Many young adults who are struggling with mental health experience some form of executive dysfunction, impacting their ability to manage emotions, complete daily tasks, or plan for the future. And for family members – the urge to step in and help may be strong. 

“Therapists often see highly organized and high-functioning family members who have unintentionally started to ‘over-function’ for their loved ones,” explains Amie DiTomasso, LICSW, MPH, Director at The Dorm D.C. “However, doing tasks or solving problems for them can actually exacerbate the dysfunction in the long run.”

We spoke with Amie, who is the leader of our popular Parent Collective group at The Dorm, to help families understand what’s actually happening when young adults are struggling with practical tasks, self care or time management, and to offer some practical tips and reminders for how to help them gain independence, confidence, and build executive functioning skills for the long-term.

Key Article Takeaways

What is executive functioning?

Executive functioning encompasses the mental processes that support planning, decision-making, focused attention, working memory, and self-regulation. These functions are essential for goal-directed behavior, attention, organization, and regulation. The eight key executive functions that therapists usually talk about include: 

1. Impulse Control – The ability to resist urges and stop oneself from acting impulsively.
2. Emotional Control – Managing emotions in a way that helps accomplish tasks or goals, rather than letting emotions disrupt progress.
3. Flexible Thinking – The capacity to adapt and shift thinking or approaches when circumstances change.
4. Working Memory – Holding information in mind while using it to complete a task or make decisions.
5. Self-Monitoring – Being aware of one’s own performance, thoughts, and behaviors, and adjusting as necessary.
6. Planning and Prioritizing – The ability to develop strategies to reach goals, including identifying the most important tasks and steps.
7. Task Initiation – Starting tasks without unnecessary procrastination, even when they seem difficult or uninteresting.
8. Organization – Keeping track of materials, information, and tasks in a logical and efficient way.

How do I know if my young adult loved one is struggling with executive functioning? 

At The Dorm, we see several common signs that indicate our clients are struggling with executive functioning. Common indicators we look out for include:

• Time blindness, or an inability to plan for and keep in mind future events
• Difficulty stringing together actions to meet long-term goals
• Trouble organizing materials and setting schedules
• Trouble controlling emotions or impulses
• Difficulty analyzing or processing information
• Making decisions that don’t align with deadlines or priorities
• Problems maintaining personal hygiene and basic self care 

“Difficulty organizing meetings, schedules, or responsibilities—and knowing where they’re supposed to be and when–is a common sign of executive dysfunction. Sometimes it can be difficult to even recall what day of the week it is.” – Amie DiTomasso, LICSW, MPH

What causes executive dysfunction?

There are many causes for executive dysfunction, but it’s important to know that all executive dysfunction is related to the brain, and can be caused by several factors. The most common factors include developmental differences, neurodivergent development, substance use, psychosis, sleep disorders, or even genetics. 

These symptoms are often associated with diagnoses of ADHD, Autism, anxiety disorders, or trauma/PTSD, but can also include many others. (Learn more about treatment and the different diagnoses we work with at The Dorm.)

“A neurodevelopmental challenge, such as ADHD, is one common diagnosis for those struggling with executive functioning. Trauma is another significant cause – after a traumatic event, individuals may experience cognitive impairments, making it difficult to stay present, organize, or implement a plan. Depression and mood disorders are also key contributors. Severe depression, for example, can greatly impact executive functioning. While these are three primary causes, they’re not exclusive.” – Amie DiTomasso, LICSW, MPH

The good news is that the brain is malleable, and with the right treatments your loved one can improve their functioning and gain new skills and systems in order to thrive.

How can I support my loved one to overcome executive dysfunction?

Leave Space for Natural Consequences

As the most common example of what our team often sees happening in family dynamics, the first thing to focus on is leaving space for natural consequences to actions (or inactions) to occur for the young adult.

“With the best of intentions, parents might complete their child’s schoolwork or submit applications on behalf of their young adult. While this ensures short-term success, it prevents the young adult from experiencing natural consequences, such as missing a deadline or not securing an internship. Over time, this can hinder their ability to function independently. Parents and family members won’t always be there to step in, so allowing natural outcomes is essential for growth.” – Amie DiTomasso, LICSW, MPH

Get Specific

Begin by having an open and empathetic conversation about the specific areas where they face difficulties. For example, they might struggle with time management, such as consistently being late or missing deadlines. They could also have trouble with organization, like keeping their workspace tidy or managing their schedule. 

With more clarity about the specific challenge they are facing, you’ll both be in a better position to seek out therapeutic or treatment opportunities. 

