Subject:
(Sprich S et al, J Child Psychol Psychiatry 2016;doi:10.1111/jcpp.12549 [Epub ahead of print])

Short Description:

Medication is an effective and necessary treatment for many adolescents struggling with ADHD. Unfortunately, even when patients and parents report significant relief from meds, symptoms persist, which can lead to ongoing problems at school, at home, and with peers. That’s why psychosocial interventions are an important part of any treatment plan for adolescents with ADHD. Given the need for effective non-medication treatments, researchers looked at a modified form of cognitive behavior therapy (CBT) specifically for adolescents with ADHD who were stable and doing well on meds but still had troubling symptoms.

A group of 46 adolescents between the ages of 14 through 18 with ADHD who had responded only partially to medication were randomly assigned to either medication plus CBT (24 subjects) or medication alone (22 subjects). CBT consisted of 12 weekly sessions teaching skills related to self-regulation, procrastination, negative thinking, and relapse prevention. The patients who were assigned to medication alone were allowed to cross over to the CBT arm of the study after 4 months; 15 of them did so. All patients were assessed blindly at baseline, 4 months, and 8 months on three outcomes: parent and child ratings of symptom severity (ADHD Current Symptom Scale) and overall distress (Clinical Global Impression Scale).

At the end of treatment, CBT clearly added value. Compared to no treatment, average scores on parent, adolescent, and distress ratings dropped by 10.93, 5.24, and 1.17 points, respectively. Researchers also used a 30% reduction on the ADHD rating scale to identify “treatment responders.” They found that, per the parents’ view, 50% of adolescents improved.

CCPR’s Take: Adolescents already on ADHD medications, and doing relatively well, can likely do even better with CBT.