ADHD Therapy in Bethesda, MD
Evidence-Based ADHD Diagnosis and Treatment
There are three major types of ADHD. The first type: a person only has challenges with attention and its related executive functions (e.g., organization, time management). About 25% of people with ADHD are diagnosed with the Predominantly Inattentive Type. The second type: a person only has challenges with hyperactivity and impulsivity and their related hot executive functions (e.g., anger control, emotional dysregulation). This is very rare to see beyond the preschool years. The third type: a person has problems with attention, hyperactivity and impulsivity, which is referred to as the Combined Type; about 75% of people diagnosed with ADHD meet criteria for this subtype.
The core problem with ADHD is thought to be impulsivity, which is akin to “ready-fire-aim” in speech and behavior. This impulsivity interferes with the development of hot and cold executive functions. For people without ADHD, self-talk is a method used to support executive functions (e.g., “I need to study for this boring test because I want to qualify to play on the school’s basketball team,” “I want to flip that other driver off but if I do it could cause them to become dangerous and aggressive”). But if a person doesn’t take the pause to self-talk, which is a common problem with ADHD, then they can’t benefit from their knowledge and they go with the flow (e.g., play a video game instead of studying, flip the other driver off). Effective treatments for ADHD include strategies for promoting pauses and adaptive self-talk.
We pride ourselves on our specialization in delivering a cost effective and thorough evaluation protocol for ADHD as well as our ability to identify conditions that commonly co-occur with ADHDADHD, or which can mimic ADHD. ADHD can easily be falsely diagnosed if the primary evaluation tool is interviewing. Evidence based approaches include other methods (e.g., rating scales completed by multiple people, review of school records). We make sure to do an evaluation that is both thorough and cost-effective (e.g., ADHD evaluations need not always require more expensive neuropsychogical testing). We then offer behavioral treatments that are research supported for treating ADHD and its commonly co-occurring problems. We also partner with expert prescribers who provide pharmacotherapy.
The behavioral treatments usually consist of two categories. First, we teach our clients how to mitigate their impulsivity and to think adaptively by using cognitive behavioral therapy and biofeedback. Second, we design tailored behavioral programs for parents and teachers to use (in the case of child or teen clients) or for clients to use themselves (in the case of adults) to promote wellness.
Dr. Dave is formerly the Clinical Director of a nationally recognized ADHD specialty clinic, has served in multiple leadership roles within the ADHD community, has published in the clinical literature on ADHD and currently serves on the national Board of Directors for CHADD.
Why Choose an Evaluation for ADHD?
- Having untreated ADHD increases the risk for many adverse outcomes such as delinquency, low self-esteem, depression, substance abuse, academic underachievement, rejection from peers and underemployment.
- ADHD is a diagnosis by exclusion, meaning that if another condition explains the symptoms, then the ADHD diagnosis is set aside. Diagnosing ADHD accurately is the foundation upon which all science-based interventions depend upon.
- If a person has ADHD, and it hasn’t been diagnosed, they often think of themselves as a major screw (e.g., stupid and unlikable). When someone thinks about themselves in that way, many, many other problems can follow.
Why Choose to Include Talking Treatments for ADHD?
- Most authoritative ADHD experts and organizations (e.g., the American Academy of Child and Adolescent Psychiatry) resounding assert that medication treatment, by itself, is insufficient for effectively treating ADHD.
- While pharmacotherapy is an essential part of the treatment plan, and when well-conceived is extremely helpful, it teaches nothing. It doesn’t teach coping strategies. It doesn’t teach parents and teachers how to set up a behavioral program. It doesn’t teach a person adaptive thinking, and so forth.
- Behavioral treatments, in the pantheon of mental health interventions, are most often short-term.
- When considering cost, it’s also important to calculate the costs of not effectively diagnosing and treating ADHD.
Common Concerns We Address
Take the First Step Toward Better Mental Health
