ADHD counseling and other academic issues you never thought about.
A friend of mine recently started her own website in an industry that has not yet wholeheartedly embraced the web yet – the psychology industry. It’s too bad, as there is a lot of room for it to grow and develop new methods to deal with a growing number of students who need help and turn first to online media. So, this is for you, all those students who have ADHD or perfectionism issues and never did anything about it.
During my academic career, I never thought much about academic counseling issues – I never had any that were serious enough thankfully. Some students really get nailed by these problems, though. Many at the top schools like Harvard and MIT and simply smart enough to get by during their undergraduate careers. However, these ADHD issues often surface in grad school when the students are being challenged more than they ever had been. In this case, find an ADHD counselor without delay! There are a lot of problems you can avoid by acknowledging the problems and finding a psychologist to help you through them.
You’re not going to find a wealth of information on academic counseling from me, so instead, go here for more articles on ADHD and perfectionism.
Just as a note: Research findings have shown that while non-pharmacological interventions improve ADHD by approximately 30%; pharmacological interventions improve ADHD symptoms by more than 70% and the combination of both kinds of interventions improves symptoms by 85%. As such, in order to get the best outcomes, we advocate a combination of both types of treatments.
The unfortunate reality is that a psychologist (can’t perscribe drugs – in Canada at least) is unlikely to have a true impact on someone with adhd unless this therapy is suppoted by medication.
Cheers,
adhdstruggles
A pet peeve of mine is when people cite studies and don’t tell others what they’re referring to. I would be interested to know which studies you are referring to and where they can be found. At the very least, it would help others find the information themselves and determine the validity of those findings. Thanks for the note, and I look forward to learning something new!
A pet peeve of mine is when people ask me to back up stuff that I post… Do you have any idea how difficult it is for me to stay focused long enought to actually write a post, let alone actually back up the statements I make as fact with hard data? That might take the fun out of blogging.
Just kidding, I will dig them up for you.
Cheers
Ha! Looking forward to the conversation. I’ll do my best to keep up!
best,
ian
The best source of information on ADHD is the work of Russel Barkley. He is recognized as the leading authority on the subject. The book of his I found the most informative is:
R. A. Barkley & K. R. Murphy (2006) Attention deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York: Guilford Publications. Copyright 2006 by Guilford Publications.
The data I provided in my intitial comment is based on a study done on approximately 600 childern: National Institute of Mental Health (NIMH) funded Multimodal Treatment Study of Children with ADHD (MTA Study) were published in 1999.
Unless you are an experienced researcher I would suggest sticking to the work of people like Dr. Barkley as he bases his writings on the analysis of many different studies which are clearly referrenced.
I would suggest taking a look at his 2002 International Consensus Statement on ADHD. It gives a brief and clear explanation of ADHD and its impact on the lives of the people who have it.
http://adhdstruggles.wordpress.com/research-and-articles/
Have fun…
Thanks for the info! ADHD in children and ADHD in adults are two different things. Findings for one group shouldn’t be assumed for the other and that’s the one thing I have trouble accepting with your argument. However, you may have been focused solely on children from the get go and that’s my fault for not clarifying. I was thinking of it more along the lines of adult ADHD. Sorry about that, if that is the case!
Let me check with some people and see if I can’t get a guest blogger to get in on this conversation. It’s definitely not my specialty, but the topic is very interesting to me.
best,
ian
ADHD in adults and children is the same… but different. It is the same disorder, with the same basic symptoms, but needless to say has greatly different impacts. The treatments are not all that different.
The biggest difference is probably (no data to back this up, just an assumption)that left untreated into adulthood ther presence of comorbidities probably increases (i.e. bi-polar, sunstance addiction, etc).
That is also why I included a referrence to Dr. Barkley’s work. He has assembled most of the data on ADHD in children as well as adults and the treatments for both in his collective writings.
I will admitt that I did not initially raelize that the numbers I initially provided were based only on a study of children with ADHD.
As I am merely an ADHD sufferer and not a doctor, shrink or scientist I a definately not an authority on the various treatments for ADHD.
I hope you can find a guest blogger as I am always interested in learning more….
http://adhdstruggles.wordpress.com/
(edit: I asked a licensed psychologist who specializes in ADHD counseling to step in and offer some opinions. -ian)
I wanted to contribute to the dialogue by offering some information from the literature in the field related to the treatment of ADHD.
First, Barkley’s work has made a significant contribution to our understanding of ADHD and how to identify it. But he is just one of many leading researchers and experts in the field, especially with regard to the work that has been done in recent years to better understand adult ADHD. (Side note: While the core symptoms of ADHD are similar for children and adults, the characteristics associated with adults who have ADHD are different than those of children, as are the difficulties associated with adult ADHD as opposed to ADHD in children).
