Cognitive-behavioral group therapy for ADHD predominantly inattentive presentation: A feasibility study of a new treatment protocol

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a highly impairing condition with varying clinical presentations. Psychological treatments for ADHD are often similar, irrespective of predominant symptomatology. However, because inattention and hyperactivity/impulsivity are associated with different challenges in daily life more presentation-specific treatments are warranted. The purpose of the present study was to evaluate the feasibility and explore the preliminary effects of a novel group-based cognitive-behavioral therapy (CBT) protocol for ADHD predominantly inattentive presentation (ADHD-I), with the aim to reduce symptoms of inattention and associated problems. Materials and Methods. Using an open trial design, 39 adult patients with ADHD-I were included. Participants underwent 14 sessions of the new CBT for ADHD-I (CADDI) protocol, which includes skills training in organizing and initiating activity and coping with procrastination and passivity. In addition, mindfulness meditation is practiced throughout treatment. Results. The CADDI protocol proved feasible in terms of session completion and treatment acceptability. However, home assignment completion was moderate and attrition was high. Inattentive symptoms, assessed by clinicians and self-report, were reduced of a medium effect size, (Cohen’s d = 0.65 and d = 0.55, respectively) and symptoms of depression of a small effect size (d = 0.48). An increase of a large effect size was observed for mindfulness meditation (d = 0.91). No effects were seen in functional impairment, nor in quality of life. Conclusions. The CADDI protocol is a potentially valuable new psychological treatment for adults with ADHD-I, although treatment effects need to be further evaluated and participant retention secured in randomized controlled trials.