experience nicely complements his professional experience with ADHD.

As the director of a psychology internship accredited by the American Psychological Association, Dr. Robin has pioneered innovative clinical-training techniques, particularly in the area of competency-based education. He has applied these techniques in training clinicians to work with adults and couples affected by ADHD, making numerous presentations at conferences on ADHD and relationships. He brings to the task of editing this book his extensive experience in teaching clinicians how to implement evidence-based family intervention techniques.

Dr. Robin is a member of the Editorial Board of the Journal of Developmental and Behavioral Pediatrics and the Journal of Attention Disorders and has served as a guest reviewer for many other journals. In 2002, he was inducted into the CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) Hall of Fame for his lifetime contributions to the field of ADHD. In 2007 he became a Fellow of the Society of Clinical Psychology (Division 12) of the American Psychological Association. 

About the Contributors

Gina Pera and Arthur Robin, PhD, are honored to have worked with these esteemed contributors to  Adult ADHD-Focused Couple Therapy: Clinical Interventions:

Barbara Easterlin, PhD

About the Contributors: ADHDFocused Couple Therapy. Barbara Easterlin, PhDBarbara Easterlin, PhD, is an assistant clinical professor at the University of California, Berkeley, specializing in ADHD diagnosis and treatment. She completed her MA at the University of California, Irvine, and her PhD at the California Institute of Integral Studies.

From 2004 to 2013, she served as an assistant clinical professor at the Hyperactivity, Attention, and Learning Problems (HALP) Clinic, within the Department of Psychiatry, University of California, San Francisco. Dr. Easterlin performed ADHD assessments as part of the clinic team and mentored postdoctoral fellows in psychoeducational evaluation, Parent Management Training, and Cognitive Behavioral Therapy for children with anxiety disorders.

She trained parents and learning specialists in San Francisco Bay Area school districts on identifying ADHD symptoms in students and deploying behavioral interventions. As a licensed psychologist in private practice, she provides individual and couple therapy as well as parenting consultation.

In 2004, Dr. Easterlin founded Authentica Center, a psychosocial group therapy program primarily targeted at helping girls with ADHD develop and maintain friendships. She lectures frequently on ADHD, the social world of girls, and parenting children with ADHD and other disruptive behavior disorders.

J. Russell Ramsay, PhD

About the Contributors: ADHD Focused Couple Therapy. J. Russell ("Russ") Ramsay, PhD

J. Russell (“Russ”) Ramsay, PhD, is co-founder and co-director of the University of Pennsylvania’s Adult ADHD Treatment and Research Program and an associate professor of clinical psychology in psychiatry in the Perelman School of Medicine at the University of Pennsylvania. After earning his PhD from Palo Alto University, Dr. Ramsay completed a postdoctoral fellowship at the Center for Cognitive Therapy at the University of Pennsylvania.

Dr. Ramsay has authored numerous professional and scientific articles and book chapters, and has lectured internationally on various issues related to Adult ADHD. He is author of Cognitive Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach (Routledge, 2008) and Nonmedication Treatments for Adult ADHD: Evaluating Impact on Daily Functioning and Well-Being (American Psychological Association, 2010).

He wrote the second edition of Cognitive Behavioral Therapy for Adult ADHD and its companion patient guidebook, The Adult ADHD Tool Kit: Using CBT to Facilitate Coping Inside and Out (both Routledge, 2015).

Dr. Ramsay serves on the editorial board of the Journal of Attention Disorders, as co-chair of the Professional Advisory Board of the Attention Deficit Disorder Association, and on the Professional Advisory Board of ADHD Aware.

 

Carol Ann Robbins, PhD

About the Contributors. ADHD-Focused Couple Therapy. Carol Ann Robbins, PhDCarol Ann Robbins, PhD, is a licensed clinical psychologist specializing in ADHD. She works closely with Kathleen Nadeau, PhD, a leading expert in the field, at the Chesapeake ADHD Center of Maryland. She is also the clinical director of the Annapolis ADHD Center. As adjunct faculty at Anne Arundel Community College, she teaches about ADHD. Dr. Robbins has presented on ADHD locally to the American Psychological Association, schools, and various public and private entities, and has been an invited speaker at national and international conferences.

She authored an article on ADHD and relationships in a 2005 issue of In Session: Journal of Clinical Psychology, and co-authored a chapter on treating ADHD and Learning Disorders in Learning and Attention Disorders in Adolescence and Adulthood: Assessment and Treatment, Second Edition (Wiley, 2011). Dr. Robbins earned her doctorate from the University of Miami and completed her internship at Children’s National Medical Center in Washington, DC.

She is a trained Imago Relationship therapist. Personally, she is married to a man who has ADHD and is raising two children with ADHD. As a volunteer, Robbins has served as coordinator of the Anne Arundel County Maryland Chapter of CHADD since 2002.

