ADHD and Motivation

How to get moving
By: Jonathan Brush, Ph.D.

How can adolescents with ADHD get motivated?

Motivation: For children and adults with ADHD, developing motivation is a major component of success in work, school and personal life. Motivation can be defined simply as ‘the reason for doing something’. For those with ADHD, some would say that there is a deficit in motivation, as in, “I couldn’t get myself to finish that report until the last minute”, or “Why won’t my son work harder at school, he would feel so much better if he would just do his homework?”.  The topic of this article is how adolescents with ADHD get motivated.

Meet Joe

One of my clients who taught me about motivation is Joe, a 15-year-old boy with superior intelligence and mild-to-moderate ADHD, who was in a power struggle with his very accomplished and caring parents. Joe had been at a small private school until 7th grade, when his parents realized it was not challenging him, and transferred him to public school. He had already been diagnosed with ADHD and was treated with stimulants, when his psychiatrist referred the family to me for consultation around behavioral issues.

In his new school, Joe was having trouble keeping up with his studies as he was not used to exerting himself, and was getting discouraged.  He was not behaving well at school or at home. His parents were angry and threatened to take away privileges if he did not improve. This only served to make Joe resentful and less interested in behaving as adults wanted. Joe and his parents were at a standoff.

What to do?

Joe’s parents were coming down harder and harder on him, and he was becoming more and more rebellious. He broke some rules about staying out late, and misused his parents’ credit card. (He continued to attend school, took his medication, and never abused drugs or alcohol, nor was there any legal involvement).

In therapy, Joe explained to me that he had plenty of motivation, just not for the things his parents valued. He was very focused on finding and impressing a peer group, and having enough money to do things with his friends and to dress like them. He made impulsive decisions, trying to make money by buying and selling tickets to sporting events, and hid this from his parents. One time, he stayed out late at a party and did not tell his parents where he was. All of these behaviors were in line with reaching his goal of being accepted in his peer group, but certainly did not make parents happy.

In therapy, Joe realized that his impulsive behavior would not help him reach his goals, and that his peer group was (fortunately) academically focused so they would respect him for this kind of achievement. In sessions with his parents, they were able to see that what Joe was trying to accomplish was appropriate to his age, and that his decisions, while not perfect, were not catastrophic. Joe was able to use coaching and support to get work done well and on time so his grades improved; he got the top score in a demanding math program, and got a summer job. Last night he made his parents a nice dinner with music and candles which they greatly appreciated (even though he said he did it because he was bored!).

This situation is a great example which makes my main point: We need to understand the difference between external motivation and internal motivation, and when each works best.

Motivation: External vs. Internal

External Motivation: This is in play when we are behaving to please others, or to achieve an external reward. Many of us respond to external motivation, for example, when we drive more carefully if a police officer is watching. Children do this when they work hard to finish their homework so they can watch the World Series playoffs. When younger children have behavioral difficulty, we use external motivation such as reward systems and removing privileges, to address these issues. However, 15-year-old Joe is at an age where his parents’ external motivation (punishment and threats) are often ineffective.

Internal Motivation: We are internally motivated when we have our own goals and work to achieve them. This is what children (and adults) do when they want to learn a new skill so they can succeed, such as hitting a baseball or shooting a basket. Just watch a 12-year-old out in the driveway taking foul shots over and over. No one is telling her to do this; she is internally motivated to improve. The older we get, the more we tend to be internally motivated. As a teenager, Joe was moving into the age when internal motivation is developing; most teens don’t respond well when adults try to assert control over them.

Why did Joe have such trouble making the change from external to internal motivation?
When Joe was in his private school, he never had to work hard due to his innate ability, and since there was a small group of peers he was comfortable. So, his ADHD didn’t really seem to interfere much with his success, as he was never under pressure to perform and his motivation never came into question.
When Joe entered public school, he was challenged both academically and socially, became stressed, and his ADHD became evident. His lack of planning, procrastination, impulsivity, and distractibility interfered with his need to perform at a higher level. This made schoolwork much less rewarding. In addition, he had lost his peer group and naturally wanted to be accepted. So he focused more on being out with friends, and less on what parents thought was important.

Once Joe’s parents learned that his behavior was within the boundaries of teenage development, they could back off on some of their attempts to control him. If he had been abusing drugs or alcohol, engaging in illegal activity, or refusing to go to school, external sanctions would have been appropriate. Fortunately, this was not the case with Joe, so his parents were able to ‘cut him some slack’. And, Joe’s insight was good enough to see the eventual results of his behavior, and could utilize supports and medication to overcome his ADHD symptoms.

References
1. Barkley, R. (2000). Taking charge of ADHD: The complete, authoritative guide for parents (Rev. ed.). New York, NY: Guilford Press.