"Cognitive and behavioral therapies that help young people reduce impulsivity and cultivate good study habits are costlier and take longer, but may be more efficacious over time..."
By SciCurious
May 15, 2012
Before stimulant drugs such as Ritalin, Concerta and Adderall began their rise to popularity in the 1970s, treatment for attention-deficit hyperactivity disorder (ADHD) focused on behavioral therapy. But as concerns build over the mounting dosages and extended treatment periods that come with stimulant drugs, clinical researchers are revisiting behavioral therapy techniques. Whereas stimulant medications may help young patients focus and behave in the classroom, research now suggests that behaviorally based changes make more of a difference in the long-term.
A new synthesis of behavioral, cognitive and pharmacological findings emerged at the recent Experimental Biology meeting, held last month in San Diego, where experts in ADHD research and treatment gathered to present their work. Their findings suggest that behavioral and cognitive therapies focused on reducing impulsivity and reinforcing positive long-term habits may be able to replace current high doses of stimulant treatment in children and young adults.
Recent surveys indicate that 9 percent of all children in the U.S. have been diagnosed with ADHD. The condition's core symptoms include hyperactivity, inattention, inability to perform monotonous tasks and lack of impulse control. Children with ADHD have trouble in school and forming relationships, and 60 percent will continue to suffer from the disorder well into adulthood.

As expected, she found that people diagnosed with ADHD had lower grades and ACT (American College Testing) scores; they also dropped more classes than their peers. But she also found that these issues were not improved by stimulant medication.
"If students had good study habits, they did not need the medication to bolster their grades."
Instead, Advokat’s new findings indicate that the ADHD students naturally divided into those who had good study habits and those who did not, regardless of treatment. If students had good study habits, they did not need the medication to bolster their grades. It is not that medication has no effect, Advokat hypothesizes that "it may be that the medications can help, not in helping you remember, but in helping you form the good study habits" necessary for academic improvement. This outcome suggests that if ADHD patients could learn good study habits early on, medication could become less necessary.

"...data suggests that lower dosages combined with behavioral therapy may provide a far better outcome than stimulant medication or behavioral therapies alone."
Independently, Pelham has also shown that behavioral therapy for children also produced effects that were equal to some doses of medication. His data suggests that lower dosages combined with behavioral therapy may provide a far better outcome than stimulant medication or behavioral therapies alone.

New unpublished results from Schweitzer’s team have shown that cognitive therapy could improve control, again potentially reducing the need for medication to "drown out" extraneous information.
Advokat, Schweitzer, Pelham and other scientists at this year's confab agreed that behavioral therapies deserve their renewed focus. These therapies create no drug-tolerance and come with no concerns about future substance abuse. The trick will be identifying which of the new therapies is most effective, and making those therapies affordable.
For now, stimulant medications are much cheaper and act faster than behavioral therapy, even if the latter may be the most effective in the long run. But experts as well as parents know that the long run is what matters most.
While many may say that CBT or Cognitive Behavioral Therapy takes a lot of time to bring about the desired effect on the patient. However, experts will always opine that CBT should be included as a part of drug addiction treatment program. In the long run, CBT has proven to be effective since it teaches the addict the ways of a sober life. Read More Visit behavioral therapy
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