Meta-cognitive therapy more effective for adult ADHD patients: study

Mount Sinai researchers have learned that meta-cognitive therapy (MCT), a method of skills teaching by use of cognitive-behavioral principles, yielded significantly greater improvements in symptoms of attention deficit hyperactivity disorder (ADHD) in adults than those that participate in supportive therapy. The study, titled "Meta-Cognitive Therapy," is now published in the American Journal of Psychiatry.

Mary Solanto, Ph.D., Associate Professor in the Department of Psychiatry and Director of the Attention Deficit/Hyperactivity Disorder Center at The Mount Sinai Medical Center examined the effectiveness of a 12-week meta-cognitive therapy group. The intervention was intended to enhance time management, organizational, and planning skills/abilities in adults with ADHD.

"We observed adults with ADHD who were assigned randomly to receive either meta-cognitive therapy or a support group," said Dr. Solanto. "This is the first time we have demonstrated efficacy of a non-medication treatment for adult ADHD in a study that compared the active treatment against a control group that was equivalent in therapist time, attention, and support."

The study observed 88 adults with rigorously diagnosed ADHD, who were selected following structured diagnostic interviews and standardized questionnaires. Participants were randomly assigned to receive meta-cognitive therapy or supportive psychotherapy in a group setting. Groups were equated for ADHD medication use.

Participants were evaluated by an independent (blind) clinician using a standardized interview assessment of core inattentive symptoms and a subset of symptoms related to time-management and organization. After 12 weeks, the MCT group members were significantly more improved than those in the support group. The MCT group was also more improved on self-ratings and observer ratings of these symptoms.

Meta-cognitive therapy uses cognitive-behavioral principles and methods to teach skills and strategies in time management, organization, and planning. Also targeted were depressed and anxious thoughts and ideas that undermine effective self-management. The supportive therapy group matched the MCT group with respect to the nonspecific aspects of treatment, such as providing support for the participants, while avoiding discussion of time management, organization, and planning strategies.