Practices

Offer school again at ten, and at eleven, and after lunch. One refusal at half past seven should not be allowed to decide the whole day.

Morning dread usually peaks around the time they would be leaving and then drains away over a couple of hours. A child who could not face it at half…

Find one adult in the building the child already trusts, and have them meet the child at the entrance. The doorway is the hardest minute of the day.

The job is small and specific: be there at the door, walk with them to their locker, get them started, be findable later on. It turns the worst…

The first day back is worse than the weeks before it, not better. Plan for that spike rather than letting it take you by surprise.

Anxiety climbs as the return gets close and peaks somewhere near the doorway, then it comes down, but only for someone who stays long enough to find…

If getting to the appointment frightened you, then you have already done the first hard thing. Walking in and talking to a stranger about yourself is the ladder, not the preparation for it.

Nobody watching later can see it. What they see is someone sitting there talking, and they miss the week of dread and the near cancellation. Say it…

Before you hand it over, read the original request again. Not your memory of it. The actual words.

Almost nobody enjoys this, which is why almost nobody does it. But work that is good except for the two things nobody remembered is the commonest…

When the thing is over, sit down for twenty minutes and go through it: what happened, what worked, what did not, what you will do differently. Put it in the diary, because it never happens on intention alone.

The monthly report, the school year, the audit. Write the answers where you will actually find them next time, and be specific about the point it…

If telling your doctor or midwife what you are using feels impossible, you can ask someone you already trust to pass it on for you, with your permission and in your words.

People often stay quiet with the very clinician who could help, because saying it out loud feels heavier than the problem does. Handing the message…

Before someone has said a word, you have often already decided what they are: only here because they were made to come, not really interested, wasting your time. That decision changes how the meeting goes.

The person sent by a court, or pushed into the room by a partner or a manager, walks in already read. Try starting the hour with nothing written: no…

Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about.

Ask which one they would be willing to have a go at this week, not which one they ought to be able to manage. The answer usually sits somewhere in…

No step happens without the person agreeing to it. Not ordered, not dragged, not talked round in a bright voice. Agreement is a condition of the thing working, not a courtesy.

Coerced exposure teaches two lessons at once: that the situation is dangerous, and that you are not safe with the people who arranged it. After that…

What you expect from a treatment shapes what you get from it. That is worth a conversation before you start, not months later when it has not worked.

If you are beginning something new and half of you thinks it is nonsense, say so. A doubt that stays unspoken tends to come out as a missed…

Nobody tolerates something unpleasant for no reason. Before starting anything difficult, get clear about what you want on the other side of it, in your own words.

Something like: I want to sit an exam without being sick, so I am willing to practise feeling uncomfortable. The sentence has to be yours. A goal…

Do not walk into a hard event and improvise. Ten minutes beforehand, work out what is likely to happen, what you will do about it, and how you get out if you need to.

If someone is coming with you, make it a shared plan. What the signal is when one of you needs air, who says what to whom, when you leave. The point…

When you cannot skip it, shorten it. Come for the meal and skip the drinks afterwards. Two hours of you at your best is worth more to everyone than five hours ending badly.

Decide the leaving time before you arrive and say it out loud on the way in, so that it is a plan rather than a walkout. Booking something afterwards…

If you are being assessed for attention, say something about your mood and your worry as well, even if nobody asks.

Anxiety and low mood sit alongside ADHD often enough that a thorough assessment will go looking for them anyway. But shame is quiet, and years of…

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…

The age by which symptoms have to have shown up is a number people agreed on, not a line in nature. It moved from seven to twelve when the manual was revised.

That matters if you are an adult wondering whether you would even qualify. The old cut-off was itself a compromise between studies pointing in…

You do not need clinical language at an assessment. Some of the wording in the manual came straight from how families described it in the first place.

Phrases about being permanently on the go are in there because people kept saying them. So use yours: that your head is like a browser with forty…

Not all distraction comes from outside. Some of it is a thought that will not leave, circling while you read the same paragraph four times.

That difference matters at an assessment. Being pulled away by everything in the room, and being held in place by an intrusive thought you cannot put…

Eating that runs away from you, and eating you cannot stop once it has started, turn up alongside ADHD more than people expect. Usually it is doing a job rather than proving a weakness.

The pattern leans towards bingeing rather than restricting, which fits: it belongs with the difficulty of stopping something already in motion. Often…