Claim social work fees for ADHD as medical expenses





As of September 26, 2012, counselling services provided by Registered Social Workers (RSWs) can be claimed as a medical expense tax deduction when you file your income tax return. In other words, Registered Social Workers are now authorized “medical practitioners” for the purpose of claiming medical expenses.

To access the CRA Chart list of professions in each province and territory so authorized, click on the following link: You can find more information at the following link:

ADHD Toronto study needs participants

ADHD (Young Adults, Parents, and Professionals) are interviewing young adults with ADHD, their parents, and professionals who work with young adults with ADHD. The insights drawn from these interviews will be used to develop health solutions and programs that better meet patients’ needs. Your personal information will be kept strictly confidential.

They are interested in interviewing individuals who meet the following criteria:

Eligibility Criteria:

Young Adults:   18-24 years old with ADHD   Canadian (both English- and French-speaking)   Currently attending or preparing to attend college/university   Available to be interviewed by phone between September 3 – October 17

Parents:   Parents of 18-24 year-olds with ADHD who are attending or preparing to attend college/university   Canadian (both English- and French-speaking)   Available to be interviewed by phone between September 3 – October 17

ADHD Educational Counselors, Student Support Services, or Health Care Professionals:   Professionals in a university/college setting who work with young adults with ADHD   Canadian (both English- and French-speaking)   Available to be interviewed by phone between September 3 – October 17

The interview will take about 45 minutes. The young adult interviews will be followed by 5 days of journal-writing (10 minutes per day). There is a financial incentive for this study.

If you are interested in participating, please contact

Thank you for your interest!

ADHD Treatment info at Toronto Danforth Ward 15 Community Program Fair

Come learn about how to support your family member with ADHD at this community hub event.

Mary Lynn Trotter MSW RSW will be on hand Thursday Sept. 27 from 3-7:30 to meet teachers, administrators and parents who are seeking supports for students with ADHD and related learning differences.

The event is sponsored by the Toronto Danforth Ward 15 Community Hub, and includes many local agencies serving children and families.

It is also a chance to let us know what services you need in your community.

The event is at Chester ES and Westwood MS – 114 Gowan/994 Carlaw Ave. (northeast of Broadview/Mortimer).


Please bring your questions about:

- what is ADHD

- how to find out if my child might have it

- where to get a proper diagnosis

-what are the treatment options

- how to work collaboratively with my child’s teacher

- how to include sports activities as key adjunct therapies

- what supports are available in the community for free

- what OHIP won’t cover

- how to find a parent support group

- how counselling helps ADHD

- how to improve my child’s behavior

- does mom or dad also have ADHD

-IEPs and IPRCs – what are they, and how do they help


ADHD at work

Adult ADHD is becoming more known, better understood, leading to improved lives for people affected by it. One area where ADHD can be managed is in the workplace. It can, and should be thought of as a disability. For those working for a progressive employer, it is hoped this is something  you are able to share. Just like in school, you should be able to ask for accomodations.

But for others, in more traditional settings, disclosing that you have ADHD may be more of a burden than a help. This is an unfortunate reality. Adult ADHD is a disorder that still carries stigma, much like disclosing you have depression or anxiety.

So, we rarely see people taking time off to deal with their ADHD treatment. What happens instead is ADHD comes to work with you each and every day. If you are lucky enough to be in a job that is a good fit, such as sales, or something with a lot of variety, you may have managed to be effective at work despite the challenges of ADHD.

Another solution is to learn how ADHD affects the tasks of your job. For many, it means getting a handle on organization, time management, deadlines, hyper-focussing, setting priorities etc. What you really need is an assistant.

That’s where devices, such as computers, smart phones, even alarms can help. There are many new tools to help ADHD’ers better manage their work demands. To find out more, put “assistive devices” into your search engine to see what’s available. There are now many apps to help you – whatever your challenge.

For example, some of the new technologies have timers and alarms connected to the calendar. Put an appointment in, and you will be notified before that appointment comes up. What a relief…you can dive deeply into that assignment, and not have to worry that you might miss your next appointment.

Do you have a favourite? Please comment on this blog, so others with adult ADHD can see what works. And if it didn’t work for you, it might work for someone else with ADHD.

ADHD is an employment barrier you can address

As a social worker practising in Toronto, I work with people who have ADHD, and other adults who face a variety of barriers to employment. (For those interested, check my other website, Because of my social work background, I bring a different focus to the area of career development, or career counselling.

Social workers are educated and trainined to help people understand and cope with their challenges – and we all have some! So, I decided to take that approach into my work with career counselling.

