Education and Counseling for Individuals Affected by Oppositional Defiant Disorder and ADHD

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Whose Problem Is It?

Hi Mark,

A million thanks!!! I had a thought/question. I know that I asked about R___'s responsibility for owning his acne regimen. Think your counsel was to leave it up to him 100% ...the work and the obvious natural consequences of not complying. Now here is a case where he DOES have a vested interest in the outcome and to date has done NOTHING.

A thought?

I think he is ADD and very easily discouraged. To date the various acne regimens have either not worked or temporarily made things worse …so my fear is that he has just given up. I KNOW this plays a BIG role in his self-esteem and mood as there is a DIRECT and understandable correlation between when this flares up and his poor attitude. Given all of this what would you think of this?

Create a chart for HIM and leave it with HIM in his room. The steps (there are a few?!) and a place for him to record observations and goals. That way he can say ...ok ...I did all of this and it got worse for 2 weeks ...but I did not expect to see improvement until week 4 I have to stay the course and then re-evaluate? Then we would tell him that he needs to have this filled-in before he sees the doctor again?

I have an appt scheduled that I will cancel it is so wasteful to go and have him tell them he did nothing or he lies and says he did? But I hate to see him in so much emotional pain needlessly?! So this way he can EARN the next doc visit and hopefully ultimately success?

Let me know if I am starting to get this?

Thanks SO much!!!


You are definitely “starting to get this” (i.e., you’re thinking like I want you to think). But I still believe you’re taking on too much responsibility for HIS acne. If you want to throw this acne problem into the “chores” category, then I like your ideas. But I’m not sure that this is a ‘chore’ in the fullest sense of the term (we got some gray area here).

You said “he DOES have a vested interest in the outcome.” -- I’m not sure about this.

If I had a toothache and wanted to get rid of the pain, I don’t think I would just hope for it to go away. I’d go to the dentist, take the antibiotic he prescribed to get the abscessed tooth (i.e., infection) under control, then I would go back to have the tooth extracted. It’s my problem, my pain – and my solution.

Also, you said “this [acne problem] plays a BIG role in his self-esteem and mood.”

This sounds a bit too much like trying to find an excuse for his disrespect/poor choices (assuming some of that is going on). Does it [acne] really affect his self-esteem? Of course. But low self-esteem is no justification for any behavior problems he may be exhibiting.

I’d give your idea about the charts a try. If it is just another failed attempt (i.e., traditional parenting strategy) at addressing HIS problem, then “let go” of it (like we talked about in the last email).


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