Practices

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…

You can screen for a processing difficulty with no test at all. Just notice, in ordinary conversation, whether the child is answering what you actually said.

A child who drifts off topic, answers a slightly different question, or needs things said twice may not be avoiding you or daydreaming. The words may…

When someone tells you they have been hurting themselves, keep your face steady and stay curious. Alarm closes the conversation, and you need it open.

A visible flinch teaches the person that this is not something you can hear, and the next disclosure goes elsewhere or nowhere. It can also make the…

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…

Agree a short phrase to use at home. Saying I am having OCD worries tells a parent what is going on without handing them the worry to solve.

Once a parent hears the details they will nearly always try to help by answering, and answering is the thing that feeds it. A label gives them…

Before you practise something exposing with someone, say out loud what is not at risk. I will not think less of you, and nothing between us changes here.

It sounds obvious and it does a great deal of work. If the relationship really is on the line, then the discomfort is not symbolic and no amount of…

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…

When someone tells you they have failed, the most useful thing you can do is nothing clever. Let your face stay soft and keep looking at them.

Shame is braced for disgust, so it reads your face before it hears your words. A quick reassurance can even land as a rush to move on. Slower is…

When someone's shame fills the room, check your own state before you say anything. If you start to shrink, or to worry that you are handling this badly, they will feel it.

Shame is catching. The particular risk is a quiet spiral of your own, along the lines of I am no good at this, which pulls you out of the room at the…

With someone carrying old shame, ask about the closeness itself. Is it alright that I am sitting here with you? Would a bit more space help? Then adjust, and let them see you adjust.

Small changes work best. Shifting your chair back slightly, looking away for a moment, softening your voice, then checking what that was like for…

When the person in front of you starts yawning during body work, it is usually not boredom. Bodies yawn as they let go of what they were holding.

Say so out loud, because most people apologise for it and then clamp down on the very thing that was starting to shift. A simple 'that is a good…

A lot of what people now know about ADHD came from a video. Some of it is genuinely good, some of it is not, and asking someone what they have been watching is a fair question to open with.

Creators who live with ADHD have done real good here. They have made people feel recognised and made asking for help less frightening, and some…