Investigating routine care non-pharmacological treatment for adolescents with ADHD.

Autor:	Sibley MH; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States.; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States., Reyes Francisco JC; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States., Rios-Davis A; Department of Psychology, Florida International University, Miami, FL, United States., Graziano PA; Department of Psychology, Florida International University, Miami, FL, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in health services [Front Health Serv] 2022 Aug 17; Vol. 2, pp. 929521. Date of Electronic Publication: 2022 Aug 17 (Print Publication: 2022).
DOI:	10.3389/frhs.2022.929521
Abstrakt:	Objective: To characterize routine non-pharmacological care for youth with ADHD. Methods: 76 audio-recorded work-samples were collected from community mental health therapists in a large metropolitan area in the United States and were analyzed for operationally defined practice elements commonly included in evidence-based non-pharmacological treatment for ADHD. Analyses characterized community provider practices and examined predictors of using evidence-based (vs.low-value) practices. Results: Individually delivered social skills training was the most commonly detected practice element (31.6% of practice samples). Parent involvement in routine care was uncommon (53.9% of sessions had no parental presence). Core elements of evidence-based practices were rarely delivered (e.g., organization skills training: 18.4% of tapes; operant reinforcement: 13.2%); when evidence-based content was introduced, it was typically implemented at a very low intensity. Patient and provider characteristics did not predict use of evidence-based practices. Conclusions: Routine non-pharmacological care for adolescent ADHD primarily consisted of low value practices such as youth-directed treatment and social skills training with low parent involvement and only occasional therapy homework. To improve quality of care, efforts to de-implement low value practices should be coupled with efforts to implement evidence-based practices (i.e., parent involvement, measurement-based care, organization skills training, use of operant reinforcement). Competing Interests: MS receives book royalties from Guilford Press for a book on treating ADHD in adolescence using non-pharmacological approaches. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Sibley, Reyes Francisco, Rios-Davis and Graziano.)
Databáze:	MEDLINE
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