Brief Cognitive Behavioral Therapy for College Students With ADHD: A Case Series Report☆

https://doi.org/10.1016/j.cbpra.2014.05.005Get rights and content

Highlights

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    Implementation and qualitative and quantitative results of an eight-session CBT protocol in four college students

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    Treatment fidelity, adherence, and satisfaction were very high across all clients

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    Pre- to posttreatment measures showed meaningful, positive treatment effects on impairment and adaptive functioning

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    Brief CBT may be a useful treatment option for college students with ADHD of mild to moderate severity

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is often diagnosed in childhood but persists into adulthood in many cases. This disorder, which is defined by the core symptoms of IA and HI, is also associated with impairment in academic settings, interpersonal relationships, and behavioral risk taking. While ADHD is most often treated with medication (e.g., stimulants), brief psychosocial treatments have also been shown to produce improvement in adults with ADHD, although these have not been adequately tested in college-age populations. The current study tested a brief, eight-session cognitive-behavioral protocol in a case-series design with four college students with ADHD. Participants completed measures tapping ADHD symptoms, anxiety, depression, and general impairment in academic, social, and employment domains. The findings indicate that the protocol may be useful as a short-term treatment option for college students with ADHD, warranting further study in controlled trials.

Section snippets

Interventions for Adult ADHD

The neurobiological nature of ADHD would seem to lend itself to pharmacological treatment. Indeed, a substantial body of research establishes that medication (e.g., psychostimulants) reduces IA and hyperactivity in adults (Mészáros et al., 2009), while the response rate is noticeably lower than that in children (Wilens et al., 1998, Wilens et al., 2002) and negative side effects such as nausea, lowered appetite, and insomnia may give adult clients further pause when considering this

Current Study

Given that most controlled trials of CBT have included 10 or more treatment sessions and samples have been largely composed of middle-aged adults, more detailed research on the efficacy of briefer protocols in younger populations is warranted. An eight-session CBT protocol could more readily be completed in one semester at a college or university, making it amenable to use by campus counseling centers, which typically cap services to cope with increased client loads (Stone & McMichael, 1996).

Participants

Four participants were recruited via staff referrals and flyers from those seeking services at a psychology department training clinic and other on-campus service providers at a public university. All participants were between 19 and 25 years old and attending the university or a community college in a rural town in the Southeastern United States. All had a documented diagnosis of ADHD-C (50%) or ADHD-IA (50%; see details in Procedures, below). Comorbid anxiety or depression were not exclusion

Case Presentation: Participant 1

Anna3 was a 19-year-old Caucasian female and a second-semester college freshman. She presented with time management and organization concerns, and reported that although she was highly motivated, she still found it difficult to study effectively, which often led to personal distress. Anna noted that her parents described her as “difficult” in childhood, and she had problems sitting still,

Discussion

The principal aim of this study was to gather evidence regarding the possible utility of an abbreviated, eight-session version of the Safren, Perlman, et al., (2005) Mastering Your Adult ADHD protocol in typically aged, full-time college students. Considering these four clients as a group, there was a trend toward positive change, but the degree and exact nature of improvement varied. Posttreatment ratings on the OQ-30 and WFIRS consistently indicated improved adjustment, with three out of four

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    ☆

    The authors would like to thank Anne Stevens for her assistance with the implementation of the protocol utilized herein. The first author received support to conduct this study from a research award from the Office of Student Research at Appalachian State University.

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    Copyright © 2014 Published by Elsevier Ltd.