Description

In this talk, Dr. Margaret Sibley presents a systematic review of treatments for adolescents with ADHD, highlighting how the disorder manifests uniquely during this developmental stage and the implications for age-appropriate intervention. The review evaluates the efficacy and safety of a wide range of treatments in adolescents aged 10.0 to 19.9 with a formal ADHD diagnosis. Randomized controlled trials (RCTs) are included if they assess either safety or efficacy. Outcomes examined include ADHD symptoms, functional impairments, and related domains. Dr. Sibley reviews acute and long-term treatment effects, as well as potential moderators. Sixty-three RCTs are identified. Medication trials (k=29) provide high-quality evidence for a strong and consistent reduction in ADHD symptoms, though effects on impairment are less consistent. In contrast, cognitive and behavioral treatments (C/BTs) show less consistent symptom reduction but consistently improve impairment and executive functioning. They also offer moderate benefits for internalizing symptoms. The review finds no significant safety concerns across interventions. C/BTs demonstrate sustained benefits up to three years post-treatment, though the quality of this evidence is moderate due to inherent challenges with treatment blinding. Findings support the complementary—not redundant—effects of medication and C/BTs. Dr. Sibley emphasizes the importance of beginning treatment with both approaches to optimize engagement and outcomes across symptom and functional domains. Engagement-enhancing strategies, such as motivational interviewing, may support treatment uptake. While novel interventions lack current evidence of efficacy, they remain a promising area for future study.

Learning Objectives

A. To identify levels of evidence for various treatments delivered to adolescents with ADHD.

B. To understand how combined treatment may be applied to maximize treatment effects. 

C. To recognize common elements of effective CBTs for adolescents with ADHD.

Related Content Links

Evidence on the non-pharmacological treatment of ADHD
Evidence on the pharmacological treatment of ADHD

Paper Link

https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.14056