Meta-cognitive Therapy More Effective than Supportive Psychotherapy for Adults with ADHD

Meta-cognitive therapy, a program that teaches skills with the use of cognitive-behavior principles, may be a more effective treatment regimen for adult ADHD patients than supportive therapy, researchers at Mount Sinai Medical Center report.

Mary Solanto, PhD, associate professor in the department of psychiatry and director of the Attention Deficit/Hyperactivity Disorder Center at the medical center, and a team of researchers observed adult ADHD patients in a 12-week meta-cognitive therapy (MCT) group intervention that focused on improving time management, organization, and planning. The study cohort included 88 adult patients with “rigorously diagnosed ADHD” who were randomized to receive either meta-cognitive therapy or supportive psychotherapy in a group setting. The patients in the supportive psychotherapy group “matched the MCT group with respect to the nonspecific aspects of treatment, such as providing support for the participants, while avoiding discussion of time management, organization, and planning strategies.” Both groups were given ADHD medication.

At the end of the 12 weeks, a significantly great amount of patients in the meta-cognitive therapy group had improved, based on a comparison of changes from start to finish that used self-report, collateral report, and independent evaluator ratings of DSM-IV inattention symptoms. Also, “logistic regression examining group differences in operationally defined response (controlling for baseline ADHD severity) revealed a robust effect of treatment group (odds ratio = 5.41; 95% CI = 1.77—16.55),” the authors write in the American Journal of Psychiatry abstract.

In adults with ADHD, “meta-cognitive therapy yielded significantly greater improvements in dimensional and categorical estimates of severity of ADHD symptoms compared with supportive therapy,” the authors conclude. “These findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention.”