For adults with ADHD, understanding what your barrier is should not pose a problem. You have likely known since you were young that you had a type of disabilty that made school, and later paid work difficult. If you were lucky enough to pick a career well suited to ADHD, you already conquered one of the biggest barriers you migh have faced!

Career counselling for ADHD includes helping people understand the unique ways ADHD affects their work styles, productivity, and creative process. As you know, there is no clear cut career plan for an ADHD client – each person is uniquely different in terms of the way ADHD poses challenges, and indeed, what strengths in confers.

I have found that people with ADHD, like any other significant issue, have to go through a process of acceptance before they can become very comfortable talking about it in terms of their on the job performance. This is where working with a career counsellor trained in ADHD is very helpful.

Before any client begins to seek out interviews, or even dust off their resume, I like to work with them to be clear and confident about the impact of ADHD on their working lives. Today many workplaces have accomodations in place to support you. Researching your local job market – talkiong to people who work in H.R. is a good place to start. Often, magazine reviews of top companies will point out who has excellent HR policies in the area of disability.

Rather than think of ADHD as a hurdle to be overcome, work to see it as a way of describing how you behave in certain situations – and how you manage it – well.

For more information on workplace disability and accomodations, please contact me.

ADHD included as exceptionality

Here is the link to the Ontario government memo that outlines the recent changes to ADHD as an exceptionality, which will result in changes in school supports:

This can mean big changes for parents with children who have an ADHD diagnosis, but no second diagnosis. In the past, many of these parents were not eligible for school support for their child’s learning challenges relating to their ADHD. Only if a child had a second exceptionality, such as a learning disability, would their needs be addressed.


Now, it is up to the school districts themsevles, through superintendeants, principals, and classroom teachers to support the intent of this policy change, and ensure children with ADHD receive all the help they need!


Here is another link to a terrific resource to provide your classroom or resource room teacher, also done for the Ontario government:

If you need help advocating for your child’s rights at school, call me today to book a consultation.

We are lucky these changes have been made, let’s ensure our children get their full benefit.

Using Cognitive Behavioral Therapy for ADHD

Cognitive Behavioral Therapy is an evidenced-based
counseling treatment that is showing promise with clients facing ADHD. Below is
part of an excellent interview conducted with the author of a treatment
guideline for using CBT in this area, reprinted from, by
Keath Low:
J. Russell Ramsay, Ph.D., is Associate Director and co-founder of the Adult ADHD
Treatment and Research Program at the University of Pennsylvania School of
Medicine, and a senior staff psychologist at Penn’s Center for Cognitive
Therapy. He is author of Cognitive Behavioral Therapy for Adult ADHD
(Routledge, 2008)
and Nonmedication Treatments for Adult ADHD:
Evaluating Impact on Daily Functioning and Well-Being (American Psychological
Association, 2010)
. Dr. Ramsay has lectured internationally to mental
health professionals on adult ADHD and the principles of Cognitive Behavioral
Therapy (CBT).

Q: What is cognitive behavioral therapy?

What sets CBT apart from other forms of psychotherapy is the emphasis it places
on the interactive role of cognitions — automatic thoughts, images, belief
systems — and behaviors. CBT certainly does not ignore emotions, but rather
targets problematic thinking and behavior patterns as the entry point to
understanding and addressing the difficulties for which people seek treatment.

CBT was originally designed as a treatment for depression
and research has consistently demonstrated that it is an effective therapy
approach for mood problems. Subsequent studies have shown CBT to be helpful for
other common problems, such as various types of anxiety, substance use, other
mood problems, and some medical issues, such as dealing with sleep problems or
headaches. The past decade has seen many clinical researchers who have worked
on modifying CBT to address coping difficulties associated with adult ADHD.

Q: What role does CBT play in a treatment plan for adult

A: Medications are considered the first line of treatment for ADHD in terms of
treating the core symptoms of ADHD. There are a variety of medication treatments for ADHD whose benefits operate through their effects on
brain functioning, generally producing improvements in sustained attention,
managing distractions, and impulse control. For many people, these symptom
improvements lead to functional improvements in their daily lives, such as
being better able to keep track of items, experiencing less physical restlessness
and greater impulse control, and being able to sustain focus on work or reading
for reasonable lengths of time, to name a few.

