Adult Treatment Guidelines


Adult Treatment Guidelines PDF



Therapist in Gladstone, Oregon, Jane Rekas, Therapist | Lifestance








Treatment


LifeStance ADHD Program
"First and foremost, a strengths-based perspective! Identify first what is good and strong and healthy in a person and secondarily what requires intervention. Individual therapy is not generally found to be effective for treating children’s symptoms of ADHD, unless its purpose is to treat comorbidities or other stressors."

4 Types of ADHD Therapy for Adults (verywellhealth.com)




 


Mindfulness for Adult ADHD


Clarify Definition of Symptoms: Complete rating scales.

• Conners Adult ADHD Rating Scales (CAARS) 
• Brown Attention Deficit Disorder Scales (BADDS)

Wender Utah Rating Scale
"The Wender Utah Rating Scale (WURS) is a self-report instrument completed by adults assessing a range of childhood symptoms and behaviors consistent with ADHD persisting into adulthood. Many items reflect emotional dysregulation."

 ASRS-5
"The Adult ADHD Self-Report Scale (ASRS v1.1) and scoring system were developed in conjunction with the World Health Organization (WHO) and the Workgroup on Adult ADHD to help healthcare professionals to screen their patients for adult ADHD."

(see ADHD Screeners and Quality of Life Assessments)

  • ADHD Rating Scale IV (ADHD-RS-IV) With Adult Prompts
  • Adult ADHD Clinical Diagnostic Scale (ACDS) v1.2
  • Adult ADHD Investigator Rating Scale (AISRS)
  • Adult ADHD Self-Report Scale (ASRS) v1.1
  • Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS DSM-5) Screener
  • Adult ASRS Symptom Checklist v1.1
  • Barratt Impulsiveness Scale (BIS-11)
  • Brown Attention-Deficit Disorder Symptom Assessment Scale (BADDS) for Adults
  • Clinical Global Impression (CGI)
  • Conners’ Adult ADHD Rating Scales (CAARS)
  • Diagnostic Interview for ADHD in Adults (DIVA) 2.0
  • Wender Utah Rating Scale (WURS)

Informant Questionnaires: 


Neuropsychological Assessment
• Helpful for learning profile
• High false negative rate for ADHD
• False positives (other factors besides ADHD)
• Continuous Performance Test (CPT) (TOVA ®)
• The Rey–Osterrieth complex figure test (ROCF)
• Processing Speed
• Working Memory
• Impulsivity
• Poor organization
• Poor Time Management

Have complete physical to rule out other medical conditions. Have psychiatric evaluation to consider medication, or with a Naturopath to consider alternative treatments, follow doctor's recommendations.




Consult with occupational therapist.




Education: Recommend reading Russell Barkley’s Taking Charge of Adult ADHD,
Taking Charge of Adult ADHD
Taking Charge of Adult ADHD
by Russell A. Barkley
 


Skills
Time Management: Establish a routine schedule. Develop your organizational system to support organizational skills. Set deadlines for everything, even for seemingly small tasks. Use timers and alarms to stay on track. Take breaks at regular intervals. Avoid piles of paperwork or procrastination by dealing with each item as it comes in. Prioritize time-sensitive tasks and write down every assignment, message, or important thought.

Create a supportive work environment. Make frequent use of lists, color-coding, reminders, notes-to-self, rituals, and files. If possible, choose work that motivates and interests you. Notice how and when you work best and apply these conditions to your working environment as best you can. It can help to team up with less creative, more organized people—a partnership that can be mutually beneficial.

Learn/Practice Coping Skills: Develop improved frustration tolerance skills, relaxation skills, social skills, exercise and stress management. Plan for successful experiences, hobbies, outlets.  Develop plan for coping, self-care and stress reduction. Engage body/mind. Occupation therapy can also address stress techniques.



Make a regular practice of relaxing: When regularly practiced, relaxation techniques can greatly reduce the symptoms of adult ADD/ADHD. “Mindful awareness” practices—meditation, yoga, or tai chi—are exercises that teach you to control your attention. Relaxation techniques like these can also raise your emotional awareness, allowing you to better control your impulses.




Increase Support: seek out support group, such as CHADD.

 Work on your relationships. Schedule activities with friends and keep your engagements. Be vigilant in conversation: listen when others are speaking and try not to speak too quickly yourself. Cultivate relationships with people who are sympathetic and understanding of your struggles with ADD/ADHD.





Medication & Alternatives: 
  • Have psychiatric evaluation to consider medication, follow doctor's recommendations.  For a list of psychiatrists and prescribers see the Medication Evaluation Page.
  • Regularly attend medication management appointments and take medication as prescribed.  



See Medication Alternatives page.  As alternative, consider Unritalin Solution. Consider consulting Naturopath. Consider natural remedies, such as Attend homeopathic and Focus herbal.  INGREDIENTS



Physical Health: Develop core strength. Consider seeing a chiropractor, occupational and physical therapists. Be sure to get adequate time outside in the sun getting exercise and Vitamin D and air. Make sure you are drinking enough water. No calories from beverages. Reduce screen time (tv, computer, video games), to reduce EMF exposure, etc.

Exercise: Working out is perhaps the most positive and efficient way to reduce hyperactivity and inattention from ADD/ADHD. Exercise can relieve stress, boost your mood, and calm your mind, helping work off the excess energy and aggression that can get in the way of relationships and feeling stable. Exercise vigorously and regularly—it helps work off excess energy and aggression in a positive way and soothes and calms the body.

Eat right. Eat a wide variety of healthy foods and limit sugary foods in order to even out mood swings. Have a screening for food allergens. Consider removing dairy and wheat/gluten. Reduce high glycemic foods, including high fructose corn syrup. Balance metabolism. Eating healthfully can reduce distractibility, hyperactivity, and decrease stress levels dramatically. Taking control of your eating habits means you can avoid low moods, weight gain, and distraction due to hunger or compulsive eating.

Get plenty of sleep. When you’re tired, it’s even more difficult to focus, manage stress, stay productive, and keep on top of your responsibilities. Support yourself by getting between 7-8 hours of sleep every night. Sleep deprivation can increase symptoms of adult ADD/ADHD, reducing your ability to cope with stress and maintain focus during the day. Simple changes to daytime habits go a long way toward ensuring solid nightly sleep, which can lead to huge improvements in your emotional balance, attention, and productivity. Avoid caffeine late in the day. Exercise vigorously and regularly, but avoid moving around at least an hour before turning in. Create a predictable, and quiet “bedtime” routine. Take a hot shower or bath just before bed. Stick to a regular sleep-wake schedule, even on weekends.

Executive Function Skills Worksheet PDF
Executive Function Workbook


Peg Dawson & Richard Guare Executive Function packet

Executive Skills Questionnaire Adult Version This will send you a PDF of your answers.

ESQ ADULTS PDF printable 

Executive Skills Questionnaire References



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