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Areas › Focus, starting, and ADHD › Treatment and medication
Thirty minutes of someone listening properly to your difficulties is not filler around the real treatment. Across the talking therapies, who the therapist is and how the relationship goes accounts for more of the outcome than which method is being used. It is also the one thing always in your gift, on a day when nothing else is working and there is no technique left to try.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
You were gentle in your dealings with them (Quran 3:159). The verse goes on to say that harshness would have scattered them, which puts manner at the centre of the work rather than at its edges.
آل عمران
فَبِمَا رَحۡمَةࣲ مِّنَ ٱللَّهِ لِنتَ لَهُمۡۖ وَلَوۡ كُنتَ فَظًّا غَلِيظَ ٱلۡقَلۡبِ لَٱنفَضُّواْ مِنۡ حَوۡلِكَۖ فَٱعۡفُ عَنۡهُمۡ وَٱسۡتَغۡفِرۡ لَهُمۡ وَشَاوِرۡهُمۡ فِي ٱلۡأَمۡرِۖ فَإِذَا عَزَمۡتَ فَتَوَكَّلۡ عَلَى ٱللَّهِۚ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُتَوَكِّلِينَ
By an act of mercy from God, you [Prophet] were gentle in your dealings with them- had you been harsh, or hard-hearted, they would have dispersed and left you- so pardon them and ask forgiveness for them. Consult with them about matters, then, when you have decided on a course of action, put your trust in God: God loves those who put their trust in Him
Qur’an 3:159read 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 whether psychological treatment helps adults who are not on medication. Both arms involve regular contact with a person who is paying attention, which the trial does not separate out and cannot. Take it as showing that structured human contact of either kind was worth having, rather than as a measurement of presence itself.
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.
Being attended to closely is itself one of the active parts, which is why time given properly is rarely wasted.
Play based programmes that build executive skills in young children have done reasonably well with children at risk of struggling at school. None has yet been tested in children actually diagnosed with ADHD, and that is a real difference rather than a technicality.
If mindfulness is going to help with ADHD, the version with a chance is small and spread out. A few seconds of noticing, several times a day, rather than one long sitting you come to dread.
Decide at the start what you are actually aiming at. Eight difficulties down to six, then to four, then perhaps to two. Never zero, because zero was never on offer.