Managing Side Effects in CBT for Adult ADHD

Knouse, Laura E.; Ramsay, J. Russell

doi:10.1521/adhd.2018.26.2.6

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…A further explanation for our results may be found in the problem activation ( 73 ) and self-awareness ( 74 ) taken place in psychotherapies. Although the aim of the psychotherapy in this study was also to activate the resources of every patients, it is important to note that only the patients of the CBT + MED group were confronted with their problems, weakness, and impairments.…”

Section: Discussionmentioning

confidence: 65%

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A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)—A Randomized Controlled Trial

et al. 2018

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In the treatment of adult attention-deficit/hyperactivity disorder (ADHD) the importance of psychological interventions in combination with pharmacotherapy is widely accepted in contemporary clinical routine. The natural course of the disorder seems to justify additional psychological interventions because even in patients who are highly compliant to pharmacotherapy full remission is not always achieved. The aim of the present study was to analyze the contribution of psychotherapy to the treatment of adult ADHD patients. In a randomized controlled study, the efficacy of a combined treatment of psychotherapy with pharmacotherapy is compared to pharmacological intervention alone. After initiation and stabilization of treatment with methylphenidate (MPH) in all subjects randomization to the two different treatment conditions was done. Afterwards both groups underwent treatment for about 10–12 weeks, the experimental group receiving sessions of cognitive-behavioral therapy (CBT) whereas the control group only received medication and standard clinical management (SCM). ADHD symptoms differed statistically during time but not between the two different treatment conditions. This result was the same for the single ADHD symptoms—inattention, hyperactivity, impulsivity, and emotional symptoms—and also for impairment. Individual standardized ADHD specific CBT program was not able to outperform SCM.

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Section: Discussionmentioning

confidence: 65%

“…Problem activation can trigger all kinds of protective and resistive mechanisms preventing change ( 73 ). Self-awareness may be accompanied by increased distress or lower self-esteem ( 74 ).…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)—A Randomized Controlled Trial

et al. 2018

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“…Second, we must carefully consider which additional constructs should be assessed as primary or secondary outcome measures. In addition, the RCT should include a specific measure of potential harms or side effects of the intervention, given that CBT can be associated with adverse effects [ 18 ]. Finally, we will need to decide on the most appropriate comparison or control group for a future RCT and will need to employ more rigorous data analytic methods with reduced potential for bias, such as multiple imputation to handle missing data from drop outs.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, access to therapists who are well trained in CBT for adult ADHD is limited and may not be available outside of urban centers. Second, traditional CBT for adult ADHD may have a high cost for clients, particularly in the United States healthcare system [18]. Finally, the skills taught in traditional CBT for ADHD can be challenging to implement in daily life, since treatment often takes place in an entirely different on this project, which included collaboration on study design, data collection, and preparation of the manuscript.…”

Section: Usability and Feasibility Of A Cognitive-behavioral Mobile A...mentioning

confidence: 99%

Usability and feasibility of a cognitive-behavioral mobile app for ADHD in adults

Knouse

Sachs³

et al. 2022

PLOS Digit Health

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Objective Cognitive-behavioral therapy (CBT) has growing evidence of efficacy for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Mobile health apps are promising tools for delivering scalable CBT. In a 7-week open study of Inflow, a CBT-based mobile app, we assessed usability and feasibility to prepare for a randomized controlled trial (RCT). Method 240 adults recruited online completed baseline and usability assessments at 2 (n = 114), 4 (n = 97) and after 7 weeks (n = 95) of Inflow use. 93 participants self-reported ADHD symptoms and impairment at baseline and 7 weeks. Results Participants rated Inflow’s usability favorably, used the app a median of 3.86 times per week, and a majority of those using the app for 7 weeks self-reported decreases in ADHD symptoms and impairment. Conclusion Inflow demonstrated usability and feasibility among users. An RCT will determine whether Inflow is associated with improvement among more rigorously assessed users and beyond non-specific factors.

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“…Professionals are cautioned that repetition is key, and strategies must be reinforced, or relapse is likely. Therefore relapse prevention is included in practice as well as model design [ 8 , 70 , 71 , 74 , 83 , 86 , 93 , 94 , 108 , 121 , 126 , 136 , 145 , 146 ]. Recommendations for resistance or avoidance of aversive emotional states is to provide therapist support to develop tolerance [ 107 , 122 , 135 ], reframe past experiences [ 112 , 128 , 147 ], and build resilience when encountering setbacks [ 8 , 111 , 118 , 137 , 138 , 146 ].…”

Section: Results and Analysismentioning

confidence: 99%

The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review

2021

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Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as accommodating context variability and heterogeneity. Research into alternative theoretical characterisations of ADHD is recommended to provide treatment design opportunities to better understand and address symptoms.

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Managing Side Effects in CBT for Adult ADHD

Cited by 5 publications

References 11 publications

A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)—A Randomized Controlled Trial

A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)—A Randomized Controlled Trial

Usability and feasibility of a cognitive-behavioral mobile app for ADHD in adults

The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review

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