Metacognitive Therapy for ADHD

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Metacognitive Therapy for ADHD : Here is a Therapy that Just Might Help

There are a number of treatments for ADHD that can help people to focus, increase awareness, and improve performance in day to day living. These include medications, certain natural alternatives like Attend, EEG Biofeedback training, and particular eating programs. But absent from this list has been any form of clinical therapy, such as psychotherapy, as these forms of talking therapies tend to focus on improving people’s feelings or insight, rather than teaching particular skills that would improve performance or focus.

Through the years a notable exception to this has been cognitive-behavioral therapy combined with a specific set of skills training. We have seen this type of therapy help lots of people, but research studies have never been able to “prove” that it helps.

However, a new form of cognitive-behavioral therapy has been developed over the past twenty years that was originally designed to better help those suffering from anxiety disorders or depression. CBT has always been helpful in treating these disorders, and therapists and researchers have invested time and money into finding ways to continually improve its impact.

This new technique is called Metacognitive Therapy (MCT), which is based on the work of Wells and Matthews (1994). To over-simplify things, let me say that MCT has helped those with anxiety disorder or depressive disorders by helping them learn how to gain both awareness over their thoughts, and control over their thoughts. It seeks to help people to learn how to change the thinking patterns that have developed over time that cause anxiety, fear, panic, or depression.

To do this, Metacognitive therapists have developed different types of awareness exercises and attention training exercises. These exercises can help people to control thinking processes, and can also train people to improve focus, attention, the flexibility of attention, decrease the noise of distractions, and increase awareness.

So, obviously then, somebody asked if this would work for people with ADHD. And this is where Mary Solanto, Ph.D., and her research team from the Attention Deficit Hyperactivity Disorder Center at Mount Sinai Hospital stepped in to find out. Dr. Solanto is the Director of the ADHD Center at the hospital there in New York. The study is published in the American Journal of Psychiatry. Her team had published a previous study on the subject in the Journal of Attention Disorders in 2008 with similar positive findings.

They designed a study where ½ of the subjects would attend either a support group for ADHD, or a MCT group. But groups received the same amount of therapist time and attention. There were 88 subjects in the study, which lasted for 12 weeks of treatment. The study began by using rigorous diagnostic standards for ADHD, and gathering baseline information on the subject’s ADHD symptoms, especially as related to inattention, time management skills, and organizational skills – real world issues with adult ADHD. The study also looked at symptoms of depression and anxiety, probably since (1) these are often seen in adults with ADHD, and (2) the MCT therapists had already developed these tools.

Those in the MCT group saw far greater improvements in their ADHD symptoms, organizational skills, and “executive functions” than did those in the support group.

We are always supportive when clinicians teach skills rather than just hand out pills. So along with Attend, EEG Biofeedback training, and a good ADHD Diet, we will add MCT to our list of non-medication treatments that just may work for you.

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