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Therapies That Can Help Manage ADHD Symptoms in Patients

Attention deficit hyperactivity disorder (ADHD) is a type of neurodevelopmental disorder that causes unusual levels of impulsive behavior along with hyperactivity. While we most often hear about children being diagnosed with ADHD, adults can also be diagnosed with ADHD. People with ADHD have a challenging time concentrating on one task or sitting still for a long time. There is a wide variety of behaviors that are typically linked with ADHD, including getting distracted very easily, talking excessively, having trouble focusing on tasks, being forgetful about tasks, interrupting others, losing items frequently, making frequent mistakes, and having trouble organizing everyday chores.(1, 2, 3 ,4)

There are many types of treatment for both children and adults with ADHD. Research has shown that the most effective treatment for ADHD is to combine medication with a form of therapy. There are many types of therapies that can help manage ADHD symptoms in patients, both children, and adults. Here are some therapies that can help manage the symptoms of ADHD in patients.  

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Therapies That Can Help Manage ADHD Symptoms in Patients

  1. Behavioral Therapy for ADHD

    People with ADHD experience symptoms that make it challenging for them to function normally at work, school, and even at the day-to-day tasks. Behavioral therapy can help people with ADHD learn new skills that help them control and manage their symptoms to succeed at their daily tasks. The ultimate goal of behavioral therapy for ADHD is to replace negative thought patterns and behaviors with positive ones. Behavioral therapy helps achieve this by teaching strategies to patients that help them work on problematic areas like focus, impulse control, and organization.(5, 6)

    While behavioral therapy is usually best continued hand in hand with the prescribed medications, but many people find that this type of therapy alone is effective enough to manage their ADHD symptoms without medication. However, you should never stop taking your medications without consulting your doctor first.(7)

    In children who have ADHD, behavioral therapy is done along with parents or guardians involved in the process. Families work together with the behavioral therapist to set certain goals, and therapists help them learn how new behavioral therapy techniques in order to help the child at home as well as at school. According to the Centers for Disease Control and Prevention (CDC), behavioral therapy can help reduce the symptoms of ADHD in children.(8, 9)

    Any good behavioral therapy plan will address the problematic behaviors that are common in children with ADHD as they are taught to structure their time at home, establish routines, and also learn techniques that promote positive attention. A good behavioral therapist focuses on teaching parents or guardians with common sense parenting.

    The behavioral therapy strategies help in the following:

    • Reinforce good behavior
    • Discourage negative behavior
    • Take away certain privileges if the negative behavior continues or becomes too serious
    • Remove the common triggers of negative behavior

    However, to derive positive results from a behavioral therapy program, it is equally important that parents should consistently implement the program plan as taught by the therapist.

  2. Cognitive Behavioral Therapy for Adults

    Cognitive behavioral therapy (CBT) is very similar to behavioral therapy. It is focused on training the brain to change the negative patterns of thinking and reframe or rethink the way the patient feels about themselves and their symptoms. There is a lot of research to show that CBT helps deliver actual real-world benefits for adults who have ADHD. These include improved productivity, higher self-esteem, and more happiness.(10, 11, 12)

    Demoralizing thoughts in people with ADHD often keep them from doing what they can do. CBT can help change the brain patterns of most patients with ADHD, especially by assisting them in managing small everyday challenges by themselves. CBT intervenes to help patients deal with their everyday struggles, including time management, procrastination, and other such challenges. It is essential to understand that CBT does not treat the ADHD core symptoms like hyperactivity, inattention, and impulsivity.(13)

    CBT focuses on identifying the situations in which disorganization, poor planning, lack of task management, and poor time management poses difficulties in a patient’s daily life. CBT sessions can help ADHD patients deal with their responsibilities and also encourage future endeavors. A CBT therapist will work with you to reduce life impairments. However, again, you should not replace your medications for ADHD or even think about lowering your dosage without consulting your doctor.

