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A person taking notes during an online ADHD therapy session on a tablet, showcasing the benefits of occupational therapy in treating adult ADHD.

Assessing the Effectiveness of Occupational Therapy in Managing ADHD

7

Patients

4

Occupational Therapists

4

Weeks

73.2%

Avg. Life Quality Improvement

“Prior to my first session, I was in a dark mental health spot. Over the last four sessions, I feel better both mentally and physically, with symptoms of anxiety and depression waning. My mental health has improved over the last four weeks.”

— A patient from insurance industry

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder affecting both children and adults. Effective treatment often involves a combination of medication, behavioral therapy, and lifestyle adjustments. This case study explores a trial involving 7 pairs of individuals struggling with ADHD symptoms and occupational therapists, aiming to assess the efficacy of a personalized occupational therapy approach through a quantitative assessment of life quality improvements.

Objectives

  1. Evaluate the impact of personalized occupational therapy on ADHD symptoms.
  2. Determine the effectiveness of therapy sessions and homework assignments.
  3. Assess the improvement in patients’ functional levels.

Participants

Patients: 7 individuals (5 diagnosed with ADHD and 2 experiencing ADHD-like symptoms).

Patient 1

26-30 years old

Technology

Not diagnosed, but struggling


Challenges

1
Inattention

Struggles to focus, feels unmotivated, zones out often. Difficulty with new hobbies and completing tasks.

2
Emotional Dysregulation

Acts goofy alone, makes extra sounds, crumbles thinking about awkward moments.

Needs

1
Self-Awareness and Understanding

Understand personal patterns better and distinguish normal behavior from what requires treatment.

Patient 2

26-30 years old

Insurance

Diagnosed


Challenges

1
Inattention

Fails to complete work responsibilities.

2
Emotional Dysregulation

Can’t maintain relationships of any kind.

Needs

1
Daily Functioning and Routine Management

Become a functioning adult who can hold down a job and take care of oneself and one’s environment.

Patient 3

30-35 years old

Insurance

Diagnosed


Challenges

1
Emotional Dysregulation

Unstable and tumultuous relationship with spouse. Low self-esteem, low frustration tolerance, and trouble coping with daily stressors.

Needs

1
Relationship and Social Skills

Improve spousal relationships.

2
Emotional Regulation

Enhance frustration tolerance and cope better with daily stressors.

Patient 4

26-30 years old

Technology

Not diagnosed, but struggling


Challenges

1
Inattention

Finds it hard to stick to tasks and gets easily distracted.

Needs

1
Daily Functioning and Routine Management

Find better ways to manage.

Patient 5

26-30 years old

Consulting

Diagnosed


Challenges

1
Executive Functioning

Poor working memory. Forgets important details from conversations. Needs multiple repetitions for instructions. Fears incompetence.

Needs

1
Executive Functioning and Cognitive Skills

Improve multitasking and working memory, enhance executive functioning, and strengthen professional social skills.

Patient 6

50+ years old

Technology

Diagnosed


Challenges

1
Inattention

Difficulty settling into the day and staying focused.

2
Executive Functioning

Struggles to stick with strategies long enough to see results.

Needs

1
Self-Awareness and Understanding

Adapt to brain function changes after menopause.

2
Executive Functioning and Cognitive Skills

Find effective new mechanisms.

3
Daily Functioning and Routine Management

Perform well in a new job.

Patient 7

18-25 years old

Technology

Diagnosed


Challenges

1
Inattention

Difficulty paying attention and fully concentrating. Hyperfocuses on less important tasks.

2
Executive Functioning

Poor executive functioning.

Needs

1
Executive Functioning and Cognitive Skills

Accomplish tasks and improve executive functioning.

Composition

The group is diverse, with a roughly equal number of women and men, ranging in age from young adults to middle-aged individuals. They hold a variety of professional roles across different industries. Their functional levels vary.

Functional Levels Definition

Challenges

Participants face various challenges, including inattention, hyperactivity and impulsivity, executive functioning, and emotional dysregulation.

* The categorization of challenges is based on standard classifications used in ADHD research.

Needs

The patients’ described needs can be categorized into enhancing self-awareness and understanding, improving executive functioning and cognitive skills, regulating emotions, and managing daily routines effectively.

* The categorization of needs is based on therapeutic approaches and support strategies commonly used in ADHD treatment.

“Main challenges for me were being overwhelmed by tasks in my personal and work life, struggling with task initiation and follow-through, procrastination, and a general feeling of being overwhelmed or anxious about missing something.”

