Cognitive therapy in the treatment of adults with ADHD: A systematic chart review of 26 cases

Despite the increasing awareness of attention deficit hyperactivity disorder (ADHD) in adults, psychotherapeutic interventions for this group remain unstudied. In this study we evaluated the potential benefit of an adapted form of Beck's Cognitive Therapy (CT) for adults with ADHD. Consecutive outpatients with DSM-III-R ADHD treated naturalistically with CT were evaluated for response to treatment using multiple variables assessed both prospectively, and by retrospective review of the medical charts. As a result 26 adults with ADHD were identified of whom all had received prior psychotherapy, 96% had lifetime psychiatric comorbidity with ADHD, and 85% were receiving medications in combination with CT. Patients were treated for a mean (±SD) of 11.7 ± 8 months and 36 ± 24 sessions. Treatment was associated with significant improvements in ADHD, anxiety, and depressive symptoms as well as overall global functioning (p's < .01). Overall, 69% of ADHD adults were considered to be much to very much improved in their ADHD at the end of treatment. The results of this chart review suggest that CT used generally in conjunction with medications appears useful for adults with ADHD. These pilot data further suggest the need for additional controlled investigations.