Psychodynamic Play Therapy With a Six-Year-Old African American Boy Diagnosed With ADHD

This article describes the effective, two-year psychodynamic treatment of Jaden, an African American boy diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Combined Type. Treatment began when Jaden was six years old and is currently in its second year. Play provided an understanding of his internal world and a holding environment (Winnicott, 1960) to contain and reflect Jaden's impulses and behavioral dyscontrol. Clinical material, which centers on character play, is presented to illustrate the evolution of Jaden's understanding of his diagnosis and his struggle to manage feelings of intense sibling rivalry, anger, envy, and frustration. Further, the transference-countertransference relationship was utilized in the clinical work and informed by a relational, integrative psychodynamic-systems perspective (Altman et al., 2002). This approach included ongoing collaboration with Jaden's family and his school, and the use of standardized psychological assessment. This integrative psychodynamic-systemic approach decreased Jaden's behavioral dyscontrol, aggression, and distractibility. These techniques fostered a realistic and more positive self-representation, enhanced his emotion and impulse regulation, and helped him improve his school performance. The implications for expanding treatment options and theoretical perspectives for ADHD are discussed.