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Evidence Based Treatment For ADHD in Adults
ADHD affects people in ways that impact their work, home and relationships. Treatments typically include medication, skills training and psychological counseling.
Atomoxetine (Strattera) is the only FDA-approved non-stimulant drug for adults with ADHD. It is safe and effective, as per research. Psychosocial interventions that address issues with organizational skills and comorbid disorders have a solid evidence base, particularly behavioral parent training (BPT). However, precision in psychosocial guidelines is not easy to achieve.
Medication
For many people with ADHD, a combination of medication and psychosocial treatment is the best method to manage their symptoms. Medication has been shown to be very effective in reducing symptoms of ADHD, but it can take some time for someone to see results. Talk to your doctor if you're considering taking medication to improve your ADHD symptoms. Be sure that the medication is safe for you and that it doesn't interact with other medications you take.
People with ADHD may have trouble focus and concentration, regulating impulses and planning tasks on time. These difficulties can affect work, school and social relationships. These difficulties can also make it hard to relax and enjoy leisure activities.
The most effective treatment for ADHD is medication. They can reduce or eliminate the requirement for psychosocial interventions and can enhance the quality of life. Fortunately, medications do not cause addiction and have an extremely low chance of being misused. People suffering from ADHD are able to benefit from stimulants, as per several studies. People who are unable to tolerate the negative effects of stimulant medication can opt for non-stimulants like atomoxetine (Strattera).
The medication isn't the only answer. A thorough assessment should include a detailed description of ADHD symptoms and the effects they have on daily functioning. It is also important to determine if the person suffers from any comorbid conditions like depression or anxiety, which could affect the response to therapy and medication.
A medical examination will generally not reveal any symptoms of the disorder. However, a diagnosis is based on clinical judgment, and an history of symptoms that began in the early years of childhood. In addition to a detailed interview, collateral information like school records and health assessments can aid in establishing a diagnosis.
There are a myriad of psychosocial therapies available for ADHD, including metacognition and cognitive rehabilitation. These psychosocial treatments do not seem to be as effective as pharmacotherapy, and are not likely to have the same effectiveness. Patients are advised to begin with a low-dose medication that can be paired with behavioral therapy.
Psychotherapy
Many people with ADHD discover that talk therapy or psychotherapy can help improve their lives. Certain studies suggest that certain forms of talk therapy, like cognitive behavioral therapy (CBT) and relapse prevention therapy (RPT) can help alleviate symptoms of ADHD. Talk therapy is a kind of psychosocial treatment which involves one-on-one sessions with a professional counselor or therapist. There are many kinds of therapy that can be used, and the therapist you choose should be based upon your goals and needs.
A common approach to treating adult ADHD is to employ a combination of medication and psychotherapy. Studies have demonstrated that combining medication and psychotherapy is more effective than either method alone. This method is also recommended by the National Institute of Mental Health (NIMH).
Talk therapy or psychotherapy can help you manage ADHD symptoms and manage these symptoms. It can also teach you strategies to cope with issues in your work, relationships and school. Based on your goals and needs, your therapist may recommend that you participate in individual or family therapy.
Cognitive behavior therapy (CBT) is a type of psychotherapy that helps adults with ADHD improve their self-esteem and functioning. CBT helps you learn how to recognize and alter negative thoughts that can influence your mood and behavior. For instance, CBT can teach you to shift your "all or nothing" thinking, which can cause people with ADHD to believe that they must do everything flawlessly or not at all.
In a therapy session your therapy therapist listens to you and asks questions to gain a better understanding of your thoughts and feelings. The therapist will then offer advice based on their experience and research. They might also provide you with homework assignments, such as journaling or trying something new. It's crucial to complete the homework as it will allow you to practice what you've learned.
It's important to keep in mind that seeking treatment is not an indication of weakness. It's a courageous choice to live the life you've always wanted. With the structure and support that you build through psychotherapy, you will be able to attain your most important goals and dreams.
Education
Education can be an effective instrument to assist adults with ADHD. Classes can be taught to improve communication skills, to learn to manage tasks and to learn how to communicate with other people. Therapy that focuses on teaching the patient to identify their symptoms and how they affect their behavior can also be helpful. This can be accomplished in a private session or group therapy.
Research has shown that a variety of psychosocial treatments can reduce problematic symptoms in ADHD individuals and improve their performance. Educational interventions can help improve academic performance and self-reporting of ADHD symptoms. A variety of behavioral and cognitive treatments have been proven to be effective, such as hypnotherapy, neurofeedback, metacognitive training, and cognitive remediation. Nevertheless they are not all have been proven superior to alternatives. Further studies are needed to verify the results.
In a study, an educational program that taught students to identify their own inattention and impulsive behaviors was discovered to be more effective than a waitlist control in improving self-report ADHD symptoms. Another study showed that a daily behavior report card improved academic performance for children with ADHD. Training for parents to be more observant has been proven effective in decreasing negative parenting behaviors and enhancing positive family functioning, but the impact of self-directed parenting training for parents versus therapist-led parenting needs more research.
Adolescents who have ADHD are at a greater risk danger of driving accidents that result from impaired thinking, like crashes that cause injuries or even death. The intensive summer "bridge" programs have been shown to improve driving abilities in adolescents suffering from ADHD. Other psychosocial interventions have been found to be helpful such as central executive training and training for working memory.
Adults with ADHD often have trouble maintaining a stable job or relationships. Inability to organize their lives and inability to finish or follow through on tasks and inattention and impulsive behavior can leave coworkers and family members angry. Psychotherapy that helps patients improve their communication skills can help manage these difficulties. Couples counseling can help partners resolve issues that arise.
Counseling
Although medications are effective for a large number of people with ADHD, it is not always enough to eliminate the severity of symptoms. The effects of medication can be unpredictable and they can affect some people in different ways. For this reason, counseling is an important component of the overall treatment plan. Counseling can help patients discover better methods to manage their emotions, improve their relationships and self-esteem, as well as learn strategies to face the unique challenges associated with living with ADHD.
The efficacy of psychosocial treatment for ADHD has been proven through multiple randomized controlled trials. A few studies showed that when a combination of behavioral therapy and medication is used, both parents and students' perceptions of academic performance improves. In more information , studies have demonstrated that using a low dose of stimulant medication with behavioral therapy can improve classroom behavior and homework performance in comparison to a control.
In a recent research study, high school counselors were instructed to implement two brief homework and organization strategies for students suffering from ADHD. The interventions were compared to the initial course, which contained a low dose medication. The results suggest that a sequential multi-assignment randomized trial may be a viable method to bridge the gap between research and practice in school-based treatment for ADHD.
Before attempting medication, it is recommended that schools implement ADHD intervention that includes behavior management and parent education. A combination of pharmacotherapy and psychosocial interventions should be the first option for treating adolescents and adults. For adults and adolescents the first drug to be considered should be stimulants (methylphenidate, dexamphetamine or lisdexamfetamine) as long as they are able to use these medications due to any other health conditions. In such cases either atomoxetine, or guanfacine may be considered.
A thorough medical exam should be performed to determine if there are any other conditions that may interfere with learning and functioning, including neurological disorders (such epilepsy, Tourette's Syndrome, or cerebral palsy), nutritional problems and substance abuse disorders (SUD) chronic diseases such as asthma, and comorbid mental disorders. If the exam and history are unremarkable and the diagnosis is not clear, ADHD can be determined by a licensed psychologist or psychiatrist using established diagnostic criteria.
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