This program is designed  for the many youths and adults whose  behaviour is associated with some or all of the characteristics of Attention Deficit Hyperactivity Disorder. Attention deficit hyperactivity disorder (ADHD). ADHD is a neurodevelopmental disorder with core symptoms of inattention, impulsivity and hyperactivity that often result in significant impairment in social functioning. The efficacy of the program has been demonstrated in several controlled evaluations in England and Scotland.

Program Development

Individuals who evidence ADHD symptoms require a specialized program. That is why R&R2 FOR ADHD YOUTHS AND ADULTS was developed. It targets the core dimensions of ADHD in order that the participants can benefit from the training in the prosocial cognitive/emotional skills and values that are taught in the R&R program. The program is designed to target not only individuals who have been diagnosed with ADHD but for the much larger population of individuals who have not been diagnosed but evidence some or all of the ADHD characteristics.

The program is designed for four groups of adolescents and adults (age 13+) who evidence ADHD symptoms:

• adolescents who have academic achievement difficulties, inadequate behavioral control, exhibit disruptive behaviour, or conduct problems at home and/or school, or are "at risk" of progressing to more severe antisocial behavior;

• youths in schools or under the supervision of social service agencies or youth justice agencies;

• adults whose ADHD symptoms engenders interpersonal problems, poor productivity and/or disruptive behavior at work;

• adults under the supervision of community criminal justice agencies or in institutions.

The program provides specially designed training to target the inattention, lack of concentration, impulsivity and hyperactivity that are often associated with poor interpersonal relationships, educational underachievement, employment problems and other social, financial, legal and/or relationship difficulties that reflect a lack of prosocial competence. 

The program provides neurocognitive skills training techniques to improve attentional control, memory, impulse control and to develop achievement strategies by teaching constructive planning and management techniques. Participants who apply those skills acquire specific prosocial competencies in coping with their ADHD symptoms. The behavioural control and listening skills they acquire help the participants to focus on the exercises that have been designed to develop pro-social attitudes, skills and values.

Evidence-base

The program has been evaluated with many youths and adults with ADHD including – mentally disordered offenders in secure hospital settings.  

Program Content

Five modules are included:

• Neurocognitive Module which introduces techniques to improve attentional control, memory, impulse control and develop skills in constructive planning;
   

• Problem Solving Module which engages the individual in a process of skilled thinking as opposed to automatic thinking, scanning for information, problem identification, generating alternative solutions, consequential thinking, managing conflict and making choices;
   

• Emotional Control Module which includes managing thoughts and feelings of anger and anxiety;
   

• Social Skills Module which includes the recognition of the thoughts and feeling of others, both verbal and nonverbal, social perspective taking and the development of empathy, negotiation skills and conflict resolution.
   

• Critical Reasoning Module which teaches that individuals have choices to make in life, that there are alternative possibilities, and trains them in effective skills in thinking and behaving, in evaluating options, and in making good choices

Design

The program is manualized and highly structured and there are clear instructions for the Trainer to follow in a Trainers Guide.  A variety of innovative training techniques are used to engage the individual and to make the ‘training’ fun by incorporating games, individual and group exercises, role-playing, brainstorming, audiovisual material, and participants’ workbooks. 

There are 15 sessions. Each session requires 90 minutes of training (with breaks) and includes out-of-class assignments.  Sessions may be delivered once a week or more frequently.

Training Video

The program kit includes a video of the principal program developer, Dr. Young, modeling  training in the program in a secure hospital setting.

Assessment

A major problem, particularly in the juvenile and adult justice systems, is that individuals'  ADHD may be undetected. Routine assessment rarely includes adequate measures of ADHD. Moreover, many individualks with ADHD evidence comorbid problems of personality, mood, anxiety and/or substance misuse which become the focus of attention.
 

