Harry's Mother: The therapist and I try to get him to understand how he comes across to others but he just argues with both of us and starts yelling. We go through this every week but neither of us can convince him.
Ryan: Harry hasn't learned social information intuitively to the same extent as his peers. He doesn't understand why he struggles with keeping friends. He gets defensive because you're bringing up a subject that is a source of shame for him, and one he doesn't understand. He needs to be taught about perspective-taking, which is the foundational social skill lagging in kids with ADHD. Sitting in a therapist's office with his mother and a therapist teaming up on him isn't going to help him improve socially. Difficulty with social skills is a learning issue, not a mental health issue and no amount of counseling is going to change that.
Harry was a 15 year old, 9th grader who has a very common trajectory I hear regularly:
His teachers began to notice at age 8 (2nd grade) that he was struggling socially. He had some friends in elementary school that he went to school, Sunday school and summer camp with. As a result this group of parents regularly saw each other.
When he was 11 (5th grade) Harry's mother noticed he was getting excluded from this group of boys consistently. This continued through Middle School. Harry's began therapy at the end of 8th grade, when his parents acknowledged he just went through Middle School without any social invitations aside from the ones where other parents invited him.
Harry didn't need his mother, and someone echoing his mother trying to convince him how he came across to other kids, he knew that but didn't understand why or how to change it.
When I "teach social" there's something I always begin with: 👂Nothing is wrong with you. Everyone's brain has things that are easier or harder for them to learn. There are kids at your school who want to be friends with you, and it's your job to show them why they would want to be friends with you. Even if there are kids who seem like they don't like you, you can help change their thoughts about you, and you have to do the work to make that happen.
💻In the pictures below (not Harry), I'm introducing the concept of perspective-taking and different types of thoughts. The most important part of this, where it says "situation" because all social interactions are context dependent.
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▶️Please check out the social skills playlist at the ADHD Dude YouTube channel. You can also watch me teaching these concepts in the Trip Camp 2020 playlist.