Francine Conway, Ph.D. ’99: Treating ADHD with Greater Compassion

by Bonnie Eissner

Attention deficit hyperactivity disorder (ADHD) now trumps all other psychiatric illnesses in its prevalence among young people in our country. Typically, the disorder is treated with stimulant drugs, such as Ritalin or Adderall, and some type of behavior modification therapy. Some families, though, pursue psychodynamic psychotherapy for treatment.

From research and clinical experience, Francine Conway, Ph.D. ’99, a professor at Adelphi University’s Gordon F. Derner Institute of Advanced Psychological Studies and chair of its undergraduate psychology program, believes that children with ADHD who receive psychodynamic psychotherapy are more likely to reap long-term benefits.

Dr. Conway first grew interested in the issue when, in her own pediatric psychotherapy practice, she noticed a spike in the number of families seeking help for their “hyperactive” and “impulsive” children, particularly boys. Often, their behaviors were disruptive in their classroom to the great distress of their parents who would ask her to “fix” their children.

Dr. Conway said she became curious as to why children’s difficulties were manifested in school in this particular way.

In surveying the literature on ADHD treatment, she came across a number of studies showing that, while typical parent interventions and cognitive therapies are effective in the short-term, the long-term benefits are far from clear.

In her own clinical work and through her research, Dr. Conway has found that a compassionate psychodynamic approach has greater potential for lasting change for children struggling with ADHD. For one, it can help them develop a deeper understanding of themselves and their relationships with others.

“We live in a relational world,” Dr. Conway said. “It doesn’t matter what you bring to the table, you have to interact with other people.”

What does this mean for children with ADHD? Often, it means that they develop a negative self-perception as they experience the criticism engendered by their impulsiveness or their inability to stay organized and on track. In very young children, disruptive behavior can even impact parent-child relations, leading to insecure attachments and even weaker ability to regulate feelings and outbursts.

By helping children and their families work through these issues, Dr. Conway believes that psychodynamic psychotherapists can bring about lasting improvement in behavior and self-esteem among young people with ADHD.

To date, Dr. Conway has interviewed analysts in the New York metropolitan area and at the Sigmund Freud Institute in Frankfurt, Germany. She noted that the analysts, particularly the ones in Germany, she said, have “had some really promising results” in the use of psychodynamic psychotherapy with children exhibiting ADHD-like behaviors.

Dr. Conway recently edited Attention Deficit Hyperactivity Disorder: Integration of Cognitive Neuropsychological, and Psychodynamic Perspectives in Psychotherapy (Routledge, 2014) and, for her next book, is examining the role of compassion in treating children with ADHD.

“There’s a moral undertone that these kids would be good kids if they would just work harder or ‘stop being bad,’ and it impacts the children and the way they feel about themselves,” Dr. Conway said. “I don’t like that, clearly.”