5 Essential Ingredients in Evidence Based Treatments

Having a child or teen who struggles with ADHD can be challenging. The good news is that Evidence Based Treatments – effective treatment programs and strategies that have been tested through rigorous scientific research - are available. These treatments aren’t going to make your child’s ADHD symptoms disappear, but research findings tell us that these treatments (either alone or in combination with medication) should lead to significant improvement. Unfortunately, for many parents it can be difficult to know if the treatment being provided by their child’s therapist is actually evidence-based. While I encourage all parents to have a direct conversation with their child’s therapist about their training and treatment approach, there are also things parents can look for in the content of the therapy sessions themselves that will indicate whether an evidence-based treatment is being used.  

There are many specific evidence-based treatments available for a variety of child and adolescent mental health problems (you can find articles and videos about specific treatments here https://effectivechildtherapy.org/therapies/), and all of these treatments for children and teens share five essential ingredients that contribute to their effectiveness.

1. Measurement of symptoms and improvement over time. All evidence-based treatments require therapists to collect initial measures of symptoms and functional impairment. These measures should be completed by the child (if they are old enough) or the teen, as well as by parents and teachers (when appropriate). Measures are administered at the start of treatment and repeated regularly to measure treatment progress.
2. Teaching new skills. All evidence-based treatments focus on learning new skills and strategies, and the emphasis on using these skills starts early. Therapists may spend only a couple of sessions getting to know the child or teen and his or her family before quickly diving in to teaching and rehearsing new skills. As the child or teen learns and practices these skills, the relationship with the therapist continues to grow and before long the child or teen is seeing improvement in symptoms and developing a strong bond with the therapist.
3. Practicing skills in-between sessions. All evidence-based treatments require the child or teen and the parents to use the new skills and strategies at home in-between sessions. Changing thoughts and behaviors takes time and practice, making between session “homework” and practice an essential component of all evidence-based treatments.
4. Parent involvement. All evidence-based treatments for children and teens require at least some degree of parent participation (more when kids are younger and a bit less as kids get older and grow into teenagers). When it comes to ADHD treatment for younger children, research has shown that parent-focused interventions (like behavioral parent training) are the most effective treatments. They can work so well that sometimes the child never needs to attend a single therapy session! For older children and adolescents with ADHD, evidence-based approaches that combine child or teen-focused sessions with sessions that target parenting skills and the parent-child relationship are typically most effective. When it comes to treatments for other disorders, like anxiety or depression, evidence-based treatments often include more child or teen-focused sessions and fewer parent-focused sessions, however parents still spend at least some time with the therapist, so they can learn about the skills and strategies that their child or teen will be using at home.
5. Improvement in a relatively short period of time. Many evidence-based treatment programs last for only 10-20 sessions, with many children and teens experiencing significant improvement after a couple of months. Since ADHD is a chronic disorder, it always requires parents and children or teens to continue to use the skills they learned in therapy even after they’ve stopped working closely with their therapist. Many kids and teens also require ongoing medication to manage their symptoms, and most require ongoing booster or maintenance therapy sessions to keep their skills current.

If your child or teen’s therapist is not providing evidence-based treatment and their ADHD symptoms at home and at school are not improving, then it’s probably time to find a new therapist. In next week’s post I’ll share a list of questions to ask a prospective therapist that will help you learn about his or her approach to treatment before you and your child start to work with him or her. Not sure where to begin your search for a new therapist? One of the following therapist directories can be a good starting point:

Society of Child and Adolescent Psychology

Association for Behavioral and Cognitive Therapies

American Psychological Association

Psychology Today

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ABOUT DR. MARY ROONEY

Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.

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This website does not provide medical advice, diagnosis, or treatment. The material on this site is provided for educational purposes only.

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