An Integrative Approach to ADD/ADHD - traditional & holistic combined Rafael Richman, PhD Psychologist, Jerusalem and Tel Aviv Israel In-person and online counseling and consulting

Rafael Richman, Ph.D., Psychologist

The integrative approach to working with ADHD provides a framework for the client and the practitioner to combine the best and most effective components of traditional interventions [medication, behavior therapy] and non-traditional interventions [complementary medicine, conscious parenting]. A primary goal is to optimize functioning and well-being and to minimize unpleasant side effects, short- and long-term harm. A secondary goal is to provide the client and his family with comprehensive information about a diverse range of treatment options for ADHD and the evidence [empirical and anecdotal] for these options. In other words, the aim is to talk about interventions such as medication therapy, alternative and holistic approaches, different parenting models, and to clarify what we know and what we don’t know about the effectiveness, and the potential benefits and disadvantages of each intervention.

Two-Track Model

I incorporate a two-track treatment model in my work with children, adolescents, and adults diagnosed with “Attention Deficit Disorder” [ADD] or “Attention Deficit Hyperactivity Disorder” [ADHD], which entails the following:

Track one: rebalance the body on all levels - biological, physical, neurological, biochemical, and molecular. For this track I often discuss the connection between what the client puts into his body [e.g., food] and how he feels. In addition to diet, we may also work with other healing professionals [e.g., naturopath, family physician]. Other components of this track include looking at exposure to environmental neurotoxins [e.g., lead, chemicals], molecular imbalance, and vitamin and mineral deficiency. For example iron deficiency is often associated with poor concentration.

Track two: rebalance the person on psychological, emotional, environmental social, and family levels. For this track I use the conscious parenting approach with ADD/ADHD-specific strategies and skills, interpersonal design elements, and individual psychotherapy and/or family therapy where appropriate.

Through experience consulting with many families, I have discovered that we are more likely to achieve successful changes in behaviour and symptoms with: a whole-scale shift in attitude; and a family-based commitment to changing their lifestyle. Simply substituting a “natural” remedy in place of medication does not usually lead to noticeable improvement or symptom reduction. Rather, a holistic, integrative approach requires considerable effort, openness, patience, awareness, perseverance and commitment, on the part of the family.

Key Points

In the integrative perspective the following key points are emphasized:

Thorough Assessment
I strongly encourage and believe it is necessary to properly and thoroughly assess for ADHD.

Human Element
It is important to remember the human element:  we are dealing with people (children, teens, adults) who are experiencing difficulties - with being able to concentrate, with sustained attending, who have difficulty inhibiting what they say and what they do, and who get easily frustrated - rather than only adopting the perspective that we are working with and treating ADHD.

Specific Symptoms
It is useful to work at the level of specific symptoms, and to reframe these symptoms as natural traits and tendencies, and as occurring along a continuum. For instance, I talk about having a tendency to be impulsive, having difficulty sustaining attention, and having a hard time inhibiting what one says and does.

Wholism
Everything is connected to everything else; change in one domain impacts and influences all other domains.

Bio-Individuality and Bio-Universality
Every individual is unique; and, at the same time, all human beings share certain universal human characteristics.

Balance – Imbalance
Individuals shift through states of relative balance and imbalance. The primary goal is to re-balance - on physical, emotional, mental, and spiritual levels – and to reduce extreme swings.

Dynamic
The state of balance/imbalance and our feelings/affect are continuously changing and in flux.  Individuals experience moment-to-moment change, and hourly, daily, monthly, seasonal cycles and patterns.

“ADD is not always a deficit, not a disorder in the usual sense, not a disease. It is a label given to a child who may think, learn, behave, and feel in a different style than others.” (Sears & Thompson, 1998)

Selected Readings on...

Natural Therapies for ADHD

Anderson, Nina (1996). A.D.D.: The Natural Approach: Help for Children with Attention Deficit Disorder and Hyperactivity. Connecticut: Safe Goods.

Armstrong, Thomas (1995). The Myth of the A.D.D. Child: 50 Ways to Improve your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion.  New York: Dutton.

Block, Mary Ann (1997). No More Ritalin: Treating ADHD Without Drugs. Canada: Penguin Books.

Crook, William G. (1991). Help for the Hyperactive Child. Jackson, TN: Professional Books.

