Symptoms of ADHD
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, meaning the onset of ADHD occurs in childhood, although diagnosis can occur at any age. The symptoms of ADHD are characterized by a consistent pattern of inattention, hyperactivity or both.
Individuals with the inattentive presentation of ADHD often struggle to follow through and stay focused on even simple tasks, have trouble listening and are easily distracted. Individuals with the hyperactive presentation of ADHD often fidget with their hands or objects, have difficulty sitting still or staying seated when necessary and interrupt others when speaking.
Individuals with a combined presentation experience a combination of all of the aforementioned symptoms. As a result of these symptoms, children with ADHD often struggle academically and have a harder time making friends and maintaining healthy social relationships (APA, 2013).
Can ADHD be cured or treated?
ADHD has been shown to respond incredibly well to treatment. There are many ways to go about treating ADHD, but the most effective and highly-recommended approach to treating ADHD is multifaceted. Research has found medication to be incredibly effective at reducing ADHD symptoms (MTA Cooperative Group, 1999).
The most common medications used to treat ADHD are stimulant medications such as Adderall or Ritalin, but other non-stimulant medications such as Strattera have also been proven effective (Cortese et al., 2018). In addition to medication, psychotherapy has also been proven to significantly help individuals with ADHD, especially in combination with medication.
Executive coaching is also helpful for individuals with ADHD who struggle with organization or time management (Parker and Boutelle, 2009). While ADHD can not be “cured,” when treated, individuals with ADHD can improve significantly (MTA Cooperative Group, 1999).
ADHD treatment for Kids
In order for a child to be diagnosed with ADHD, symptoms must be observed in two or more settings (home, school, with friends, etc.) (APA, 2013). Therefore, for children with ADHD, it is important that the child’s family and school are involved in treatment, along with the child themselves.
Having a child with ADHD can be incredibly difficult for parents and siblings, so family therapy and/or parent coaching can be incredibly valuable. Children with ADHD can also benefit greatly from having additional support in school, such as one-on-one educational attention or academic accommodations.
For the children themselves, the American Academy of Pediatrics recommends behavioral therapy as the first-line treatment for children under six, and a combination of behavioral therapy and medication for children over the age of six (AAP, 2019).
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ADHD treatment for Adults
For adults with ADHD, the recommended treatment is also multifaceted. Medication has also been proven effective in adults, although behavioral psychotherapy is also recommended (MTA Cooperative Group, 1999). However, for adults psychotherapy as a means of ADHD treatment goes beyond simply managing symptoms.
Because of the social and academic/professional difficulties that can come as a result of having untreated ADHD, many adults who go undiagnosed until adulthood have suffered throughout their lives. Therefore, it is important that psychotherapy for adults who are diagnosed with ADHD later in life provides the space for the client to address the ways their ADHD has impacted their past, as well as work on managing their current symptoms (Ramsay and Rostain, 2005).
Additionally, adults with ADHD are also more likely to suffer from other psychological disorders such as anxiety, depression and substance abuse. It is important that clinicians are able to make differential diagnoses and provide appropriate treatment (Barkley and Brown, 2008)
Why cognitive behavior therapy is the best ADHD treatment
Many studies have shown that cognitive-behavioral therapy (CBT) is incredibly effective in reducing ADHD symptoms in adults. One study conducted in 2012 found that individuals participating in CBT but not taking medication improved just as much as individuals in CBT who were taking medication (Weiss et al, 2012).
Another study from 2016 concluded that CBT was effective in helping reduce the severity of ADHD symptoms in adolescents who were not improving from medication alone (Sprich et al., 2016). There are many reasons why CBT is so effective for individuals with ADHD. Many adults who were not diagnosed with ADHD until later adulthood report feeling “dumb” or “lazy” throughout their lives as they struggled to accomplish what they set out to do.
While a diagnosis of ADHD can be a relief for these individuals, many of them have internalized these beliefs about themselves. These, and other negative core beliefs we have about ourselves, can impact the way in which we think, feel and behave. CBT is designed to help individuals address and challenge their negative core beliefs, and improve their self esteem – something that individuals with ADHD benefit greatly from (Newark and Stieglitz, 2010).