Kevin Roberts, MA

Kevin RobertsKevin Roberts holds a Master’s degree in ADHD Studies and is an ADHD coach who also helps clients worldwide who are struggling with cyber addiction.

Roberts has trained parents, doctors, nurses, therapists, and teachers on cyber addiction and ADHD. Fluent in several foreign languages, he has also given seminars internationally on the topic. He regularly talks to audiences of young people, warning them of excessive dependence on “the screen.”

As a self-described recovering cyber addict, as well as an adult with ADHD, Roberts has a strong personal interest in this area. He has been interviewed as an expert on cyber addiction on television and radio in the United States and abroad, including NBC, ABC, Fox News, and the BBC. Roberts is the author of two books: Cyber Junkie: Escape the Gaming and Internet Trap (Hazelden, 2010) and Movers, Dreamers, and Risk-Takers: Unlocking the Power of ADHD (Hazelden, 2012).

Professional Endorsements

We are grateful to receive endorsements for our book from preeminent experts in the fields of couple therapy and of Adult ADHD:

Professional Endorsements — for ADHD-Focused Couple TherapyHarville Hendrix, PhD, and Helen LaKelly Hunt, PhD, Getting the Love You Want and Imago Relationship Therapy

"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."

 

 

Barkley, Russ 2010Russell A. Barkley, PhD.,Clinical Professor of Psychiatry, Virginia Commonwealth University Medical Center

Excerpted from the foreword:

"The counseling of couples in which at least one member has ADHD has received scant research attention. Fortunately, this book draws together not only what is known, but also what methods of treatment are likely to address these relationship issues.

"Here we find experts in various approaches to treatment contributing to create the first book of its kind, one that provides a thorough review across a diverse array of modalities as well as detailed guidance on implementing them for the ADHD-affected couple.

"Congratulations on having the good sense to read it."

 

Stephen HinshawStephen P. Hinshaw, Ph.D., Professor of Psychology, University of California, Berkeley; Professor of Psychiatry, University of California, San Francisco

"If you work with adults experiencing ADHD, Adult ADHD-Focused Couple Therapy: Clinical Interventions 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!"

Professional Endorsements — for ADHD-Focused Couple TherapyDouglas K. Snyder, Ph.D., Professor of Clinical Psychology, Texas A&M University, Co-editor of Treating Difficult Couples and the Clinical Handbook of Couple Therapy (5th ed.) and co-author of Getting Past the Affair

"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."

Professional Endorsements — for ADHD-Focused Couple TherapyPhilip Asherson, MD, PhD, Professor in Molecular Psychiatry and Honorary Consultant Psychiatrist, King’s College London

"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."

 

 

patricia-quinnPatricia Quinn, MD,  Co-editor of Gender Issues and ADHD and co-author of Understanding Girls With ADHD

"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 effectively 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!"

 

linda p

Linda Pfiffner, PhD, Professor of Psychiatry, University of California, San Francisco

"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 co-parenting, 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."

 

Mark A. Stein, PhDMark A. Stein, PhD, ABPP, Professor of Psychiatry & Behavioral Science Pediatrics University of Washington

"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!"

 

Martin Kutscher, MDMartin L. Kutscher, MD, behavioral neurologist, author of ADHD: Living without Brakes

"'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."

 

Lily Hechtman, MDLily Hechtman M.D. F.R.C.P. Professor of Psychiatry and Pediatrics, Director of Research, Division of Child Psychiatry, McGill University, Montreal Children's Hospital

"ADHD-Focused Couple Therapy: Clinical Interventions 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."

 

Andrea Bilbow OBE, Founder & Chief Executive ADDISS, London

Andrea Bilbow, OBE, ADDISS Founder and Director"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."

LOZENGE

Chapter Descriptions

Chapter Descriptions

by Gina Pera

Chapter 1: Meet the Couples and Their Common Challenges

Before delving into six case studies, this chapter explores the shared foundation of their challenges: ADHD symptoms plus the poor coping strategies and cognitive distortions common to late-diagnosis ADHD individuals and their partners.

by Gina Pera

Chapter 2: Principles of ADHD-Focused Couple Therapy

Drawing upon established principles of effective couple therapy and the particular concerns presented by ADHD symptoms, this chapter presents a flexible meta-model for addressing the full range of issues for any given couple.

by Arthur L. Robin, PhD

Chapter 3: Psychoeducation

Clinicians are guided in the foundational process of educating couples about ADHD, including handling their reactions to the diagnosis, addressing resistance, and increasing motivation to participate in the evidence-based change techniques offered in subsequent chapters.

by J. Russell Ramsay, PhD

Chapter 4: A CBT Model for ADHD-Challenged Couples

Cognitive-Behavioral therapy (CBT) has emerged as the psychosocial treatment of choice for Adult ADHD. A leading clinician and researcher adapts his model (with Anthony Rostain, MD) for the first time to serve couples.

