ADHD and Behavioral Treatment
Behavioral treatment is the second-most effective treatment for reducing the symptoms of ADHD. Studies show that whereas medication is more effective than therapy in reducing the symptoms of ADHD in children, the two combined are more effective than either one alone in obtaining an optimal response. 1
What is it? Behavioral treatment is a type of psychotherapy based on the concept of replacing undesirable behaviors with desirable ones through positive and/or negative reinforcement.
Effect of Behavioral Treatment on ADHD
The efficacy of behavioral treatment relies on the emotional development of both the patient and their caretaker to implement change. Parents who themselves are ADHD may be less successful at administering behavioral treatment than their non-ADHD counterparts. In addition, not all kids respond well to behavioral treatment due to the severity of their problems. In some cases behavioral treatment can be modified although it may have to be abandoned altogether in the case of a child struggling with an associated condition such as autism or bipolar disorder.
Research Evidence on Behavioral Treatment
Behavior treatment has been shown to reduce the symptoms of individuals with ADHD. In a 1998 study of psychosocial treatments for ADHD, researchers showed that behavioral parent training and behavioral interventions in the classroom meet the criteria for well-established treatments.2 A second study conducted by the National Institute of Mental Health in 1999 further supported the efficacy of behavioral treatments in reducing the symptoms of ADHD.3 Finally, in a review of the evidence of different treatment options, a third study showed that combined with stimulation mediation, behavioral treatments may help individuals with ADHD to function better to the point of lessening their reliance on stimulation medication.4
How to Use Behavioral Treatment
Behavioral treatment can be applied at home or at school/work and often involves both the patient and his or her caretaker. Its basic principles include the following steps:
- Assess and prioritize undesirable behaviors;
- Monitor compliance
- Identify consequences for non-compliance; and
- Evaluate efficacy.
Side Effects and Warnings
Many parents in particular find behavioral treatment preferable to stimulation medication for reducing the symptoms of ADHD in their children. However, behavioral treatment is limited to both the parent and the child's ability to follow the recommendations and the duration of the treatment.
Many parents of children with ADHD and ADHD adults will choose behavioral treatment for the following reasons:
- Many parents are opposed to the use of medication;
- For some (about 20 percent), medication doesn’t work;
- Many find medication limited; whereas it can help a person to better focus their attention, it can’t solve a person’s social, behavioral or academic difficulties.
- Behavioral therapy when combined with medication can increase the chances of an individual meeting their social, behavioral and academic goals.5
- Thomas E. Brown, Ph.D., Attention Deficit Disorder: The Unfocused Mind in Children and Adults, (New Haven and London: Yale University Press, 2005): 280.
- William E. Pelham Jr., T. Wheeler and A. Chronis. “Empirically supported psychosocial treatments for attention deficit hyperactivity disorder,” Journal of Clinical Child Psychology 27, no. 2 (June 1998): 190–205.
- William E. Pelham, Jr. “The NIMH Multimodal Treatment Study for Attention-Deficit Hyperactivity Disorder: Just Say Yes to Drugs Alone?” The Canadian Journal of Psychiatry 44, no. 10 (December 1999): 981–990.
- Ronald T. Brown et al. “Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence,” Pediatrics 115, no. 6 (June 2005): e749–e757. doi: 10.1542/peds.2004–2560
- “Attention Deficit / Hyperactivity Disorder (ADHD)—Treatment,” Marriage and Family Encyclopedia, http://family.jrank.org/pages/122/Attention-Deficit-Hyperactivity-Disorder-ADHD-Treatment.html