DeBroiter, Rita Kirsch (1997). Moving Beyond A.D.D./A.D.H.D.: An Effective Holistic, Mind-Body Approach. Illinois: Contemporary Books.

Hartmann, Thom (1996). Beyond ADD: Hunting for Reasons in the Past and Present. California: Underwood Books.

Hartmann, Thom (1993/97). ADD: A Different Perspective. California:  Underwood Books.

Lyon, Michael (2000). Healing the Hyperactive Brain. Calgary, Canada: Focused Publishing.

Murrey, Michael,  & Pizzorno, Joseph (1998). Encyclopedia of Natural Medicine. California: Prima Publishing. (refer to chapter on Hyperactivity and Learning Disorders)

Sears, William, & Thompson, Lynda (1998). The A.D.D. Book: New Understandings, New Approaches to Parenting Your Child. Toronto: Little, Brown, and Company.

Weintraub, S. (1997). Natural treatments for ADD and Hyperactivity.

Homeopathy

Reichenberg-Ullman, Judyth, & Ullman, Robert (1996). Ritalin-Free Kids: Safe and Effective Homeopathic Medicine for ADD and Other Behavioral and Learning Disorders. California:  Prima.

Food Allergies

Bateson-Kock, Carolee (1994). Allergies:  Disease in Disguise. Burnaby, B.C.:  Alive Books.

Gislason, Stephen (1989). Core Diet for Kids. Vancouver, B.C.: Persona Audiovisual Productions.

Rapp, Doris (1991). Is This Your Child?  Discovering and Treating Unrecognized Allergies. New York: William Morrow.

ADHD - General

Barkley, Russell (2000). Taking Charge of ADHD. New York: Guilford.

Hallowell, Edward, & Ratey, John (1994). Driven to Distraction. New York: Simon & Schuster.

Wender, Paul (1995). Attention Deficit Hyperactivity Disorder in Adults. New York: Oxford University.

Wender, Paul (1987). The Hyperactive Child, Adolescent, and Adult. New York Oxford University.

Selected Readings on Food and Mood

Carper, Jean (1988). The Food Pharmacy. London: Simon and Schuster.

Chopra, Deepak (1991/2000). Perfect Health:  The Complete Mind/Body Guide. New York: Three Rivers Press.

Christensen, Larry (1996). Diet-Behavior Relationships: Focus on Depression.  U.S.A.: American Psychological Association.

Colbin, Anne-Marie (1986/96). Food and Healing. New York: Ballantine Books. www.foodandhealing.com

Connors, C. Keith (1989). Feeding the Brain: How Food Affects Children. New York: Plenum.

Cousins, Gabriel (2000). Conscious Eating. California: North Atlantic Books.

David, Marc (1991). Nourishing Wisdom: A Mind-Body Approach to Nutrition and Well-Being. New York: Harmony/Bell Tower.

Gagne, Steve (1990). The Energetics of Food: Encounters with your most Initimate Relationship. www.stevegagne.com

Kushi, Michio (1985/2004). The Macrobiotic Way. New York: Avery/Penguin.

Morningstar, Amanda, U. Dessai, & Urmijla Desai (1990). The Ayurveda Cookbook. U.S.A.: Lotus Press.

Murrey, Michael,  & Pizzorno, Joseph (1998). Encyclopedia of Natural Medicine [revised 2nd edition]. California: Prima Publishing.

Pitchford, Paul (1993/2002). Healing with Whole Foods: Oriental Traditions and Modern Nutrition. California: North Atlantic Books.

Richardson, Alex (2006). They are What You Feed Them: How Food Can Improve your Child’s Behavior, Mood, and Learning. Harper Thorsons.

Schlosser, Eric (2002). Fast Food Nation: The Dark Side of the All-American Meal. U.S.A.: Harper Collins.


Dr. Rafael Richman
Rafael Richman, Ph.D.
Psychotherapist & Psychologist

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  • Dr. Rafael Richman, Psychologist, provides psychotherapy and consulting to adults, couples, and families, and to adolescents, parents and children. He offers services for people suffering from a wide range of difficulties and life circumstances, including depression, anxiety, marriage and relationship difficulties, ADHD, insomnia and sleep difficulties, and trauma.
  • Dr. Richman's office is located in the German Colony neighborhood of Jerusalem, Israel.
  • Psychological Services are available in English and Hebrew.
  • Online counseling, consulting, and therapy is also available.