J Atten Disord. 2015 Mar;19(3):260-7. DOI: 10.1177/1087054714535951
“Pilot Randomized Controlled Trial of Dialectical Behavior Therapy Group Skills Training for ADHD Among College Students”
Fleming, A.P., McMahon, R.J., Moran, L.R., Peterson, A.P., Dreessen, A.
This article reports on the results of the first randomized controlled clinical trial of treatment program for college students with ADHD. Thirty-three college students with ADHD between the ages of 18 and 24 years were randomized to receive either group administered Dialectical Behavior Therapy (DBT) supplemented by individualized week coaching phone calls or a skills handouts (SH) intervention based on a published manual for adults with ADHD. The DBT intervention consisted of eight weekly 90 minute sessions and seven weekly 10-15 minute individual coaching phone calls designed to assist participants to address key areas of difficulty. A booster session was offered to subjects during the first week of the following academic quarter. Session topics included psycho-education about ADHD, mindfulness, daily planner use, chunking tasks, prioritization, structuring the environment, using social support, managing sleep, eating and exercise, emotion regulation, and troubleshooting about skills use. The SH material topics included psycho-education about ADHD and executive functioning, organization, planning, time management, structuring the environment and stress management. Outcome measures included the Barkley Adult ADHD Rating Scale IV (symptom measurement), the Brown ADD Rating Scales (as a proxy for executive functioning), the ADHD Qualify of Life Questionnaire, the Beck Depression and Anxiety Inventories, the Fie Facet Mindfulness Questionnaire, the subject’s GPA from the academic quarter prior to each assessment point, and performance on the Conners’ Continuous Performance Task (CPT). Both groups had similar baseline measures and treatment completion rates. At the conclusion of the study, compared to the SH participants, subjects receiving DBT and coaching phone calls showed significant improvement in treatment response rates (59-65% v 19-25%) and clinical recovery rates (53-59% v 6-13%). At follow up, DBT subjects showed greater improvements in ADHD symptoms, executive functioning and mindfulness. No differences between groups were seen in comorbid symptoms, GPA or on CPT measures, although a trend toward significance was reported. Of note, subjects in the SH group did have a treatment response rate of 25% which suggests this may be a cost effective alternative. Participants in the DBT group reported that mindfulness, planning and organization were the most helpful aspects of the program. Overall, these are promising results from a small RCT of a structured group-administered skills training program for college students with ADHD. While it is important to replicate this intervention on a broader scale, these results suggest that programs of this sort should be made more widely available to this population.