Consistent Occupational Therapy Improves ADHD Outcomes: A Sustainable Approach to Behavioral Health

Introduction

This case study presents the second phase of our ongoing occupational therapy research, focusing on managing ADHD symptoms and improving life quality. It continues the work initiated in the first phase, extending the study to gather new data and insights.
A person taking notes during an online ADHD therapy session on a tablet, showcasing the benefits of occupational therapy in treating adult ADHD.
Case Study of Trial I
Assessing the Effectiveness of Occupational Therapy in Managing ADHD
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Unlike the structured participant selection in the first phase, where participants were manually recruited and evenly distributed by gender, this phase adopted a more natural recruitment process. Participants independently scheduled their first therapy session through organic website traffic and Google Ads outreach.
While the study reaffirms the effectiveness of occupational therapy, it also highlights key factors that influence therapeutic outcomes. These insights emphasize the importance of encouraging regular participation and understanding the diverse contexts that affect therapeutic outcomes.

Objectives

  • Evaluate the impact of personalized occupational therapy on quality of life and ADHD symptoms.
  • Assess the effectiveness of therapy sessions in driving improvement.
  • Explore the impact of therapy in a natural, self-directed recruitment setting.
  • Identify key factors that influence therapeutic outcomes.

Participants

Patients: Trial II included 7 participants aged 30–60 years who were selected from a larger group of individuals actively engaged in the trial. These participants met the inclusion criteria, which required agreement to participate in the study and the completion of at least two valid assessment submissions.
For a detailed breakdown of participant demographics, challenges, needs, and assessment data, refer to the full PDF report.
Report · Dec 20, 2024
Consistent Occupational Therapy Improves ADHD Outcomes: A Sustainable Approach to Behavioral Health
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Combined with the 7 participants from Trial I, the study comprises a total of 14 individuals, enabling a comprehensive analysis of outcomes across both trials.

Composition

The group consists of individuals aged 30 to over 50, with diverse professional backgrounds spanning multiple industries. Participants demonstrate varying functional levels, reflecting a wide range of life and work contexts.
Functional Levels Definition

Challenges

Participants face various challenges, including attention-related difficulties, executive functioning issues, and disruptions in lifestyle and daily routines.
* The categorization of challenges is based on standard classifications used in ADHD research.

Needs

The patients’ described needs can be categorized into developing cognitive and behavioral strategies, improving emotional regulation, managing lifestyle and daily routines effectively, and enhancing social skills and relationships.
* The categorization of needs is based on therapeutic approaches and support strategies commonly used in ADHD treatment.

Methodology

1

Initial Assessment

Comprehensive evaluation of each patient’s symptoms, functional levels, and personal goals. Patients completed the ADHD Quality of Life Assessment and the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist to quantify their initial state.
* Compared to Trial I, this trial introduced the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist for a more detailed evaluation of symptoms.
2

Pairing

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

3

Intervention

  • Therapy Sessions: Individualized one-on-one sessions focusing on behavior management, cognitive restructuring, and coping strategies.
  • Homework Assignments: Tailored activities designed to reinforce session learnings and facilitate real-world application.
4

Monitoring and Evaluation

Pre- and post-intervention assessments using the ADHD Quality of Life Assessment and the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist to evaluate changes in quality of life and symptom severity. Regular feedback sessions to adjust therapy plans.
5

Sample Selection

Participants are screened based on the submission of at least two qualified assessments, enabling month-on-month comparisons.
* For this study, month-on-month is defined as a comparison between consecutive qualified submissions with an interval of no less than 7 days. Only participants meeting this criterion are included in the final analysis.

Results

The ADHD Quality of Life Assessment Showed Improvement, While the Adult ADHD Self-Report Scale Symptom Checklist Showed a Reduction in Symptoms

Quantitative data from two pre- and post-intervention assessments show an average life quality score increase of 19.6% from the ADHD Quality of Life Assessment and a symptom reduction of 8.8% from the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist.
Consistent Therapy Maximizes ADHD Outcome Improvements
Quantitative data was derived from pre- and post-intervention assessments, including Quality of Life measures and the Adult ADHD Self-Report Scale (ASRS v1.1), a 5-point Likert-based tool designed to evaluate ADHD symptoms in adults. These results highlight improvements achieved through personalized therapeutic interventions.

Therapy Frequency Influences Outcomes

Participants in both Trial I and Trial Ⅱ were categorized as consistent weekly patients or intermittent frequency patients, based on the regularity of their therapy sessions.
In Trial I, all participants were classified as consistent weekly patients. In contrast, Trial Ⅱ primarily consisted of intermittent frequency patients, with only a few classified as consistent weekly patients. The improvement observed in Trial Ⅱ was less pronounced compared to Trial I, highlighting the potential impact of consistent engagement on outcomes. This underscores the importance of therapy frequency and sets the stage for further analysis of factors influencing performance across these groups.
  • Consistent Weekly Patients
  • Intermittent Frequency Patients
Trial I
Trial Ⅱ
Frequency Distribution

More Factors Affecting Performance Enhancement

Beyond therapy frequency, the analysis reveals additional factors that influence performance enhancement across various criteria.
Age shows a clear trend, with older participants experiencing lower improvements in overall performance, life productivity, and psychological health, while life outlook and relationships show minimal variation across age groups.
Therapist impact varies significantly, with some achieving the highest improvements in specific criteria, such as overall performance, life productivity, psychological health, life outlook, and relationships. However, one therapist showed negative outcomes across multiple criteria, though these were exclusively linked to a single patient.
Job group classification also plays a role, with participants in high-functioning roles, such as Physician Assistants, exhibiting greater improvements in most areas compared to those in less likely high-functioning roles, except for relationships, where the difference was negligible.

Updated Results Considered in Conjunction with Trial I

The overall quality of life improvement is 46.4%.
62.8%
Avg. Life Productivity Improvement
72.3%
Avg. Psychological Health Improvement
46.5%
Avg. Life Outlook Improvement
61.2%
Avg. Relationships 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.
The sample for Trial I was from June 2024, conducted at a different time than Trial II. Both trials utilized the ADHD Quality of Life Assessment, allowing for the integration of data from both studies to calculate a combined reference improvement value. While the combined analysis provides valuable insights, the differing contexts and timelines of the two trials should be considered when interpreting the results. For more details about Trial I, please visit the Melo official website: https://www.hellomelo.co/assessing-the-effectiveness-of-occupational-therapy-in-managing-adhd/

Conclusion

The occupational therapy model demonstrated measurable benefits in managing ADHD symptoms and improving functional levels across a diverse patient population. Tailored therapy sessions, supplemented by practical homework assignments, contributed to noticeable improvements in both high-functioning individuals and those facing significant challenges.
However, the findings also highlight the importance of consistent therapy frequency and other factors, such as age, therapist impact, and job roles, in optimizing outcomes. These insights underscore the value of a comprehensive and individualized approach to ADHD management.

Recommendations

  • Continue using tailored occupational therapy approaches for ADHD treatment, emphasizing the importance of consistent therapy engagement.
  • Expand the trial to include a larger and more diverse patient population, with a focus on validating the impact of therapy frequency and other influencing factors, such as age, therapist effectiveness, and job roles.
  • Explore complementary approaches, including group therapy and additional digital tools, to enhance accessibility and engagement.
  • Investigate long-term outcomes to better understand the sustained impact and scalability of occupational therapy interventions.

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 neuroscience, 9(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]

PDF Report

Report · Dec 20, 2024
Consistent Occupational Therapy Improves ADHD Outcomes: A Sustainable Approach to Behavioral Health
Download (PDF)
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. 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.