However, many individuals may continue to struggle with
the effects of ADHD despite adequate medication treatment. That is, individuals
may continue to experience residual symptoms of ADHD and/or have ongoing
difficulties implementing the coping strategies that they know would be
helpful. Moreover, individuals with ADHD may struggle with difficulties
managing their emotions in daily life, an increasingly recognized feature of
ADHD, or may experience problematic levels of depressed mood, anxiety,
substance use, or low self-confidence. These adults with ADHD require
additional help to experience improved well being and functioning in their
daily lives.

CBT has been found to be a useful adjunctive treatment
that directly addresses the sorts of impairments and coping issues associated
with adult ADHD that were described above. While the coping solutions may seem
simple — use a daily planner, start working on tasks well in advance of their
deadline, break large tasks into smaller tasks — they can be difficult to
implement. Facing these longstanding challenges may also trigger negative
thoughts, pessimism, self-criticism, and feelings of frustration that create
additional barriers to follow through. There also may be a minority of
individuals with ADHD who cannot take medications due to medical
contraindications, intolerable side effects, non response, or who simply
decline medications for whom CBT may be the central treatment approach. Hence,
CBT may be recommended in cases in which medications alone are not sufficient
to address problems associated with ADHD.

Q: How does CBT address some of the day-to-day problems
caused by ADHD symptoms?

A: A common example is a patient who arrives late for the first session — citing
that addressing “poor time management” is a goal for CBT. Such events
are used to “reverse engineer” the various component parts of the
problem in order to provide increased understanding of how ADHD (and other
factors) may contribute to the development and maintenance of their functional
problems, in this case “poor time management,” and to provide some
initial ideas for coping strategies. This sort of review also allows treatment
to be personalized to the individual’s circumstances, thereby making it a
relevant and salient opportunity to strategize for the implementation of coping

To continue with the aforementioned example, the issue of “time management” related to being late for an
appointment could be the result of poor schedule-keeping (e.g., not having a
daily planner with a record of the appointment), disorganization (e.g., not
being able to find the piece of paper with the appointment date and time), poor
problem-solving (e.g., not thinking through options for obtaining the
appointment time, such as researching the number for the office and calling to
confirm), poor planning (e.g., not setting a realistic time frame for leaving
for the appointment, factoring in travel, parking, etc.), and becoming over
focused on distracting tasks (e.g., working on the computer), to name but a few
factors. Issues related to anticipations of the appointment may also create
barriers to follow through, such as feelings of anxiety (which can be
distracting and lead to avoidant behaviors) and task-interfering cognitions,
either negative (e.g., “This doctor will not tell me anything I have not
already heard”) or positive (e.g., “I’m sure there will be plenty of
parking” or “It won’t matter much if I’m late”).

Each of these components of “poor time management” offers an opportunity for change. As the various difficulties
associated with ADHD are identified, there will be recurring themes that emerge
and the various coping skills discussed can be applied to various situations to
improve overall functioning. It is not a “quick fix” and skills must
be implemented in a consistent fashion, but the combination of increased
recognition of the effects of ADHD and a plan for handling them provides a
template for making sense of what had previously been experienced as factors
beyond one’s control.

Can you give an example of a negative
behavior pattern in which an adult with ADHD may find him or herself stuck and
walk us through how CBT may be used to change that maladaptive behavior into a
more productive and positive one?

Procrastination is one of the most common problems reported by adults with
ADHD. Although virtually every patient with ADHD cites procrastination as an
issue, every individual’s struggle is unique.

After having defined procrastination as a target for
treatment, the patient is encouraged to share specific examples, preferably
recent ones, of procrastination in his or her daily life. We slowly and
collaboratively review in specific terms the ultimate goal of the task, be it
simple, such as organizing a shopping list, or more complex, such as writing a
paper for a college class. We then review the individual’s relationship with
the task, either recent experiences of procrastination or the current
anticipation of the task. That is, we discuss the plan for the task, the
component parts of the task in order to break it down into steps (also known as
“chunking”), identifying any potential barriers or factors that could
influence followthrough. An important aspect of this process also is to
explicitly explore the individual’s cognitive and emotional reactions at the
prospect of this task. That is, asking “what thoughts go through your mind
about performing this task?” and “what emotions do you notice when
you think about this task?” Another question we commonly ask is “what
is it like to be in your skin when you are facing this task?” The purpose
of these questions is to uncover the role of negative thoughts and emotions
that may contribute to procrastination. We also want to identify the person’s
“escape behaviors” and rationalizations, such as “I’ll check my
e-mail first and then I’ll get right to work.”

The CBT interventions operate in the way executive
functions are designed to operate, to help individuals to be able to plan,
organize, and choreograph their time, energy, and effort in order to accomplish
tasks that may not be immediately rewarding (although the small rewards of
completing small steps is often minimized) but that are associated with larger,
more rewarding outcomes.

