Efficacy of Cognitive Behavioral Therapy With and Without Medication for Adults With ADHD: A Randomized Clinical Trial

Abstract

CBT + medication outperformed CBT alone for ADHD symptoms, organizational skills, and self-esteem, although its superiority tended to decrease over follow-up.

Long-Term Efficacy of Psychosocial Treatments for Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review

“…Meta-regression results indicate that follow-up length (from 3 to 12 months) does not predict treatment efficacy, which further supports the stability of the gains. In addition, the results indicate that medication is a factor that influences treatment effectiveness, according to the CGI measure, which increased when the percentage of medicated participants was greater, supporting the conclusions of several previous RCTs (Philipsen et al, 2015 ; Cherkasova et al, 2016 ). This finding offers empirical support for the combination of psychotherapy, particularly CBT, and pharmacotherapy as the most effective treatment option for adults with ADHD.…”

“…From 236 records, nine RCTs and three uncontrolled single-group pretest-posttest studies were identified and included in the quantitative review, based on the reading of full-text reports (Figure 1 ). Two RCTs were excluded from between-groups, but included in within-subject meta-analyses, because the control group was not assessed at follow-up (Pettersson et al, 2014 ) and all groups received specific ADHD psychotherapy (Cherkasova et al, 2016 ). Thus, finally, seven and 12 studies were included in the between-groups and within-subject meta-analyses, respectively.…”

“…A number of studies have evaluated the efficacy of such interventions in the long-term, and demonstrated that it is maintained from 3 to 12 months after the end of the treatment (Safren et al, 2010 ; Salakari et al, 2010 ; Emilsson et al, 2011 ; Pettersson et al, 2014 ; Fleming et al, 2015 ; Salomone et al, 2015 ; Young et al, 2015 ; Cherkasova et al, 2016 ; Gu et al, 2017 ; Nasri et al, 2017 ), although the magnitudes of the reported effects are heterogeneous. The largest clinical trial so far published in the field found that groups receiving psychosocial therapy had superior outcomes to active control groups at follow-up only in the CGI measure, but not in ADHD symptoms (Philipsen et al, 2015 ).…”

Long-term Effects of Multimodal Treatment on Adult Attention-Deficit/Hyperactivity Disorder Symptoms

“…Current evidence on follow-up assessments of cognitive behavioral therapy (CBT) in adults with ADHD is limited in terms of sample size and shorter follow-up periods compared with COMPAS. 6 , 51 , 52 , 53 , 54 , 55 , 56 A 2018 meta-analysis on long-term efficacy of psychosocial treatments for adults with ADHD 57 found evidence of sustained effects of ADHD-specific psychosocial treatment approaches on ADHD symptoms for at least 12 months.…”

Managing Side Effects in CBT for Adult ADHD

“…Similarly, after establishing some degree of progress, shorter-length follow-up sessions can be employed, such as 30-minute meetings, and costs prorated accordingly; on the other hand, sessions can be spaced out to reduce the costs of travel, such as meeting every other week. Planned coaching contacts between sessions (see, for example, Cherkasova et al, 2016) can be used to further promote follow-through, and in the future, credible and accessible online content may become increasingly available to further support CBT-based coping principles.…”