To learn more about ADHD diagnosis and symptoms, please read the first blog post in this series (https://www.tapclinicnc.com/post/what-is-adhd). The initial post discussed differences between inattentive, hyperactive, and combined presentations of ADHD; difficulties and issues to look for among adolescents with ADHD; and specific questions to ask to help determine if it would be useful to pursue an ADHD evaluation and treatment. The following blog will turn its focus towards evidence-based treatment for ADHD.
Evidence-based Treatment for ADHD
Evidence-based psychological treatment refers to treatments that have undergone significant research to determine whether they are effective for a given condition or population they aim to treat. When the phrase “evidence-based” is used, this denotes that the research studies (typically including randomized controlled trials; RCTs) conducted to date provide evidence that the treatment is effective when used adherently. There are currently several evidence-based treatments that are commonly used for children, adolescents, and adults with ADHD described in further detail below.
Medication Versus Therapy:
Currently, medication interventions (primarily prescription stimulant medications) are commonly used to treat ADHD. For individuals with ADHD, the research and clinical use are often with stimulant medications such as Adderall or Ritalin. Evidence suggests that the stimulants can be helpful at reducing symptoms; however, they often come with unwanted side effects such as appetite suppression, sleep difficulties, irritability, and possible addiction. There are also non-stimulant medications that are available; however, there is not as much research on these medications compared to stimulant use for ADHD. Given the side-effects of many ADHD medications, some individuals choose to seek therapy for ADHD without medication. This is effective for some and insufficient for others. Most of the current research shows that individuals with ADHD tend to see the most improvement when they engage in a combination of medication and evidence-based psychological treatment. Many adolescents and adults respond well to evidence-based psychotherapy interventions (described below), including Cognitive and Behavioral Therapy (CBT). If you suspect that you or your child have ADHD, you might consider meeting with a psychiatrist for a medication evaluation to determine whether medications could be useful.
School-based Interventions:
For children, school interventions utilizing Cognitive Behavioral Therapy (CBT) are commonly used and involve helping children improve their school success by involving both teachers and parents. These programs are often included in schools as part of programs to support students with learning disabilities (e.g., 504 plans or IEPs). Children learn coping skills and receive specific accommodations to help improve their ability to stay focused in class and complete assignments on time. Parents also receive daily reminders and checklists to help their children stay on top of their assignments. If your child has ADHD, it is recommended that you speak to a school counselor or psychologist to ask about any accommodations and programs (including a 504 plan) for which your child might qualify to best support your child’s success in school. More information about these programs can usually be found on a school’s website under counseling and/or disability services.
Cognitive Behavior Therapy (CBT):
Two of the most researched evidence-based treatments for ADHD are called “Overcoming ADHD in Adolescence” and “Mastering Your Adult ADHD”. Both interventions utilize CBT to help adolescents and adults with ADHD increase coping skills to improve executive functioning (i.e., planning, decision, organization, etc.) and attention/concentration, while reducing symptoms of ADHD such as impulsivity and hyperactivity. Typically, treatment includes approximately 12 to 16 weekly individual therapy sessions with homework assignments to give individuals the coping skills they need to improve overall life functioning/management as well as academic and job performance.
ADHD Coaching
ADHD coaching is considered a psychological treatment that is commonly delivered by mental health professionals such as psychologists, social workers, or counselors. Although it is not currently considered an evidence-based treatment (more research is required), there are many published case studies on the effectiveness of its use. ADHD coaching can be used for both adolescents and adults who wish to decrease their symptoms through changes in their daily behaviors/patterns. An ADHD coach teaches individuals coping strategies to help improve their organizational, planning, task completion, and other associated skills by checking-in several times during each week. ADHD coaching is different from other psychological interventions in that individuals typically meet with the coach several times per week, meet for a shorter duration of time (e.g., 15-30 minutes), and focus exclusively on ADHD symptoms and their effect on day-to-day functioning. In addition, phone calls, texts, and emails can be used in between sessions to help remind individuals of therapy homework assignments, to-do lists, and other items/tasks that are relevant to the treatment. When looking for ADHD coaching, we recommend consumers search for providers with substantial expertise in ADHD who are also training in evidence-based protocols such as CBT.