Reflect on Past Challenges & Successes

Encourage your loved one to think about past situations where they faced similar challenges and successfully navigated them. 

For instance, if they previously struggled with completing a big project but managed to finish it by breaking it down into smaller tasks, remind them of this accomplishment! On the other hand, if during that task they had worked with a coach or teacher to complete it, asking for help when needed is another essential skill to celebrate and rely on. 

Reflecting on these past experiences can help identify effective strategies and coping mechanisms that they can apply to new challenges.

Model the Behavior

Demonstrate effective executive functioning skills in your daily life as a way to provide a living example for your loved one. For instance, plan your week on a calendar or a to-do list in a visible space. When faced with a problem, verbalize your thought process for solving it, such as breaking it down into smaller steps or prioritizing tasks. Additionally, practice emotional regulation by staying calm and composed in stressful situations. 

It may also be helpful to speak with a therapist or counselor about specific steps you can take to reach your own functioning goals to be of best support to your young adult.

Seek out Neuropsychological Testing

Accurate and comprehensive neuropsychological testing can be an encouraging and educational tool for helping your loved one identify what’s going on with their executive functioning abilities. As we’ve outlined in previous blog posts, Neuropsych testing can help identify neurological differences, forms of neurodivergence like ASD or ADHD that may be impacting their ability to perform tasks. 

What behaviors should I avoid if my loved one is experiencing executive dysfunction?

Labels & Name-Calling

When supporting someone with executive dysfunction, it is important to avoid certain behaviors. Do not engage in name-calling (e.g., “You’re so lazy!”). Also avoid comparing one person to another, or one child to another, or equating executive functioning with intelligence level. 

As one clinician at The Dorm explains, “Executive dysfunction has very little to do with intelligence level. It’s about how a student takes in information, takes in all the variables surrounding the information, organizes it all, processes it, and then understands how to navigate the impulses that come up that make them say, ‘I’m not doing this,’ or, ‘I can’t do this.’” 

Performing the Task Yourself

Especially for parents, it’s important that you don’t do tasks for your young adult that you know they can do themselves. This includes not evaluating and expressing how simple a task is based on your own experience. 

Over-Praise or Comparison

Along the same lines, while genuine praise and admiration may be valuable to your loved one, it’s important not to go overboard in recognizing a helpful behavior, and especially important to not make passive comments about their ability to continue it. Everyone’s ability differs from week to week and day to day. 

On another note, if your loved one has more recently faced challenges with executive functioning, don’t compare them to how they were in high school or earlier childhood, which was a completely different environment and experience. 

Executive Functioning Support at The Dorm

We offer a variety of both group and individual support options for young adults to build executive functioning skills. 

• First and foremost is our Executive Functioning Skills Group, which focuses on different executive functioning skills tailored to the individual. Our community supports clients in adapting several executive functioning skills to meet the client’s specific needs. 

Other groups include: 

• Cognitive Behavioral Therapy (CBT) groups are also helpful. CBT helps clients recognize thought patterns, behaviors, and emotions, building awareness and tools for change.
• Dialectical Behavioral Therapy (DBT) skills, like behavioral activation, support executive functioning. 
• DBT for Neurodiverse Clients is designed to help clients with ASD, ADHD, or other forms of neurodivergence with the essential skills of DBT in a supported community environment. 
• Learning Labs —spaces where clients can break down work tasks, like school assignments, and focus on getting them done.

Lastly, solutions-focused individual coaching (motivational coaching) can help clients analyze obstacles, create actionable plans, and implement them. Motivational interviewing techniques also guide clients toward meaningful change.

A Closing Reminder

In closing, Amie offered family members a simple reminder to fall back on when they feel the urge to ‘over perform’ for their loved one. 

“One important strategy is to reframe conversations with your loved one with the goal of asking an open-ended question, and put the responsibility back on the person. For example, instead of saying, ‘This is what you have going on this week’ ask, ‘What do you have going on this week?’ This slight adjustment in language fosters critical thinking and allows the individual to identify and organize their tasks rather than relying on someone else to do it for them. It’s a small but impactful way to encourage autonomy and skill-building.” – Amie DiTomasso, LICSW, MPH

Thank you, Amie!

Apps to Support Executive Functioning

• iPhone Native Settings: For setting time limit reminders.
• Pomofocus.io: For listing tasks and working with the Pomodoro technique.
• Paprika App: For meal planning and grocery shopping.
• SuperBetter: For “gamifying” daily tasks like brushing teeth, drinking water, and packing a work bag.
• Finch: A self-care pet app with personalized exercises.
• TickTick: A to-do list, checklist, and task management app.
• Evernote: A note-taking and task management application.