Miss Appointments?
March 23, 2009
Jim and I set our next appointment time, but he didn’t write it down. He just agreed to the appointment, collected his cell phone and keys, said goodbye and headed out the door.
As soon as he was gone I grabbed my cell to make the call before my next client. I quickly looked up the number and dialed. I got his machine – good, he’d remembered not to answer; I punched “1” and said, “Hi, this is Szifra. We have an appointment on Thursday at 2:30. See you then. Goodbye!”
With that one phone call I cleared my responsibility before I could forget, and had given Jim an appointment reminder that he could replay again and again all week long. That’s right; my quick phone call was to Jim as he walked out to his car. It was an arrangement that we had devised to help him remember, and it worked great for the entire time he saw me.
Before my first appointment with a client ends, I ask them if they need a reminder for appointments. Each client has a different need. For some, despite the fact they have ADHD, they never have any difficulty remembering when we’re getting together, as long as they have a card with the time.
Some clients prefer an email the morning of their appointment and others request a phone call to remind them as they start their day. A few clients, who need some time to make the drive to my office, ask for a call about 90 minutes before they’re supposed to be there.
If possible, I try to accommodate whatever approach works. With Jim that means calling him as he leaves my office and leaving the reminder on his cell phone where he likes stumbling across it all week. Jim thought of this idea when I was offering the list of possibilities.
If you have trouble remembering appointments, be a good observer of what works well for you. Once you find a system don’t be afraid to tell your dentist, accountant, personal trainer or other service providers. They may appreciate knowing what will get you to your appointment on time and on the right day. You may even teach them to ask other clients who sometimes forget.
Knowing it’s Time to Change is a Great Start
March 13, 2009
Change is a process and by definition, a process is something that happens gradually. So, if you’re feeling like it’s time to change, celebrate the beginning of a process.
Creating change in yourself is a campaign that starts with recognizing a pull within yourself toward something new or away from something familiar. What hook will get you thinking about change? Your too-tight pants might bring the idea to your attention. Puffing your way up a flight of stairs is hard to completely ignore. Losing a large client interrupts the bliss. Feeling burned out suggests something is off. Having your spouse discouraged with you is a strong clue.
What we’re likely to miss are not these in-our-face examples, but the ones we turn away from without a thought; “You’re frustrating me! You don’t understand me! My client just doesn’t get it! Why is it so hard to explain simple ideas to people? Are these people stupid?” The situation is crying out for change, but we deflect the responsibility to someone else. We miss the full role we play in the miscommunication.
Noticing that we have the leverage to start the ball rolling is not a small accomplishment. Being aware of ourselves – insight – is not a commonly held skill. Coaching may ignite it; therapy can nurture it; pressure from a loved one occasionally forces it. But it isn’t easy to grab insight or to hold on to it.
So, if you feel it’s time for some change, celebrate. Even if you don’t know how you got there, pat yourself on the back and take a breath; you’ve taken a good step and you’re already beginning to change.
http://www.livingstonservices.com/
Internet Addiction: A New Diagnostic Category?
March 11, 2009
Rebecca Shafir
The American Medical Association (AMA) is looking to determine whether Internet Addiction should be considered an official diagnostic category. Since an “Internet addiction” has been becoming a more frequent “off-the-cuff” complaint of parents and adult patients during neurofeedback intakes, I decided to see whether a formal category exists.
The authors of “i-Brain: Surviving the Technological Alteration of the Modern Mind ” (2008 Collins Living) a new book by Dr. Gary Small and Gigi Vorgan propose five criteria for Internet Addiction Disorder. If you meet all five criteria, chances are an Internet addiction is present:
1) Preoccupation: The person constantly thinks about previous and future online sessions.
2) Tolerance: Longer periods of online activity are needed to feel satisfied.
3) Lack of Control: The person cannot cut back or stop online activities.
4) Withdrawal: Irritability and other mood changes occur when the person tries to stop online activities.
5) Staying online: The user remains online longer than intended.
Furthermore, if the user has demonstrated at least one of these behaviors, an Internet addiction is highly likely:
- jeopardized a job, educational opportunity or a relationship
- led to concealment of the online activity, and/or
- been used as a means of escaping problems or relieving uncomfortable feelings.
Seeking the help of a psychotherapist specializing in addiction disorders can be helpful in taming the symptoms associated with an Internet Addiction Disorder.
Driving with ADHD
March 9, 2009
A recent article in Dr. Barkley’s ADHD Report brings to light some frightening research regarding the risk of driving with ADHD. Among other skills, driving requires prolonged sustained attention, impulse control, planning/executive functioning, and the ability to ignore distractions. So researchers wondered if having ADHD could make all of these tasks more difficult and therefore potentially impair driving performance. A good question to explore given the safety concerns around operating a motor vehicle.
In order to answer that question, researchers have compared actual driving records of those with ADHD verses those without and found an increased rate of car accidents, speeding, loss of license, and traffic violations among the non-medicated ADHD group. It turns out that these risks decrease significantly if the individual is taking medication for their ADHD. These results were further supported by studying individual performance in driving simulators – a video game type experience – comparing groups of drivers with ADHD to those without.
So just how risky is driving with ADHD? The answer is shocking. If you are an adult with ADHD not taking medication, your risk of driving impairment may be as compromised as a driver with blood alcohol level of .08% (the legal level of intoxication in the U.S.) In other words, a sober individual with ADHD may exhibit symptoms behind the wheel of a car similar to that of a drunk driver. Seems hard to believe, but driving under the influence of ADHD can be as dangerous as driving under the influence of alcohol.
Additionally the ADHD individual in this study was more likely than the non-ADHD participant to consider themselves capable of driving despite having equal doses of alcohol. The ADHD group was under estimating both their level of intoxication and impairment. For further information the study can be found in the journal Experimental and Clinical Psychopharmacology.
This information is a stern reminder that ADHD is not just about school performance for an adolescent or workplace performance for an adult. ADHD is a condition with far reaching medical and safety implications for everyone. We need to consider all the aspects of ADHD beyond inattention and hyperactivity and carefully weigh the risks and benefits of treatment, including medication. When it comes to driving with ADHD, talk to your doctor to make the best choice you can live with.
Subscribe In A Reader
