6: Treatment of ADHD Flashcards
What is Evidence based treatment?
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
How does a therapist know which treatment is gucci?
Guidelines: show what type of treatment is recommended for specific disorders
Zorgstandaard & National Institute for Health and Care Excellence (NICE)
What is effectiveness?
The extent to which a treatment achieves its intended effect in the usual clinical setting.
Pros of medication use?
- Effective in 70%
- Direct effect on symptoms and functioning
- Choice between short- and long acting formula
- Less sensitive to addiction later in life
Cons of medication use?
- Not effective in 30%
- Does not cure ADHD, when it wears out, effects stop
- Suboptimal delivery of dose and monitoring
- Effects might wear of in time: tolerance
- Long term effects not known
- Reduction of height
- Side-effects
- Forgetting to take medication
What are the criteria of NJI of levels of efficacy?
- Well reasoned: clear description of the treatment that makes effectiveness plausible
- First indications of effectiveness: two studies using pre- to postmeasurements (1 in NL)
- Good indications of effectiveness:
- Strong indications of effectiveness: two studies with strong evidence
What does medication do?
- Reduce overactivity, impulsivity and inattention
- Improve associated behaviors, including on-task behavior, academic performance and social functioning
Where does treatment start?
Psycho-education!
What’s recommended for kids?
Combi between behavioral and medication therapy
When are behavior interventions most effective?
- Psycho-education in 2 sessions (not more)
- Individual instead of grouptraining
- When CD, single parent or severe ADHD, child symptoms worsen without BI
Why study adolescents with ADHD separately?
In the adolescence there is more independence, which creates a greater demand on EF, Motivation and Timing, which can bring more problems (school, parents, friends, comorbidity)
Guidelines on treatment of adolescents with ADHD
Advise:
- CBT/skills training
- Parent/teacher training
- Medication
What can you say about motivation for treatment?
45-60% of adolescents drop out of treatment
ADHD is important predictor for dropout
What can you say about motivation for treatment?
45-60% of adolescents drop out of treatment
ADHD is important predictor for dropout
What can you say about Zelf Plannen?
Invention gericht op planning
- In high school effective, less effective in university