    A successful CBT program for adults with ADHD helps correct the following negative thought patterns in patients:

    • All-or-nothing thinking in which patients view everything as either being totally good or totally bad.
    • Overgeneralization where they see even one adverse event as being a part of an overgeneralized pattern.
    • Mind reading where they assume to already know what others think about them or what they have done. Of course, the assumption is always negative.
    • Forecasting that things will only have a bad outcome.
    • Exaggerating the importance of the smallest of problems and trivializing their accomplishments.
    • Focus on how things should be, which often leads to severe self-criticism and feelings of resentment towards others.
    • Constantly measuring yourself unrealistically against others and feeling inferior.
  3. Dialectical Behavioral Therapy (DBT)

    Dialectical behavioral therapy is another therapy similar to CBT that is used to help people with ADHD deal with their social and emotional challenges, along with other neuro-psychological disorders. DBT helps prevent ADHD patients deal with their intense emotions. DBT is not a new therapy type, and it has been used to assist in the treatment of adult ADHD since the early 2000s. In DBT, patients are advised on how to improve their self-regulation skills. This type of therapy helps those who do not respond to other treatment approaches.(14)

    DBT was created by Marsha Linehan, a professor of psychology at the University of Washington, as well as the founder of The Linehan Institute. The therapy was previously being used for the treatment of other mental conditions before being adapted for the treatment of adult ADHD. DBT was initially designed to withstand the emotional turmoil, including self-harming behavior, in people who were diagnosed with borderline personality disorder (BPD).

    Today, DBT is one of the most successful forms of therapy for improving ADHD patients’ emotional turmoil. DBT is a group-based treatment where every group member also has an individual therapist as well to provide additional support to allow the therapist to personalize the treatment for each patient.

    DBT also has many characteristics of CBT, but there is one major exception. DBT focuses on validation or on the importance of accepting the negative or uncomfortable emotions of the patients before the therapist begins to try to change them. When patients come to terms with their adverse or troubling feelings or thoughts, it becomes easier to make positive change possible. Then patients are also more accepting of working with their therapist to come up with a treatment plan.(15)

  4. Music and Art Therapy

    People with ADHD, both children, and adults, have been found to benefit from music and art. Music therapy helps increase an ADHD patient’s attention and concentration, reduces hyperactive behavior, and also helps build their social skills in the following ways:(16, 17)

    • Music provides structure to the ADHD brain, relaxing the brain that is struggling to gain a sense of control and regulate itself to put it on a linear path.
    • Research has shown that good music boosts the levels of dopamine in the brain, which is a neurotransmitter that is responsible for regulating motivation, attention, and working memory. An ADHD brain has low levels of dopamine.
    • It helps ADHD patients connect socially with others.

    Meanwhile, art therapy helps adults and children with ADHD become capable of communicating their thoughts more easily through art instead of speaking or writing. Art therapy is especially effective for hyperactive children with ADHD as it keeps them busy and also lets them focus on something.(18, 19)

  5. Neurofeedback or Brain Training

    Neurofeedback is another type of therapy that makes use of brain exercises to increase attentiveness while also reducing the urge of impulsiveness in both children and adults with adults. Neurofeedback trains the brain to emit specific brain wave patterns that help ADHD patients focus as compared to those brain wave patterns that are linked with daydreaming and impulsivity. Neurofeedback helps control the ADHD symptoms like acting out, tantrums, hyperactivity, distractibility, and impulsivity.(20, 21)

    In neurofeedback, patients wear an electrode-lined cap while carrying out several complex cognitive tasks. This can include simple tasks like reading out loud as well. A computer reads the brain activity waves and maps the parts of the brain where there is a lack of or too little brain wave activity. This is the theoretical source of ADHD symptoms.(22, 23)

    While neurofeedback is used for ADHD patients, but this therapy process has not been studied extensively, and more research is still needed on brain training exercises.

References:

