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Areas › Focus, starting, and ADHD › Treatment and medication
That is worth saying because a thin research base is not the same as a therapy that fails. Approaches that work through relationship, imagery or the body are harder to break into countable pieces, so fewer trials get run and the evidence stays thin whether or not the work helps. Having said all that, the structure of CBT, the homework and the concrete skills do genuinely suit ADHD, so its standing is not an artefact of measurement alone.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
How can those who know be equal to those who do not know? (Quran 39:9). Knowing is held up as worth having, and it is worth knowing why one shelf of research is fuller than another.
الزمر
أَمَّنۡ هُوَ قَٰنِتٌ ءَانَآءَ ٱلَّيۡلِ سَاجِدࣰ ا وَقَآئِمࣰ ا يَحۡذَرُ ٱلۡأٓخِرَةَ وَيَرۡجُواْ رَحۡمَةَ رَبِّهِۦۗ قُلۡ هَلۡ يَسۡتَوِي ٱلَّذِينَ يَعۡلَمُونَ وَٱلَّذِينَ لَا يَعۡلَمُونَۗ إِنَّمَا يَتَذَكَّرُ أُوْلُواْ ٱلۡأَلۡبَٰبِ
What about someone who worships devoutly during the night, bowing down, standing in prayer, ever mindful of the life to come, hoping for his Lord’s mercy? Say, ‘How can those who know be equal to those who do not know?’ Only those who have understanding will take heed
Qur’an 39:9read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A randomised clinical trial in 88 adults compared group CBT with individual coaching, with and without medication, asking in particular whether psychological treatment helps adults who are not medicated. Comparisons like that are possible because both approaches can be delivered to a protocol and scored the same way. Eighty eight people across several arms leaves each group small, so read it as one careful contribution rather than a verdict.
Cherkasova MV, French LR, Syer CA, Cousins L, Galina H, Ahmadi-Kashani Y, Hechtman L. (2020). Efficacy of Cognitive Behavioral Therapy With and Without Medication for Adults With ADHD: A Randomized Clinical Trial.. Journal of attention disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
What is easy to measure gets measured most, so the research pile reflects countability as well as usefulness.
The most convincing programme for teenagers does the obvious thing. It runs at school, twice a week, so nobody has to be driven anywhere: homework systems, organisation, some social practice and sport, in the place where the trouble actually happens.
A ramp does nothing for someone's legs, and it gets them into the building. Timers, visible clocks, a shorter task list and a calendar somebody else keeps do the same job here.
Long acting does not automatically suit everybody. Some people genuinely do better on shorter doses, and it is worth saying so rather than assuming the newer option must be right.