by Gina Pera and Arthur L. Robin, PhD

Chapter 5: The Role of Medication

Medication can provide the single most effective means of mitigating ADHD symptoms, but prescribing physicians are often rushed and poorly trained. Empowering the couple to engage in the process can be vital to a positive outcome. 

by Arthur L. Robin, PhD

Chapter 6: Behavior and Habit Change

The clinician builds a strong logistical framework for success by emphasizing and guiding the couples in teamwork around improving time management, memory management, and organizational techniques so as to more cooperatively accomplish the tasks of daily living.

by Carol Ann Robbins, PhD

Chapter 7: Imago Relationship Therapy Adapted for ADHD

ADHD neurobiology often contributes to the development of poor social and problem-solving skills. With certain adaptations, Imago Relationship Therapy (IRT) can assist these couples in slowing out-of-control interchanges and promoting better communications and cooperation.

by Barbara Easterlin, PhD

Chapter 8: Co-Parenting Strategies

Effective parenting requires a certain degree of consistency, a primary challenge with ADHD. When a child also has ADHD—and, the genetic odds are strong—it is even more imperative that the couple adopts a set of parenting strategies that are jointly supported and include structure and behavior modification.

by Gina Pera

Chapter 9: Money

ADHD-related traits can adversely affect finances in terms of both lowered income and increased outgo. It is important to work with these couples on identifying financial goals and implementing ADHD-informed habits to help meet those goals.

by Kevin Roberts, MA

Chapter 10: Cyber Addictions

ADHD neurobiology can confer a vulnerability to addictive behaviors, including excessively pursuing “cyber” activities such as video games and social media. The clinician can engage the couple in strategies to assist the ADHD adult in overcoming overuse behaviors and re-focusing on the relationship.

by Gina Pera

Chapter 11: Sexual Intimacy

ADHD symptoms can affect intimacy directly, such as being distractable during lovemaking, and indirectly, with workaday conflicts mutually dampening ardor. Because it is extremely difficult to find ADHD-informed sex therapists, it is vital that couple therapists at least be able to explain the nature of these challenges to clients.

by Gina Pera

Conclusions and Resources

In these final pages, we summarize and synthesize the book’s chief clinical points and refer to information sources.

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Demand for Adult ADHD Couple Therapy Is Skyrocketing

Consider this: Adults who have ADHD number in the tens of millions in the U.S. alone. But only 1 in 10 is diagnosed.

The 1990s "Decade of the Brain," attention expanded our understanding of Adult ADHD. That includes the havoc it can wreak on all aspects of adult life—including driving safety, financial management, education and employment,  interpersonal difficulties, and even substance abuse and chronic health conditions such as obesity and sleep disorders.

Far from being a limited specialty, Adult ADHD cuts across the problems that bring people to couple therapy—including conflicts over money, communication, chore-sharing, and co-parenting. Yet, when Adult ADHD is missed or its interventions poorly understood, these clients rarely rise above their problems. 

ADHD awareness is burgeoning. Individuals and couples worldwide seek clinical expertise. Yet they seldom find it.

Enter Adult ADHD-Focused Couple Therapy 

We created this book to guide mental-health professionals in identifying these clients and steadily working with them to create positive changes that last.

Moreover, our therapeutic interventions stand to help even greater numbers of people: the millions of individuals who struggle with similar behaviors yet do not fully qualify for the ADHD diagnosis. After all, the associated traits of ADHD—procrastination, distractibility, emotional dysregulation, and the like—fall on a continuum in the human population.

A Nuts and Bolts Guide—Based On Evidence

To develop this model, we carefully the merged the best evidence for effective couple therapy and adult ADHD treatment.

Our interventions help professionals and the couples themselves:

  • Adult ADHD specialists gain a roadmap for sensitively expanding treatment to include a client’s romantic partner.
  • Individual therapists learn to recognize Adult ADHD in their clients and adopt best practices for helping them in their relationships.
  • Couple therapists gain guidance for adapting empirically supported couple-counseling principles to include the specific issues presented by ADHD in one or both partners.
  • Individuals and Couples gain highly readable explanations and interventions that they can use directly or share with their therapist.

Major Topics Covered

Adult ADHD-Focused Couple Therapy provides a step-by-step approach.  Each topic acknowledges the complexity of these clients with a collection of flexible interventions.

Topic include:

Psychoeducation

Medication guidelines

Professional endorsements from preeminent experts

Cognitive restructuring

Habit change & Communication

More than twenty detailed case studies

Co-parenting techniques

ADHD-specific “hot spots”

Companion worksheets

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Harville Hendrix, PhD and Helen LaKelly Hunt, PhD,

Getting the Love You Want and Making Marriage Simple

"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."