In terms of treatment for ADHD, the best approach is to follow an individualized, comprehensive plan specifically designed for you, based upon your particular situation and needs. This is one point where a counselor or psychologist trained in, or having experience in working with ADHD can be helpful. This may be in addition to working with a psychiatrist or physician for medication treatment, but for others it may replace the use of medication altogether.
Note that the issue of medication becomes more complicated in adulthood as it has been shown in controlled studies of stimulant medications and open studies of antidepressants that 20-50 percent of adults are considered nonresponders due to insufficient symptom reduction or inability to tolerate these medications (Wender, 1998; Wilens et al., 2002a). Moreover, adults who are considered responders typically show a reduction in only 50 percent or fewer of the core symptoms of ADHD, and these response rates are worse than the rates found in children (Wilens et al., 1998a, 2002a). So, although medications are highly useful in the treatment of adult ADHD, they are only partially effective and many residual symptoms often persist for adults with ADHD after adequate medication treatment.
Also, while medication may ameliorate many of the core symptoms of ADHD (attentional problems, high activity, impulsivity), it does not provide you with concrete strategies and skills for coping with associated difficulties. Quality-of-life impairments such as underachievement, unemployment or underemployment, economic problems, and relationship difficulties associated with ADHD in adulthood (see Biederman et al., 1993; Murphy & Barkley, 1996a; Ratey et al., 1992) require active problem-solving, which can be achieved with skills training over and above medication management.
The literature supports counseling, psychotherapy, and coaching, in one form or another, as key ingredients of a comprehensive plan to address the difficulties associated with ADHD (see the references listed below as well as Wilens etal., 1999 and McDermott, 2000). These forms of support can help you in developing skills for organizing and planning, coping with distractibility, managing anxiety and depression, avoiding procrastination, and imporving interpersonal interactions. Moreover, these forms of support can help you identify talents and strengths and promote them. People struggling with ADHD usually know their shortcomings all too well, while their talents and strengths have been camouflaged by what’s been going wrong. Working with a counselor, therapist or coach can help you to discover and promote the more advantageous characteristics of ADHD.
Other references that I find helpful with regard to understanding, living with, and treating ADHD are Hallowell and Ratey’s (2005) Delivered from Distraction (and their earlier book Driven to Distraction) and Brown’s (2005) ADD: The unfocused mind in children and adults.
Boston-Psychology.com
Thanks so much for the repsonse. I agree with you it needs to customized to the individual’s needs and situation. For example, in my case I also have impulse control disorder(gambling) and bi-polar. Fast acting stimulants are not really an option in my situation as they can make controling severe impulsivity difficult (in some cases). I tried them and it actually made the impulse related symptoms of adhd more difficult for me to manage. The combination of Lamotragine as a mood stabalizer and Concerta (long acting stimulant) has helped deal with a great deal of the symptoms in my case. That being said, the medications do little to counter a lifetime of habits I have developed as a response to my illness. That has required indepth therapy and Gamblers Anonymous.
That being said I still stand by the statement that a combination of therapy and medication is likely to get far better results than either one on its own.
The unfortunate thing about therapy is that while you are actively in it, the results are good. If you stop going the symptoms of ADHD (and whatever fun comorbididies you may have) tend to come back. In my case as long as I kept going to mt therpist and my Gamblers Anonymous meetings a great deal of the behaviors associated with my illness would have been managed. However if I felt I was “better” (and this happens quite often in mental illness) and stopped going the long term benefit of the therapy would almost be non existant.
The combination treatment method is effective in many ways as the two treatments compliment each other. Either one on its own would be far less effective than the the combination.
If you medicate and undergo therapy to learn the new skills necessary to manage your life you can grsdually reduce the therapy as the medication will help keep you from developing new bad habits. I see my therapist very regularily now but the ultimate goal is to only see him on a very occaisional basis.
Also like I mentioned above a probable difference between childhood adhd and adult adhd is the existance of far more cormorbididies which needless to say would definately complicate the application of medications as a treatment.
But the reality is that regardless of the type of medication used you are far more likely to acheive life manageabilty than with therapy alone. In all of the reading I have done the concensus seems to be that medication alone yields better results than therapy alone.
I have just finished reading:
ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults, edited by Thomas E Brown
and
ADHD in Adults: What the Science Says by Russell A. Barkley PhD ABPP ABCN, Kevin R. Murphy PhD, Mariellen Fischer PhD.
I have found both books to be enlitening and they both really shed some light on the complexity of treating adults with adhd.
Thanks again for you information. I will be following up on some of the referrences you provided. I am always looking to learn more about my illness.
Regards.
This is the kind of interaction I’d love to have on this blog more often! I had no idea that a quick post on ADHD would start this great conversation. Thanks for taking the time to drop by and leave a note in the first place!
best,
ian