Efficacy of meta-cognitive therapy for adult ADHD
Open accessAbstract
OBJECTIVE: The authors investigated the efficacy of a 12-week manualized meta-cognitive therapy group intervention designed to enhance time management, organization, and planning in adults with attention deficit hyperactivity disorder (ADHD). METHOD: Eighty-eight clinically referred adults who met DSM-IV criteria for ADHD according to clinical and structured diagnostic interviews and standardized questionnaires were stratified by ADHD medication use and otherwise randomly assigned to receive meta-cognitive therapy or supportive psychotherapy in a group modality. Meta-cognitive therapy uses cognitive-behavioral principles and methods to impart skills and strategies in time management, organization, and planning and to target depressogenic and anxiogenic cognitions that undermine effective self-management. The supportive therapy condition controlled for nonspecific aspects of treatment by providing support while avoiding discussion of cognitive-behavioral strategies. Therapeutic response was assessed by an independent (blind) evaluator via structured interview before and after treatment as well as by self-report and collateral informant behavioral ratings. RESULTS: General linear models comparing change from baseline between treatments revealed statistically significant effects for self-report, collateral report, and independent evaluator ratings of DSM-IV inattention symptoms. In dichotomous indices of therapeutic response, a significantly greater proportion of members of the meta-cognitive therapy group demonstrated improvement compared with members of the supportive therapy group. 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). CONCLUSIONS: Meta-cognitive therapy yielded significantly greater improvements in dimensional and categorical estimates of severity of ADHD symptoms compared with supportive therapy. These findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention.
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One subsequent randomized controlled trial found better outcomes for a group-based cognitive behavioral treatment compared with a time-matched control group treatment.
“Subsequent to our review, one randomized controlled trial found better outcomes for a group-based cognitive behavioral treatment compared with a time-matched control group treatment.6”
From Cognitive Behavioral Therapy vs Relaxation With Educational Support for Medication-Treated Adults With ADHD and Persistent Symptoms (2010) · cites this paper as [6]
Patient #2's symptom improvement surpassed the 30% threshold commonly used to define treatment response.
“The change in ADHD symptom severity scores for Patient #2 is greater than 30% symptom reduction criterion used in treatment outcome studies to classify treatment responders (e.g., Safren et al., 2010; Solanto et al., 2010).”
From Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions (2015) · cites this paper as Solanto et al., 2010
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- Authors
- Solanto, M. V., Marks, D. J., Wasserstein, J., Mitchell, K., Abikoff, H., Alvir, J. M. J., & Kofman, M. D.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Venue
- American Journal of Psychiatry
- Published
- 2010-08-01
- Volume
- 167
- Issue
- 8
- Pages
- 958-968
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3633586
- OpenAlex
- W2106508714
- Cited by
- 370
- References
- 33
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 11 · 2023: 13 · 2022: 9 · 2021: 22 · 2020: 15 · 2019: 19 · 2018: 18 · 2017: 28 · 2016: 32 · 2015: 34 · 2014: 47 · 2013: 27 · 2012: 34
- FWCI
- 20.77
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r34mh071721-03)
- National Institute of Mental Health (R34 MH071721, 1R34MH071721)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- adult ADHD, attention deficit hyperactivity disorder, group therapy, time management, inattentive symptoms, supportive therapy, psychosocial interventions, cognitive behavioral therapy, ADHD medication use, treatment efficacy
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Double-Blind Method, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotherapy, Psychotherapy, Group, Surveys and Questionnaires, Self Care, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
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