Cognitive-behavioural therapy for adult attention deficit hyperactivity disorder: a proof of concept randomized controlled trial

Objective
To investigate efficacy, patient acceptability and feasibility of formulation-based cognitive behavioural therapy (CBT) for adults with attention deficit hyperactivity disorder (ADHD). NICE guidelines for adult ADHD recommend further research into psychological treatments.
Method
60 participants with adult ADHD were randomly allocated to treatment as usual (TAU) vs TAU plus up to 16 sessions of individual formulation-based CBT for ADHD.
Results
Adding formulation based CBT to TAU for ADHD significantly improved ADHD symptoms on the Barkley Current Symptoms Scale and scores on the Work and Social Adjustment Scale. Adjusted effect sizes (ES) were 1.31 and 0.82 respectively.
There were also significant improvements on secondary outcomes including independently evaluated clinical global improvement, self-rated anxiety, depression, global distress and patient satisfaction (adjusted effect sizes 0.52-1.01).
Conclusions
This is the first randomized controlled trial to provide preliminary evidence of efficacy and acceptability of individual formulation-based CBT for ADHD when added to TAU over TAU alone. This approach now needs to be tested in a larger multi-centred randomized controlled trial.