Attention Deficit Hyperactivity Disorder (ADHD): Assessment and Treatment Plans for Adults

I have written at length about the necessity of obtaining a comprehensive evaluation for Attention Deficit Hyperactivity Disorder (ADHD) elsewhere in my blog and on my website. ADHD is a very general diagnosis and most likely doesn’t tell you much about the particular problems you are having as an individual with ADHD. The neuro-cognitive assessment I provide include, but are not limited to, issues such as verbal memory, visual memory, processing speed, executive function (decision making, picking out what is important or salient, impulsivity and emotional control), psychomotor speed, reaction time, complex attention, cognitive flexibility and long term attention and focus. Additionally we usual look at factors that might direct us towards other or co-morbid diagnoses such as depression, anxiety and so on.

This is far more comprehensive than the assessment you might have received from your medical doctor, which might have included little more than one or two self report forms and a short history taking. That’s not to say that your MD didn’t get it right, or can’t make such a diagnosis that quickly. Often it can be. What a more comprehensive evaluation provides is a deeper understand of your individual strengths and weaknesses. From this we can determine how to help you develop an individualized intervention plan that addresses deficits, and also makes use of your cognitive strengths.

What would a treatment plan for an adult look like?
Often I see adults for an initial evaluation and then meet an average of eight times, using a combination of psycho-educational planning and weekly consultation to get them off on a a program they themselves can continue. Here is a general outline of the meeting schedule:

Assessment, Review and Overview
Session 1: Review of assessment results
Overview of the ADHD program
Discussion of involvement of family and workmates

Organization and Planning
Session 2 The basics of organization and planning skills
Organizing multiple tasks
Session 3 Problem-solving and managing overwhelming tasks
Organizing papers

Reducing Distractibility
Session 4 Gauging your attention span and distractibility
Modifying your environment

Adaptive Thinking
Session 5 Introducing the Cognitive Model of ADHD
(Cognitive Behaviour Therapy)

Session 6 Review of Adaptive Thinking and previous sessions
Session 7 Dealing with Procrastination
Session 8 Preventing Relapse and setting future goals

For adults we often use the Cognitive-Behavioural Treatment Program developed by Safren and Sprich, which has been found useful with adults. I also ask clients to watch Russell Barkley’s A New Understanding of ADHD (a DVD available in the office) and read either Kelly and Ramundo’s You Mean I’m Not Lazy, Stupid or Crazy?, Hallowell and Ratey’s Driven to Distraction or Thomas E. Brown’s Attention Deficit Disorder: The Unfocused Mind in Children and Adults. All three of these books can be obtained in my office or for those who find reading difficult or finding time to read difficult (and these are all 300-400 page books) I have them available on CD.

Following this eight week plan we can cover all major areas of concern that come from ADHD, and we can additionally fine tune the program to address your specific deficits and strengths, making success much more likely. Individuals are then able to use self-help tools with confidence and the underlying knowledge and experience they need to make the most of them. After this initial program clients sometimes see me on a monthly basis, or even quarterly, for “check up” and to address problems with relapse.

Finally, for those who, with the help of their primary medical provider, decide to take medication to deal with this disorder we are able to provide ongoing neuro-cognitive assessments that help monitor the effects of the medication.

In the next few weeks I will be trying to address some of these specific topics here in the blog. If you would lke more information about my practice and the assessment and treatment of Attention Deficit Hyperactivity Disorder (ADHD) please look at my web site: www.relatedminds.com or my Psychology Today website by clicking here.