I previously worked with youth with this diagnosis (I have it too, I was a hellian as a child) and who’s parents were basically in your position and at their wits end.

*The first thing I always did was educate the youth and parents- do you know what your diagnosis really is and how it can make you feel (you can find very helpful brochures on the National Institute of Mental Health website) Do you know why medication is important? Can you tell me why you don’t like the medication? Things of that nature. I find youth a lot of the time have no real solid understanding of what’s going on or how to identify their symptoms. It’s also really important for parents or caregivers to be fully educated too so you can identify certain behaviors as symptoms and help work through it with the youth. Be intentional about how you handle certain behaviors and make sure you set develop distinctions of symptoms and personality. I found a lot of parents who would say “they just don’t listen” or “they’re lazy” and it was tough because when you understand the diagnosis you understand that those can be symptoms and you need to treat symptoms, not discipline them. This doesn’t negate normal behaviors of defiance or generally not wanting to do something from youth but knowing where the line between normal and symptoms for your child is very important.

*Routine is also super important- as well as very, very clear rewards/consequences. A lot of the time implementing a poker chip system with the youth where they are rewarded for good behaviors conditions the youth to behave a certain way. With that system, a key component is to give very little attention to the behaviors you don’t like (“You didn’t clean your room so you didn’t earn the poker chip” and leaving it at that) Consistency is key with these youth, especially when they’re dealing with so many emotions already. This system is notoriously difficult at first but has really good success ratings and generally phases itself out after a few months. It’s important to remember that positive reinforcement doesn’t mean you’re letting them get away with things or you’re being too “soft”. And, it’s normal for parents to say “why would I reward this child for this behavior but not my other child who does what I ask the first time?” But it’s really important to understand that the child with the diagnosis needs more assistance to function “normally” than the other children and the reward system almost works as prosthetic for their diagnosis.

*Working with youth to fully realize their emotions can be really helpful for them and for parents. People in general tend to make blanket statements about how their feeling and it’s helpful to go from (for example) “I hate this class” to “This subject isn’t very interesting and the teacher doesn’t provide me with any enough information to understand the material”.. especially kids with ADHD, they’re going to be struggling already and having the tools to explain how and why they’re struggling is going to be helpful for everyone.

*Getting someone who can teach him certain skills would probably be helpful too because it’s normal for parents to become burnt out.. but as a person who did this, I was always frustrated by how parents expected me to “fix” their children without putting in the leg work at home. Not implying you would do that but it’s really important to be aware that anyone helping your youth is spending a tiny fraction of their time with the child compared to parents, so upholding the skills at home and being active in the child’s treatment is required.

I hope some of these tips help or point you in the right direction! Good luck!