Attention deficit hyperactivity disorder (ADHD) is often complicated by long term impairments that persist throughout life (persistence rate 30-75%). Ramsay reports that these impairments often require the use of pharmacotherapy and adjunctive psychosocial treatment for adequate treatment. Recently there has been a surge in research looking at psychosocial treatments for adult ADHD, which are highlighted in this paper, including (i) psychoeducational therapy, which looks similar to cognitive behavioral therapy (CBT) focused on coping strategies; (ii) modified CBT called group dialectical behavioral therapy (DBT) yielding a substantial improvement in ADHD impairments; and (iii) cognitive remediation program either in group or as self-directed treatment. Two additional strategies that have produced significant improvements on measures of mood, anxiety and overall functioning are manualized versions of CBT and problem-focused therapy (PFT). Ramsay emphasizes that the central outcome from any of these psychosocial treatments is to help adults with ADHD to institute effective coping regimen, effective problem-management approaches and maintain adaptive outlooks about themselves and their circumstances. Nonetheless, Ramsay reviews the limitations of and future directions for psychosocial treatment research. The main caveat for extant psychosocial studies is that most have been clinic-based outcome studies without use of random assignment or control groups. [It should be noted that two randomized control studies of psychosocial treatments for adult ADHD have been published since Ramsay’s article appeared.] Ramsay also suggests that study participants may not adequately reflect the severe end of the impairment continuum or adequate ethnic diversity. A clinically useful focus of future psychosocial studies is reaching patients with ADHD who decline or cannot use or benefit from medications. Opportunities to integrate technology to extend the benefits of treatment may also be utilized, such as websites, cell phones and text messaging for gathering data in a timely manner on behavior at certain point of performance.
Ramsay JR. Evidence-Based Psychosocial Treatments for Adult ADHD: A Review