  1. Lange, K.W., Reichl, S., Lange, K.M., Tucha, L. and Tucha, O., 2010. The history of attention deficit hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders, 2(4), pp.241-255.
  2. Swanson, J.M., Sergeant, J.A., Taylor, E., Sonuga-Barke, E.J., Jensen, P.S. and Cantwell, D.P., 1998. Attention-deficit hyperactivity disorder and hyperkinetic disorder. The Lancet, 351(9100), pp.429-433.
  3. Barkley, R.A. and Murphy, K.R., 2006. Attention-deficit hyperactivity disorder: A clinical workbook. Guilford Press.
  4. Wender, P.H., 1998. Attention-deficit hyperactivity disorder in adults. Psychiatric Clinics of North America, 21(4), pp.761-774.
  5. Fabiano, G.A., Pelham Jr, W.E., Coles, E.K., Gnagy, E.M., Chronis-Tuscano, A. and O’Connor, B.C., 2009. A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical psychology review, 29(2), pp.129-140.
  6. Knouse, L.E. and Safren, S.A., 2010. Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatric Clinics, 33(3), pp.497-509.
  7. Mongia, M. and Hechtman, L., 2012. Cognitive behavior therapy for adults with attention-deficit/hyperactivity disorder: a review of recent randomized controlled trials. Current psychiatry reports, 14(5), pp.561-567.
  8. Brown, R.T., Amler, R.W., Freeman, W.S., Perrin, J.M., Stein, M.T., Feldman, H.M., Pierce, K., Wolraich, M.L. and Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder, 2005. Treatment of attention-deficit/hyperactivity disorder: overview of the evidence. Pediatrics, 115(6), pp.e749-e757.
  9. Therapy to improve children’s mental health (2022) Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/childrensmentalhealth/parent-behavior-therapy.html (Accessed: October 15, 2022).
  10. Knouse, L.E. and Safren, S.A., 2010. Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatric Clinics, 33(3), pp.497-509. Fehlings, D.L., Roberts, W., Humphries, T. and Dawe, G., 1991. Attention deficit hyperactivity disorder: does cognitive behavioral therapy improve home behavior?. Journal of Developmental and Behavioral Pediatrics.
  11. Toplak, M.E., Connors, L., Shuster, J., Knezevic, B. and Parks, S., 2008. Review of cognitive, cognitive-behavioral, and neural-based interventions for Attention-Deficit/Hyperactivity Disorder (ADHD). Clinical psychology review, 28(5), pp.801-823.
  12. Mongia, M. and Hechtman, L., 2012. Cognitive behavior therapy for adults with attention-deficit/hyperactivity disorder: a review of recent randomized controlled trials. Current psychiatry reports, 14(5), pp.561-567.
  13. Moritz, G.R., Pizutti, L.T., Cancian, A.C., Dillenburg, M.S., de Souza, L.A., Lewgoy, L.B., Basso, P., Andreola, M.M., Bau, C.H., Victor, M.M. and Teche, S.P., 2021.
  14. Feasibility trial of the dialectical behavior therapy skills training group as add‐on treatment for adults with attention‐deficit/hyperactivity disorder. Journal of Clinical Psychology, 77(3), pp.516-524.
  15. Cole, P., Weibel, S., Nicastro, R., Hasler, R., Dayer, A., Aubry, J.M., Prada, P. and Perroud, N., 2016. CBT/DBT skills training for adults with attention deficit hyperactivity disorder (ADHD). Psychiatria Danubina, 28(suppl 1), pp.103-107.
  16. Jackson, N.A., 2003. A survey of music therapy methods and their role in the treatment of early elementary school children with ADHD. Journal of music therapy, 40(4), pp.302-323.
  17. Zhang, F., Liu, K., An, P., You, C., Teng, L. and Liu, Q., 2017. Music therapy for attention deficit hyperactivity disorder (ADHD) in children and adolescents. The Cochrane Database of Systematic Reviews, 2017(5).
  18. Smitheman-Brown, V. and Church, R.R., 1996. Mandala drawing: Facilitating creative growth in children with ADD or ADHD. Art Therapy, 13(4), pp.252-260.
  19. Habib, H.A. and Ali, U., 2015. Efficacy of art therapy in the reduction of impulsive behaviors of children with ADHD co-morbid intellectual disability. Pakistan Journal of Psychology, 46(2).
  20. Arns, M., Heinrich, H. and Strehl, U., 2014. Evaluation of neurofeedback in ADHD: the long and winding road. Biological psychology, 95, pp.108-115.
  21. Lofthouse, N., Arnold, L.E., Hersch, S., Hurt, E. and DeBeus, R., 2012. A review of neurofeedback treatment for pediatric ADHD. Journal of attention disorders, 16(5), pp.351-372.
  22. Holtmann, M., Sonuga-Barke, E., Cortese, S. and Brandeis, D., 2014. Neurofeedback for ADHD: a review of current evidence. Child and Adolescent Psychiatric Clinics, 23(4), pp.789-806.
  23. Arns, M., De Ridder, S., Strehl, U., Breteler, M. and Coenen, A., 2009. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clinical EEG and neuroscience, 40(3), pp.180-189.
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