Sometimes, the quickest route to symptom relief is not what is wanted or needed. When this is the case, stand alone Cognitive Behavioral Therapy (CBT) may be the right option.
Most who are “in the know” regarding older adults with ADD (ADHD) will agree that Cognitive Behavioral Therapy (CBT) done in conjunction with PRN medication dosing, provides the fastest route to measurable improvement with most problematic ADHD symptoms. Sometimes, the quickest route to symptom relief is not what is wanted or needed. When this is the case, stand alone CBT may be the right option.
Last week I did a brief review of the latest ADHD research and discovered one study published October 6, 2016 in The Journal of Attention Disorders that shows CBT by itself becomes more effective “as time goes on.” For those who prefer non-medication treatment alternatives, this appears to be good news.
Before everyone breaks out their Party Pants, however, as always, we need to remember that this new finding is true for SOME people and not everyone. Keep in mind, that most mental health issues will appear to improve over time if one keeps to the work of therapy, CBT or otherwise.
Keeping the focus on our topic of ADHD in Adults, I believe it is imperative that people considering all the various treatment options out there, understand that medication has literally changed the lives and even saved the lives of some individuals truly suffering the effects of the ADHD brain. That stated, medication is still, no magic wand.
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Based on this one study, it appears that clinicians such as myself must let our patients know that according to new research we can no longer definitively state that one therapy is better or more effective than other. There are too many variables that must be taken into account. I state this with a caveat. As a clinician working with persons with ADHD for 20 years, as an educator and as a spouse, mother, grandmother and daughter of persons with ADHD, it has been my personal/professional experience that only those mildly to moderately affected by ADHD achieve complete emotional and behavioral symptom relief with CBT only.
Further research needs to include spouses of those with moderate to severe ADHD as persons with ADHD are usually not reliable historians or self-raters. In some cases the person with the ADHD can feel tremendous symptom relief but their ADHD BEHAVIOR continues to negatively impact their spouse and children. and possibly even an employer.
When an adult has a severe case of ADHD, I maintain that bipartite (CBT + medication) treatment is the best way to proceed; particularly when a spouse and other family members are hugely impacted by the ADHD behavior. Medication promotes faster symptom regulation and even resolution in some cases. Stimulant medications also help the ADHD brain settle down enough to focus on and apply the lessons taught in therapy and coaching, thus mitigating further pain and problems.
When the individual is a single person, a child, or a married adult with MILD ADHD and relationships and employment are not in jeopardy, I wholeheartedly support CBT and other behavior and brain therapies.
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