A screening measure, the “RATE” rating scale has been developed to determine the suitability of participants. It is specifically designed to identify individuals whose antisocial behaviour is associated with symptoms of ADHD. The RATE measure that is included in the program kit provides 4 sub-scales:
 

• ADHD symptom scale

• Emotional problem scale

• Antisocial behaviour scale

• Social functioning scale

The RATE can also be used as an outcome measure to evaluate progress. 

Participants Workbook

Each participant is are given a Participants Workbook which provides a summary of each session that includes a review of what they have learned and their 'homework' assignment. It also provides a variety of exercises for them to complete during or after the sessions.

PAL’s Guide

A novel feature of the program is the "PAL" (Participant’s Aide for Learning). Prior to attending the program, each participant is asked to select a PAL.  A PAL may be a parent, friend, or member of staff. The PAL must be in regular contact with the participant and must be able to meet with the participant at least once per week.

The PAL component of the program is designed to maintain participants' motivation and attendance and to reinforce their acquisition and practicing of the skills they are learning in the sessions. The PAL serves as a prosocial model and makes suggestions about how the participant can introduce new techniques and skills into their everyday life. This helps the transfer of skills and makes the program seem more personal.  The PAL has a Guidebook which defines the PAL's role, explains their role and provides helpful suggestions. The PAL helps to generalize the participants' skill acquisition from the classroom to their everyday living.

Booster Sessions

Another feature is the provision of an optional three-session follow-up or Booster Program.  The purpose of these sessions is to remind participants of the skills they have learned from participating in the main program, to reinforce them in order to further consolidate these skills, and to provide them with additional and longer term support. 

 TRAINER'S KIT                     

Individuals registered for a Training workshop by Dr. Young and in order to conduct the program with clients each R&R2ADHD Trainer requires a Trainer's Kit that includes the following:

TRAINER'S HANDBOOK: The Handbook articulates the development of the program and the teaching principles and objectives. It will be sent electronically (without cost) by Dr Young for distribution to all staff who are registered for a Staff Training Workshop.

TRAINER'S KIT: A "Trainer's Kit" includes:

• PROGRAM MANUAL - detailed instructions for Trainers
• DVD
• POWERPOINT SLIDES for each session;
• MYSTERY GAMES for participants to practice the thinking and problem-solving skills they are taught in the program; 
• MPEG Movies for in-class exercises in social cognitive emotional skills
• DVD  of Dr. Young teaching the program 
• STIMULUS CARDS for in-class exercises dilemmas game cards, non-verbal emotion cards, non-verbal situation cards, non-verbal question cards,goals cards  (reproducible by Trainers)         
• SIGNS to stimulate the participants' thinking and behavior
• SESSION RECORD FORM (reproducible by Trainers);
• PROGRAM REPORT FORM (reproducible by Trainers);
• TRAINER'S SARA CARD – a wallet-sized card of SARA problem-solving steps (reoducible by Trainer)
• ASSESSMENT FORMS AND SCORING KEYS for the RATE measure (reproducible by Trainer.
• PARTICIPANT'S WORKBOOK
• PALS GUIDE – each PAL receives a manual of instructions for each session
• SARA CARD – a wallet-sized business card for participants that list the steps they have been taught to follow in solving problems (reproducible by Trainers)
• CERTIFICATE OF ACHIEVEMENT
• BOOSTER PROGRAM MANUAL - Instructions for conducting unlimited training for clients who have been trained in the program and would benefit from additional training 
• BOOSTER PROGRAM PARTICIPANT'S WORKBOOK for enabling the Booster Program to be delivered (reproducible by Trainers)

COPYRIGHT PURCHASE 

Exclusive copyright purchase enables the purchaser to produce, distribute and train professionals in this program throughout a country, province or state on a fee-for-service basis. Copyright can be purchased by a university, government or approved social agency. Contact the Cognitive Centre of Canada for information.

Note: To ensure quality control, Trainers' Kits may be ordered only for individuals who have been or are registered to attend Dr. Young’s staff training workshop.

Note: A Trainer's Kit must be purchased for each staff member attending a Staff Training Workshop.

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