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knowledge and understanding of ADHD.The client identified several helpful strategies learned from readings assigned to help improve attention span, academic performance, social skills, and impulse control.The client has not read the helpful information on ADHD and was redirected to do so.

      28 Assign Self-Help Readings on ADHD (28)The client was assigned self-help reading to facilitate understanding of ADHD.The client was assigned Driven to Distraction (Hallowell & Ratey).The client was assigned ADHD: Attention-Deficit Hyperactivity Disorder in Children, Adolescents, and Adults (Wender).The client was assigned to read Putting on the Brakes (Quinn & Stern).The client was assigned to read You Mean I'm Not Lazy, Stupid, or Crazy!? (Kelly & Ramundo).The client was assisted in processing the material that they read.The client has not read the assigned information on ADHD and was redirected to do so.

      29 Engage Significant Other (29)The client was allowed to invite a significant other to participate in the therapy.The significant other was taught to help support the change and reduce friction in the relationship introduced by the ADHD.It was reflected that the significant other has been helpful in supporting the client's changes and reducing friction in the relationship.The significant other has struggled to be helpful to the client's change process and was provided with remedial feedback in this area.

      30 Teach About the Use of a Reminder Calendar (30)The client was taught about the use of making lists and of using a calendar to remind them about appointments and daily obligations.The client has implemented structured reminders and organizers, and these have been noted to be helpful in reducing forgetfulness and completing necessary tasks.The client has failed to use the structured reminders and continues to forget about daily obligations; the client was redirected to use these organizers.

      31 Develop Organizational Skills (31)The client was assisted in developing a procedure for classifying and managing mail and other papers.The client was assisted in developing a procedure for remembering scheduled appointments.The client was reinforced for use of organization and classification systems.The client was redirected when they did not use helpful classification and organizational skills.

      32 Teach Problem-Solving Skills (32)The client was taught problem-solving skills as an approach to planning.The client was taught to break down each plan into manageable, time-limited steps in order to reduce the influence of distractibility.The client was assigned “Getting Organized” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).The client was reinforced for regular use of problem-solving skills.The client has not regularly used problem-solving skills and was redirected to do so.

      33 Practice Problem-Solving (33)The client was assigned homework to apply problem-solving skills to an everyday problem.The client was assigned the exercise “Problem-Solving: An Alternative to Impulsive Action” from the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client's use of problem-solving skills in everyday problems was reviewed.The client was provided with positive feedback about the ways in which they have appropriately used problem-solving skills.The client was provided with corrective feedback toward improving use of problem-solving skills.

      34 Identify Typical Attention Span (34)The client was asked to do various tasks to the point that they indicated distraction.The client attempted various tasks, continuing until distraction was indicated; this was used as an approximate measure of the client's typical attention span.

      35 Teach Stimulus Control Techniques (35)The client was taught techniques that use external structure such as lists, files, and daily rituals to improve on-task behavior.The client was taught to remove distracting stimuli from their environment when performing a task requiring focus.The client was urged to self-reward for successful focus and follow-through with on-task behavior.The client followed through with implementing techniques to increase on-task behavior and was reinforced for doing so.The client did not follow through with implementing on-task behavior and was encouraged to do so.

      36 Break Tasks into Smaller Units (36)The client was taught to break down tasks into meaningful units based on the client's demonstrated attention span.The client was assisted in breaking down tasks into meaningful units.

      37 Teach Use of Cues (37)The client was taught to use timers or other cues to remind them to stop task units.The client was taught about reducing off-task time or distractions by limiting the length of time expected to focus on one area.The client was reinforced for use of timers and cues.The client does not regularly use timers and cues and was redirected to do so.

      38 Change Maladaptive Self-Talk (38)Cognitive therapy techniques were used to help the client identify and change maladaptive self-talk.The client was assisted in challenging the biases that lead to maladaptive self-talk and to generate alternative thoughts.The client was assigned “Negative Thoughts Trigger Negative Feelings” from the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client was reinforced for regular use of healthier self-talk.The client has not regularly used healthy self-talk and was redirected to do so.

      39 Discuss Metacognitive Therapy Approach (39)The client was taught about using a metacognitive approach to examine “thinking about their thinking.”The client was assisted in developing a more adaptive plan based on new, less-threatening metacognitive appraisals.The client was provided with positive reinforcement for use of a metacognitive approach to examining their thinking.The client was provided with corrective feedback toward improving ability to examine thinking.

      40 Practice Cognitive Knowledge and Skills (40)The client was assigned homework to implement cognitive knowledge and skills in relevant tasks.The client's cognitive knowledge and skills were reviewed.The client was provided with corrective feedback for their struggles in implementing cognitive knowledge and skills.The client was reinforced for regular use of cognitive knowledge and skills.

      41 End Procrastination (41)The client was assisted in identifying the positives and negatives of procrastination.The client was challenged to change their pattern of procrastination.

      42 Develop Specific Plans for Overcoming Procrastination (42)The client was asked to apply problem-solving skills to planning as a first step in overcoming procrastination.The client was assisted in breaking down each plan into manageable, time-limited steps to reduce the influence of distractibility and increase the likelihood of successful completion.The client was reinforced for use of problem-solving skills as a way to overcome procrastination.The client has not regularly used problem-solving skills to overcome procrastination and was provided with remedial feedback in this area.

      43 Embrace Action Over Procrastination (43)The client was taught to apply cognitive restructuring skills to challenge thoughts encouraging the use of procrastination.The client was taught to change their thoughts toward embracing action.

      44 Develop Calendars and Lists (44)The client was assisted in developing calendars to record details of scheduled activities and obligations.The client was assisted in developing lists of responsibilities.The client was directed to keep their calendars and lists with them on a regular basis and mark off each item as it is completed.

      45 Assign Practice of Ending Procrastination (45)The client was assigned specific homework tasks to accomplish without procrastination.The client was assigned “Self-Monitoring/Self-Reward Program” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client was urged to use techniques learned in therapy to complete homework without procrastination.The client was provided with corrective feedback toward improving this skill and decreasing procrastination.

      46 Develop Distraction-Free Environment (46)The client was assisted in designing and implementing an environment that is free of extraneous stimulation.The client was directed to use their environment as place of study, concentration, and learning.The client was provided with ideas about how to organize the environment to be free of extraneous stimulation.

      47 Teach Self-Control Strategies (47)The client was taught the self-control strategy of “stop, listen, think, and act” to assist in curbing impulsive behavior.The client was taught problem-solving self-talk as a means of reducing impulsivity.The client was assigned “From Recklessness to Calculated Risks” from the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).Role-playing was used to help the client apply self-control strategies to daily life situations that are affected by ADHD symptoms.The client reported success at applying self-control strategies and

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