Medication is the first-line treatment for ADHD unless the person prefers psychological treatment. Medication is part of a comprehensive treatment program addressing psychological, behavioural and educational or occupational needs. Our Psychiatrist will be able to provide the most appropriate pharmacological intervention that works for you.
For ASD pharmacological intervention is not the first choice, psychological therapies are shown to be effective in addressing the core symptoms of ASD. However, if other conditions co-exists (e.g. anxiety, depressive disorder) then medications might be a appropriate.
For other general mental health conditions, such as anxiety depression and other mood disorders, substance abuse/misuse, personality disorders, anger outbursts and other impulsive based disorders such as OCD, the treatment plan usually combines pharmacological and non pharmacological interventions.
Evidence-based psychological therapies include all the following (modified versions of CBT and Integrative approaches are also adapted to treat other general mental health conditions).
Cognitive Behavioural Treatment (CBT) for Adult ADHD
Very briefly, prior literature shows that Cognitive-Behavioural Therapies tailored to ADHD symptomatology is an effective treatment for ADHD in adults. A recent randomized, placebo controlled study showed that the effect of medication was augmented by CBT but, strikingly, medication did not impact on the capacity to learn the skills taught during CBT. This suggests that CBT can be effective in adults with ADHD, even in patients who cannot tolerate stimulants. This study suggests that CBT is an effective treatment for adults with ADHD with or without stimulant therapy.
Mindfulness based CBT for Adult ADHD
In recent years, mindfulness based CBT has been proposed to improve attention, reduce stress, and improve mood. Studies examining the efficacy of mindfulness based cognitive therapy show improvements in ADHD symptoms and performance on neuropsychological tasks measuring attention and cognitive inhibition. Improvements in anxiety and depressive symptoms were also observed. Animal research and research with memory training in ADHD support the idea that repetition of the same activity can activate corresponding brain regions and potentially strengthen the underlying circuitry.
Psychoeducation and Social Cognition Training for ASD
This approach has the aim to improve individuals’ ability to grasp social cues and, as a consequence, improve social functioning. Indeed, one problem central to individuals with autism is impaired social cognitive functioning. These social impairments encompass basic emotion recognition (reading specific emotions from human faces), theory of mind deficits (inferring intentions and beliefs in others and themselves) and other social cues (e.g. vocal tone), significantly affecting the lives of people with ASD and their families. The training employed here will focus in enhancing emotion/beliefs recognition using external cues, role playing, and facial emotion and prosody/vocal tone/body language recognition training tasks.
Applied Behaviour Analysis for ASD
This is a series of interventions that will lead to modification of behaviours. The Analysis focuses on an antecedent, which is a verbal or physical stimulus such as a command or request. This may come from the environment or from another person, or be internal to the subject; a resulting behavior, which is the subject’s response or lack of response to the antecedent; a consequence, which depends on the behavior. The consequence can include positive reinforcement of the desired behavior or no reaction for incorrect responses. ABA targets the learning of skills and the reduction of challenging behaviors. Most ABA programs are highly-structured. Targeted skills and behaviors are based on an established curriculum. Each skill is broken down into small steps, and taught using prompts, which are gradually eliminated as the steps are mastered.
Integrative approach for Adult ADHD and ASD
Research evidence also shows treatment effect when employing an integrative treatment approach based on cognitive behavioural (CBT), systemic paradigms, and attachment theories. Acceptance and Commitment Therapy (ACT) has also shown promising results.