Individuals identify the specific plan for implementing
specific skills on a specific day and time on a specific task to increase the
likelihood of follow through (e.g., “When you walk in the door after work,
you may drift towards the television and rationalize that you need to ‘veg
out;’ what can you do differently to make sure that you get your mail before
you sit down? Where can you sort through the mail for that day? What will you
say back to those rationalizations for procrastination?”). The process is
not always an easy one and it is common that change occurs in a “two steps
forward, one step back” manner, but these sorts of skills delivered in the
context of a relationship with a therapist who understands adult ADHD can be
helpful for many people. The goal is to make the coping strategies “sticky”
so that they go with the patient and can be remembered and used in daily life.


J. Russell Ramsay, Ph.D. Email correspondence/interview.
February 4, 2011.


Get organized!

The holidays are often a time of great stress for those with mental health challenges. It’s the same for those with ADHD – this ultra busy time of year demands exceptional organizational ability, abilty to handle stress, willpower to withstand the influences of too many goodies….all the things that are hard for folks with ADHD.

Yes, it’s a demanding time when the pressure is on to finish work, enjoy the time off with family and friends, but not blow the budget! The holidays are particularly challenging for those with impulse control issues. Last minute shopping is the norm, but fast purchases, often bought on credit, leaves a bit of mess come January.

This might be the time to think about giving yourself a holiday gift: make 2012 a year to take charge of your ADHD symptoms! If you are one of many whose ADHD has got in the way of your work, your school grades, or your relationships, take the time to think about how you are going to make some changes in the new year.

Learn as much as you can about how ADHD affects your life: it plays out differently with everyone. Think about your core challenges, and what type of support might be used to address them. Do you need a coach? A therapist? A med review from your physician? A new workout buddy?

And if it’s your child that has ADHD, this is also a time to plan for the year ahead. Have you been keeping good contact with his or her teachers this year? Does your IEP reflect their true needs, strengths and challenges? Are they headed toward a great June report card, or another year of disappointment?

Over the holidays, when you have time to slow down and think about what you want in the coming year, do yourself a favour and plan for some support, either for yourself or your child.

Contact me now to set up some early counselling sessions, either by phone or email, to get you headed in the right direction!

Happy Holidays to All!

Learn ADHD from the experts in Toronto

I am heading to the CADDAC conference this weekend in Toronto to hear Dr. Ross Greene, noted author of Lost at School and The Explosive Child.

We are lucky to live in a large urban centre which can attract experts on child development and related issues such as adhd in children. This is the 3rd annual conference for CADDAC. Dr. Greeene will be speaking with Dr. Anthony Rostain, a developmental neuropsychiatrist. The session is for parents and the medical community.

Often, well known trainers come to Toronto as part of large educational conferences for professionals, but often tack on a low-cost session for parents. They are often delivered with less “techno-babble”, and are a great way to learn up-to-the-minute information about your child’s issues.

The two will speak on Neurodevelopmental Disorders in the Home and Community.

I’m also planning to catch Dr. Rostain speak on Adult ADHD: Treatments and Strategies. He will address the combined use of medication and cognititve behavioral therapy, which has shown promise in recent research. He will address how CBT can improve the daily functioning of adults with ADHD.

Cognitive Behavioral Training is one of the treatment services I am trained to provide.

There will be other presentations this weekend relating to adults, including coaching, ADHD in the workplace, relationships, and parenting when you have ADHD.

The fee for the one day session on Adult ADHD is also reasonable. For more information, contact – space is limited!

I have also had the opportunity to hear Dr. Russ Barkley speak this fall in Toronto, another noted expert and author of Taking Charge of ADHD. He spoke on the key importance of emotional regulation as an area that has been overlooked in the understanding and treatment of ADHD in children and ADHD in adults. Dr. Barkley has conducted and published a huge amount of research in the field, and has graciously posted most of it at

I find it very helpful to listen to these experts speak on topics they are so knowledgable about, but in a way parents can relate to.  Sessions such as these allow you to become more informed, and meet others who are parenting similar children, or face the same adults issues as you do. Parent education is the second most important treatment for adhd in children, after medication!

Report cards out Monday

If this week’s report card isn’t what you expected, or you need some help clarifying what it means, call me for a free consultation. I’ll help explain what the comments mean about your child’s ability to learn – which are far more important than actual grades. Get an early appointment to help prepare for your parent-teacher interview later in the week. And remember: if you’re not ready, you can always ask them to book it later.

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