Practices

Feeling bad about being late is a consequence you can talk yourself out of in about four seconds. Telling a friend you are buying dinner if you are late is not.

Pick something small and real, and pick a person who will hold you to it without being unkind about it. Dinner, the coffees, the taxi fare. The size…

The conversation only counts if the decisions end up in the calendar. 'You take Tuesday, I'll take Thursday' has to be written down or it did not really happen.

Both of you were relying on the same tired memory that caused the trouble in the first place. So do the writing during the conversation rather than…

Put the stake outside your own head. Tell a colleague that if you are late to the meeting, lunch is on you.

The link between being late and buying lunch is arbitrary, and that does not matter at all. What matters is that it is real, it happens soon, and…

Choose one person and tell them you will send the finished thing by a set time. Not a conversation about how it is going, just the file, the photo, or the word done.

The sending is the whole mechanism, so keep it small and exact: what, and by when. It does not have to be someone qualified to judge the work, and it…

Let the child score themselves on the same sheet the teacher scores. Two columns, filled in separately, then looked at together.

At first the two columns can be miles apart, and that is the useful bit rather than a problem. Nobody is being caught out. Over the weeks the gap…

When someone says they feel restless inside, ask what the restlessness wants. Restless to move, or restless to do one particular thing until it feels right?

The two feel similar from the inside and point in different directions. With ADHD it is usually undirected: the legs go, the chair is wrong, you need…

A distracted person can be brought back with a nudge. Someone who has gone elsewhere cannot, and the difference shows itself in a couple of seconds.

Say their name, ask something simple, and watch what returns. Attention that has drifted comes back with a small apology and picks the thread up…

Try not to ask why. If the person knew why, they would probably have sorted it out already, and the question tends to land like an accusation.

Ask what happened just before instead. What was going on, what they felt, what came after, what sort of day it had been. Those answers can be worked…

If someone was adopted, or simply does not know their family history, say early and plainly that this is not a problem. It helps to have and it is not needed.

Otherwise the question lands as one more reminder of what is missing, and some people will spend the rest of the appointment feeling they brought the…

When someone says their heart races on their medication, ask whether it ever did before they started. It is the cheapest question you have and it usually sorts the answer out.

Go looking for the old settings: waiting to be called on in class, standing outside a room before a difficult conversation, three in the morning with…

While you are taking the family history, ask about seizure disorders and psychosis too, not only about attention. A family carrying other neurological or psychiatric conditions is worth knowing about whatever you end up concluding.

Keep the list short and ask it plainly: epilepsy, psychosis, learning difficulties, head injuries, anything neurological. Some of it will matter for…

The most useful question about a dose is whether the person can tell. A shrug and 'I think it sort of helps a bit' usually means it is not yet doing its job.

At a dose that suits them, most people can say when it comes on, what the middle of the day feels like, and when it leaves. Vagueness points…

Half the useful health information arrives sideways. Someone says 'I am so tired' on the way into another subject, and that is an opening worth taking gently.

People rarely bring sleep or food to a session as a topic, because they do not file them as symptoms. So the tiredness, the skipped meals and the…

Fasten a time you keep missing to another person. Go up when your partner goes up. Ask a colleague to knock for you on the way to the meeting.

A person moving is much easier to notice than a number changing. Ask for it as a favour and keep it small and specific, because a vague request to be…