Updated 14 July 2017

Behavioural therapy for adult ADHD

A form of behavioural therapy that focuses on practical skills may help adults with attention-deficit hyperactivity disorder (ADHD), a new study suggests.

A form of behavioural therapy that focuses on practical skills such as time management and planning may help adults with attention-deficit hyperactivity disorder (ADHD), a new study suggests.

ADHD is often thought of as a problem of childhood, but many adults have the disorder too.

A number of studies have found that ADHD medications are effective for adults, but there has been little research into whether behavioural therapy is helpful. The new study, published in the American Journal of Psychiatry, looked at the effectiveness of a newer type of behavioural therapy called meta-cognitive therapy -- which aims to give people new ways of thinking about and tackling their daily tasks and longer-term goals.

In this case, the therapy focused on helping adults with ADHD hone their time management, planning and organisational skills, according to lead researcher Dr Mary V. Solanto of the Mount Sinai School of Medicine in New York City.

How the study was done

For the study, Solanto and her colleagues randomly assigned 88 adults diagnosed with ADHD to attend small-group sessions of either meta-cognitive therapy or "supportive" therapy -- where patients met with a therapist for education and advice on dealing with their symptoms.

Patients in both groups had two-hour therapy sessions once a week for 12 weeks. Those in the meta-cognitive group also performed "home exercises" so they could put into practice whatever strategies they had learned during therapy.

At the end of the study, patients in the meta-cognitive therapy group showed greater improvements in inattention symptoms, which were assessed by an independent psychologist or psychiatrist who did not know which patients were in which group.

Overall, 53% of the meta-cognitive group responded to therapy -- which meant that they had at least a 30% reduction in inattention symptoms on a standard measure.

That compared with 28% of patients who received supportive therapy.

Meta-cognitive therapy group improved

The supportive-therapy group, Solanto explained, was used as a "control" to try to isolate the specific effects of meta-cognitive therapy -- over and above the more general benefits of simply receiving a therapist's attention or support from other people with ADHD.

The fact that patients in the meta-cognitive therapy group improved to a greater degree suggests the therapy has specific benefits for adults with ADHD.

Solanto and her colleagues also found that in general, patients' inattention symptoms tended to improve along with the number of home exercises they completed.

That, Solanto said, suggests that the at-home portion of the therapy is "very important", and helps patients start to implement what they learn in their daily lives.

Right now, however, adults with ADHD who are interested in meta-cognitive therapy are unlikely to find it in their communities. The approach is not yet widely available, according to Solanto, and researchers are still studying how effective it is for ADHD -- and how it may best fit in with overall therapy for the disorder.

Some remaining questions include how effective meta-cognitive therapy is in comparison to ADHD medications, and whether the benefits may be greater for some patients if they receive a combination of therapy and medication. - (Reuters Health, April 2010)


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Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation ( She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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