+ Assessment
Evidence-based care begins with proper assessment. Gold standard assessment of ADHD includes: (a) a comprehensive interview with an individual and relevant parties (for children, this is parents; for adults, this may include speaking with a partner or parent as well) and (b) standardized questionnaires, which are scored based upon the general population and offer quantitative measures of symptoms. Because understanding one’s diagnosis (or diagnoses) and participating in one’s treatment planning are paramount in importance, we follow up our assessments with a feedback session at a later date, offering an opportunity to receive “psychoeducation” about the findings and collaborate on one’s treatment plan.
Oftentimes neuropsychological testing is a useful way to more thoroughly examine a diagnostic question. For instance, what is the relative contribution of attention versus a learning disorder to a child’s academic struggles? Where do strengths and weaknesses lie, and how can a learning plan be optimized given a child’s individual profile? For adults, neuropsychological testing can offer an informative snapshot of one’s functioning, providing clarification regarding past struggles and recommendations around compensatory strategies given one’s strengths.
+ Psychotherapy and Coaching
Psychotherapy and coaching can address practical obstacles to productivity and success, such as those related to executive functioning (EF): planning, time management, organization, regulating attention, impulse control, prioritization, motivating to act, or overcoming procrastination. In children with ADHD, EFs are targeted through the training of organizational skills, in collaboration with parents and teachers. In adults with ADHD, EF skills training is often critical to resolving lifelong difficulties in these areas to perform in the workplace and to manage personal obligations more effectively. College students with ADHD often struggle due to poor EFs and require skills coaching to cope with unstructured schedules and the adjustment to independent living.
Beyond addressing EF skills, evidence-based psychotherapy also targets symptoms commonly associated with ADHD, such as anxiety, depression, anger or irritability, or related to confidence or self-esteem. Stress management, emotion regulation, interpersonal skills, and transitions or life stressors are also effectively targeted in therapy. Cognitive-behavioral therapy (CBT) and related techniques are considered “evidence based” treatments in that they are consistently efficacious at ameliorating symptoms in clinical trials.
While psychotherapy is provided in the office or remotely, coaching is done remotely or in the home. Whether a client will benefit most from psychotherapy, coaching, or a combination of the two can be determined based on an informational call and/or through an initial evaluation.
+ Behavior Management
For children with ADHD and/or disruptive behaviors, behavioral work focuses on the home and school environments. While these interventions do not typically alter the core attentional deficit, they are incredibly helpful at shaping more desirable behavior and mitigating against impairment. Behavioral strategies are tailored according to the age of the child and their needs; for instance, parents require different strategies for preschool children than for teens or college-aged young adults.
Parenting work teaches parents to “think like a therapist,” creating an environment that encourages desirable behavior while extinguishing unwanted or disruptive behavior.
School consultation typically involves coaching teachers and implementing a plan that reinforces prosocial and learning-oriented behavior and maximizes children’s potential to be successful in the classroom.
+ Medication
Medication is extremely beneficial at addressing the core symptoms of ADHD as well as related symptoms (e.g., anxiety, depression). We work with experts in this area of psychopharmacology who serve as integral members of our treatment teams. We would be happy to recommend a colleague who is a good fit.