— Patient, Software Engineer

Methodology

1

Initial Assessment

Comprehensive evaluation of each patient’s symptoms, functional levels, and personal goals. Patients completed a Quality of Life assessment form to quantify their initial state.

2

Pairing

Matching patients with therapists based on professional background and specific needs.

3

Intervention

  1. Therapy Sessions: Weekly one-on-one sessions focusing on behavior management, cognitive restructuring, and coping strategies.
  2. Homework Assignments: Tailored activities designed to reinforce session learnings and facilitate real-world application.

“Over the last four weeks, I’ve gained various strategies and had time to iterate on them to suit my needs. Applying these strategies has helped me stay on top of tasks. Additionally, I’ve developed strategies to make use of downtime before important meetings.”

— Patient, Software Engineer

“Susan is good at coming up with concrete and doable plans, not just ambitious but less concrete ones.”

Patient, Software Engineer
4

Monitoring and Evaluation

  1. Pre- and post-intervention assessments using standardized ADHD rating scales and Quality of Life surveys.
  2. Regular feedback sessions to adjust therapy plans.

Results

Transformative Impact

Transformative Impact of Occupational Therapy in Managing ADHD: 73.2% Average Life Quality Improvement
Quantitative data was derived from pre- and post-intervention Quality of Life assessments using a Likert Scale, highlighting significant improvements through personalized therapeutic interventions.

Quantitative data from pre- and post-intervention Quality of Life assessments highlight significant improvements, with an average life quality score increase of 73.2%. The diverse sample, covering various professions, ages, and high to moderate functional levels, shows notable life quality enhancements across all participants. The increase rate was calculated using the formula, reflecting substantial improvement in participants’ overall well-being.

0
High functioning patients’ average life quality improvement
0
Moderate functioning patients’ average life quality improvement

“The strategies have immediate applicability, especially at work. Restructuring my calendar and being mindful of energy loss have improved my ability to handle challenges. This positive impact extends to my home life as well.”

— Patient, Senior Role in Design

“Through my sessions with Anne, I transitioned from feeling overwhelmed and stressed to finding a comfortable balance in my busy life. The practical methodologies and personalized support provided by Anne have been invaluable in managing my ADHD symptoms and improving my overall well-being. This experience has been insightful, comfortable, and significantly beneficial.”

— Patient, Data Scientist

Conclusion

The occupational therapy model demonstrated substantial benefits in managing ADHD symptoms and improving functional levels across a diverse patient population. Tailored therapy sessions combined with practical homework assignments proved effective in enhancing both high functioning individuals and those with significant challenges.

Recommendations

  • Continue occupational therapy approaches for ADHD treatment.
  • Expand the trial to include a larger and more diverse patient population.
  • Explore additional support mechanisms, such as group therapy and digital tools, to complement one-on-one sessions.
  • Investigate long-term outcomes and scalability of occupational therapy.
  • Assess the potential for automated occupational therapy approaches in ADHD treatment.

Appendix

Reference & Assessment Tools
  • Gjervan, B., & Nordahl, H. M. (2010). The Adult ADHD Quality of Life Questionnaire (AAQoL): A new disease specific measure for assessment of ADHD. Nordic Psychology, 62(1), 24–36. [Link]
  • Agarwal, R., Goldenberg, M., Perry, R., & IsHak, W. W. (2012). The quality of life of adults with attention deficit hyperactivity disorder: a systematic review. Innovations in clinical neuroscience9(5-6), 10–21. [Link]
  • Yamashita, T., Millar, R.J. (2021). Likert Scale. In: Gu, D., Dupre, M.E. (eds) Encyclopedia of Gerontology and Population Aging. Springer, Cham. [Link]

All patient information presented in this case study has been anonymized to protect patient privacy in compliance with relevant privacy regulations, including the Health Insurance Portability and Accountability Act (HIPAA), Common Rule (45 CFR 46), Massachusetts Data Privacy Law (201 CMR 17.00), and applicable state and provincial privacy laws in the United States and Canada. The details provided are for illustrative purposes only and do not contain any personally identifiable information. Any resemblance to actual persons, living or deceased, is purely coincidental. Informed consent has been obtained from the patients for the use of their anonymized data in this case study.

Due to the limited number of participants and restrictions related to therapy licensing and regulations, formal occupational therapy services could not be provided in this trial. The coaching intervention was designed to closely replicate the content and approach of occupational therapy, but it was not officially recognized as such. The findings of this case study should be interpreted within this context.