Focused talk therapy helps adults with ADHD


Roughly 9 million American adults (4.1% to 4.4% of the population) are thought to suffer from attention deficit and hyperactivity disorder (ADHD). And even among those who have been diagnosed and medicated for the condition, life can be a continuing cycle of disorganization, procrastination, missed deadlines and unfinished business.

A form of psychotherapy that focuses on changing patterns of thought and behavior that are counterproductive can help these adults, a new study concludes.

The study, published Wedneday in the Journal of the American Medical Assn., or JAMA, finds that 12 sessions of “cognitive/behavioral therapy“--50-minute sessions that aimed to educate, coach and devise strategies to improve and sustain focus -- helped subjects live and work more effectively. And those subjects were better at doing so than others who spent 12 sessions learning a relaxation technique and getting general “supportive therapy.”

Nine months after getting the specialized form of cognitive behavioral therapy, the adult ADHD sufferers were still more organized and focused.

The subjects getting cognitive behavioral therapy spent several sessions learning about their disorder, and getting instruction on techniques to keep them organized, including use of calendars and task-list systems. Two sessions were spent learning techniques to reduce distractibility, such as writing down distractions while working on a task, rather than acting on them. Subjects also learned to break down overwhelming jobs into smaller tasks, and to recognize and respond more effectively to challenges that caused stress.

The study is among the first to rigorously to compare “psychosocial” methods of helping those with ADHD. Its findings suggest that this highly structured form of psychotherapy might be the best “next step” for adults who take medications for ADHD but still have problems with focus. The authors cautioned that it’ll take more study to determine whether the same technique might be a good first-line treatment for adults with ADHD who cannot or will not take the medications -- mostly stimulants -- that are typically prescribed for the condition.

Cognitive behavioral therapy is enjoying a growing reputation for effectiveness for a wide range of mental disorders. In addition to the longstanding finding that the technique is effective in treating anxiety, recent studies have found the focused form of talk therapy useful in lessening the tics and accompanying anxiety and depression symptoms of Tourette’s Syndrome, in improving function in children and adults with obsessive-compulsive disorder, and in adults with post-traumatic stress disorder. A form of cognitive behavioral therapy for families immediately affected by suicide was found to reduce self-blame and grief reactions that were considered unhealthy.

-- Melissa Healy / Los Angeles Times