CBT also includes psychoeducation, which is educating clients about their diagnosis, in this case ADHD. Psychoeducation for clients with ADHD and their families has been shown to be an important aspect of treatment (Ramsay and Rostain, 2005).
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How to look for in ADHD treatment in NYC
If you are looking for treatment for ADHD for yourself or your child, it is important to first consider what type of treatment you are looking for. Pediatricians are often very familiar with working with children with ADHD and can be a good place to start. If you are curious about medication, you will want to schedule an appointment with a Psychiatrist or Psychiatric Nurse Practitioner.
These are the professionals who are able to prescribe and manage medication. If you are looking for behavioral psychotherapy as a means of treating ADHD, you will want to look for therapists who specialize in behavioral therapy, and have experience working with ADHD.
Finding a therapist can be daunting, and often takes time. Do not be afraid to try working with a few different therapists until you find one who you feel is a good fit. Also, the cost of therapy varies significantly, but there is still high quality therapy available at lower costs.
Try looking for practices with intern programs, sliding scale options or who take insurance – all of these options can provide you with effective therapy within your budget. Many neighborhoods in NYC also have community health clinics which provide low- or no-cost therapy.
What to expect ADHD treatment in New York Behavioral Health
ADHD treatment at New York Behavioral Health will utilize Cognitive Behavioral Therapy to help you improve your ADHD symptoms. Your therapist will work with you or your child to assess the ways in which ADHD is interfering with quality of life, and help you to identify goals for treatment.
Your therapist will provide you with specific interventions to improve focus and reduce impulsiveness, as well as improve mood and alleviate anxiety. This, in turn, will help you be better able to achieve your goals and improve the quality of your interpersonal relationships.
Your NYBH therapist will also communicate with medication prescribers, executive coaches and/or school personnel in order to make sure your treatment is cohesive and effective.
References:
American Academy of Pediatrics, Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of children and adolescents with attention‐deficit/hyperactivity disorder. Pediatrics, September 30th, 2019.
A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. (1999). Archives of general psychiatry, 56 (12), 1073–1086. https://doi.org/10.1001/archpsyc.56.12.1073
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) https://doi-org.ezproxy.cul.columbia.edu/10.1176/appi.books.9780890425596.dsm01
Barkley, R., & Brown, T. (2008). Unrecognized Attention-Deficit/Hyperactivity Disorder in Adults Presenting with Other Psychiatric Disorders. CNS Spectrums, 13(11), 977-984. doi:10.1017/S1092852900014036
Cortese, S., Adamo, N., Del Giovane, C., Mohr-Jensen, C., Hayes, A. J., Carucci, S., Atkinson, L. Z., Tessari, L., Banaschewski, T., Coghill, D., Hollis, C., Simonoff, E., Zuddas, A., Barbui, C., Purgato, M., Steinhausen, H.-C., Shokraneh, F., Xia, J., & Cipriani, A. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 5(9). https://doi.org/10.1016/s2215-0366(18)30269-4
Newark, P.E., Stieglitz, RD. Therapy-relevant factors in adult ADHD from a cognitive behavioural perspective. ADHD Atten Def Hyp Disord 2, 59–72 (2010). https://doi.org/10.1007/s12402-010-0023-1
Parker, D.R. and Boutelle, K. (2009), Executive Function Coaching for College Students with Learning Disabilities and ADHD: A New Approach for Fostering Self-Determination. Learning Disabilities Research & Practice, 24: 204-215. https://doi-org.ezproxy.cul.columbia.edu/10.1111/j.1540-5826.2009.00294.x
Ramsay, J. R., & Rostain, A. L. (2005). Adapting Psychotherapy to Meet the Needs of Adults With Attention-Deficit/Hyperactivity Disorder.Psychotherapy: Theory, Research, Practice, Training, 42(1), 72–84. https://doi-org.ezproxy.cul.columbia.edu/10.1037/0033-3204.42.1.72
Sprich, S. E., Safren, S. A., Finkelstein, D., Remmert, J. E., & Hammerness, P. (2016). A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents. Journal of Child Psychology and Psychiatry, 57(11). https://doi.org/10.1111/jcpp.12549
Weiss, M., Murray, C., Wasdell, M. et al. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC Psychiatry 12, 30 (2012). https://doi.org/10.1186/1471-244X-12-30
