ADHD and Psychotherapy
Relative to medication therapy, psychotherapy is a safe means of treating ADHD. Most effective with adults, psychotherapy is also used in the treatment of adolescents and, to a lesser degree, children. There are a number of different types of psychotherapy for ADHD including talk, family, social and psycho-education. Each is designed to lessen the feelings of low self-esteem, inadequacy, anxiety and depression associated with ADHD.1
Effect of Psychotherapy on ADHD
Psychotherapy is not the most effective treatment for treating ADHD in children—psychostimulants are. However, psychotherapy is often an important component in the treatment of ADHD in adolescents and adults. In Scattered: How Attention-Deficit Disorder Originates and What You Can Do About It, Gabor Maté states “Adults who hope their ADD–related problems can be addressed without psychological work under the guidance of a professional are, in most cases, setting themselves up for failure.”2
Research Evidence on Psychotherapy
Psychotherapy has shown to lessen negative symptoms in children diagnosed with disruptive disorders, ADHD included. In a study of 135 children and adolescents with disruptive disorder, 36 percent of those with ADHD showed significant improvement while undergoing psychotherapy. The study also revealed that the success rate was even higher for those participants who remained in therapy for more than a year.3 Research also supports the efficacy of psychotherapy on many of the disorders associated with ADHD in adults. For this reason, the German Federal Ministry of Research and Education is currently conducting a five-year study to measure the efficacy of an ADHD-specific support group on adults compared to medication and combination treatments.4
How to Use Psychotherapy
The most important aspect to psychotherapy is finding a good mental health provider. According to Mate, psychiatrists are often ill equipped to do talk therapy with clients. States Maté, “Psychiatry tends to accept the medical model of disease and cure. Despite many visits to psychiatrists, people often report that none of the very basic issues in their lives that have led to their depression or attention deficit or anxiety or panic problems were touched on, or only in a superficial fashion.”5 Maté maintains that the success of a psychotherapist is related more to their ability to treat their patients with, what Carl Rogers called “positive regard” or respect. “No formal training and no diploma can by itself inculcate the requisite qualities of a good psychotherapist: empathy, integrity, compassion, honesty, insight and skill.”6 A potential drawback of therapy is cost. Not all insurances cover psychotherapy and the ones that do, generally limit the number of visits. As most people with ADHD have needs that supersede the amount time allotted by insurance, this can be a real roadblock to an individual using therapy as a primary treatment. In addition, the Mayo Clinic offers the following steps to ensure the best results when working with a therapist:
- Make sure you feel comfortable with your therapist
- Approach therapy as a partnership
- Be open and honest
- Stick to your treatment plan
- Don’t expect instant results
- Do your homework between sessions
- If psychotherapy isn’t working, talk to your therapist.7
Types of Professionals That Would Be Involved with This Treatment
According to MayoClinic, psychotherapy is practiced by the following mental health professionals: psychiatrists (MD or DO), psychologists (PhD, Psyd), licensed professional counselors (LPC), licensed social workers (LCSW) and psychiatrist nurse (APRN). However as previously noted, psychologists generally make better therapists than psychiatrists who receive less training in talk therapy techniques. The best therapists can be obtained through word of mouth.8
Side Effects and Warnings
Psychotherapy is a low-risk treatment. While therapy sessions could bring up strong feelings for a client (i.e. anxiety, stress), it is unlikely to lead to any adverse effects down the road.
- Carole Jacobs and Isadore Wendel, “Types of Psychotherapy,” netplaces.com, 2010, http://www.netplaces.com/adult-add-adhd/exploring-the-benefits-of-talk-therapy/types-of-psychotherapy.htm
- Gabor Maté, Scattered: How Attention Deficit Disorder Originates and What You Can Do About It. (New York, NY: A Plumb Book, 2000): 279.
- Peter Fonagy and Mary Target, “The Efficacy of Psychoanalysis for Children with Disruptive Disorders,”* Journal of American Academy of Child and Adolescent Psychiatry 33*, no. 1 (1994): 45–55.
- Alexandra Philipsen and Swantie Matthies, “Psychotherapy in Adult ADHD,” Verhaltenstherapie & Verhaltensmedizin 59, no. 3–4 (March 2009): 132–140.
- Gabor Maté, Scattered: How Attention Deficit Disorder Originates and What You Can Do About It. (New York, NY: A Plumb Book, 2000): 280. 6 Gabor Maté, Scattered: How Attention Deficit Disorder Originates and What You Can Do About It. (New York, NY: A Plumb Book, 2000): 281.
- The Mayo Clinic staff, “Psychotherapy: Results,” MayoClinic, September 1, 2010, http://www.mayoclinic.com/health/psychotherapy/MY00186/DSECTION=results
- The Mayo Clinic staff, “Psychotherapy,” MayoClinic, September 1, 2010, http://www.mayoclinic.com/health/psychotherapy/MY00186/DSECTION=how%2Dyou%2Dprepare