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Alan. S. Bellack - One of the best experts on this subject based on the ideXlab platform.
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the 2009 schizophrenia port Psychosocial Treatment recommendations and summary statements
Schizophrenia Bulletin, 2010Co-Authors: Lisa B Dixon, Alan. S. Bellack, Faith Dickerson, Melanie E Bennett, Dwight Dickinson, Richard W Goldberg, Anthony F Lehman, Wendy N Tenhula, Christine Calmes, Rebecca M PasillasAbstract:The Schizophrenia Patient Outcomes Research Team (PORT) Psychosocial Treatment recommendations provide a comprehensive summary of current evidence-based Psychosocial Treatment interventions for persons with schizophrenia. There have been 2 previous sets of Psychosocial Treatment recommendations (Lehman AF, Steinwachs DM. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) Treatment recommendations. Schizophr Bull. 1998;24:1–10 and Lehman AF, Kreyenbuhl J, Buchanan RW, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated Treatment recommendations 2003. Schizophr Bull. 2004;30:193–217). This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the Psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. Our review process produced 8 Treatment recommendations in the following areas: assertive community Treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, Psychosocial interventions for alcohol and substance use disorders, and Psychosocial interventions for weight management. Reviews of Treatments focused on medication adherence, cognitive remediation, Psychosocial Treatments for recent onset schizophrenia, and peer support and peer-delivered services indicated that none of these Treatment areas yet have enough evidence to merit a Treatment recommendation, though each is an emerging area of interest. This update of PORT Psychosocial Treatment recommendations underscores both the expansion of knowledge regarding Psychosocial Treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
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The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements
Schizophrenia bulletin, 2009Co-Authors: Lisa B Dixon, Alan. S. Bellack, Faith Dickerson, Melanie E Bennett, Dwight Dickinson, Richard W Goldberg, Anthony F Lehman, Wendy N Tenhula, Christine Calmes, Rebecca M PasillasAbstract:The Schizophrenia Patient Outcomes Research Team (PORT) Psychosocial Treatment recommendations provide a comprehensive summary of current evidence-based Psychosocial Treatment interventions for persons with schizophrenia. There have been 2 previous sets of Psychosocial Treatment recommendations (Lehman AF, Steinwachs DM. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) Treatment recommendations. Schizophr Bull. 1998;24:1–10 and Lehman AF, Kreyenbuhl J, Buchanan RW, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated Treatment recommendations 2003. Schizophr Bull. 2004;30:193–217). This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the Psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. Our review process produced 8 Treatment recommendations in the following areas: assertive community Treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, Psychosocial interventions for alcohol and substance use disorders, and Psychosocial interventions for weight management. Reviews of Treatments focused on medication adherence, cognitive remediation, Psychosocial Treatments for recent onset schizophrenia, and peer support and peer-delivered services indicated that none of these Treatment areas yet have enough evidence to merit a Treatment recommendation, though each is an emerging area of interest. This update of PORT Psychosocial Treatment recommendations underscores both the expansion of knowledge regarding Psychosocial Treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
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Psychosocial Treatment in schizophrenia.
Dialogues in clinical neuroscience, 2001Co-Authors: Alan. S. BellackAbstract:Optimism about the use of Psychosocial Treatment for schizophrenia has waxed and waned over the years, but there is now a growing consensus that Psychosocial interventions play an essential role in the rehabilitation and management of people with schizophrenia. 1-3 Psychosocial Treatment may not “work” if the term work is narrowly applied to remission of acute episodes, control of symptoms, and prevention of relapses. However, these are not the only criteria by which an intervention for this complex disease should be judged. Schizophrenia is characteristically a multiply handicapping, chronic disorder involving marked impairments in social role functioning (eg, as a spouse or a worker), excess rates of medical illness, and poor quality of life. Medication is generally a necessary component of Treatment, but is rarely sufficient given the diffuse nature of residual neurocognitive impairment and the history of social and functional failures that mark adolescent and adult development. Psychosocial interventions can play a critical role in a comprehensive intervention program, and are probably necessary components if Treatment is viewed in the context of the patient's overall level of functioning, quality of life, and compliance with prescribed Treatments. Current thinking suggests that, in addition to medication, effective care, and management, patients with schizophrenia require: Problem-specific Psychosocial Treatment Family psychoeducation Day hospital/vocational rehabilitation and educational opportunities Access to crisis counseling Easily available inpatient psychiatric care Supervised residential liging arrangements Case management to obtain entitiements and coordinate the various facets of Treatment Issues to be considered in the design and implementation of psychological Treatment programs for schizophrenia Progress in Treatment should be expected to be slow and marked by periodic disruptions and periods of regression. Consequently, it is important that Treatment be long term, extending over months and years. Treatment should also be guided by concrete, short-term goals that are likely to be achieved (eg, to attend day hospital at least twice a week for 1 month). While there are a number of illness characteristics that are common to most patients, there are extensive individual differences, as well as differences within the same patient over time. Thus, Treatment must be tailored to the needs of each patient and adjusted as the patient changes. Regardelss of the severity of illness, the patient must be included as a parther in Treatment planning and goal setting in order to secure effective cooperation. Treatment should be conducted in collaboration with the patient, not done to the patient. Effective Treatment targets specific skills or problem areas that the patient can agree to work on (eg, social skills, drug use, or vocational skills). Nonspecific group or individual psychotherapy is not effective. The illness is marked by significant deficits in memory, attention, and exectuve functioning that have major effects on the Treatment process. Treatment must be adapted to these impaiments if patients are to be able to learn and retain what is discussed in sessions. Treatment should inadvertently become a memory or attention test. Four Psychosocial Treatment approaches have received substantial empirical support and warrant further study: Social skills training. This Treatment approach, which can be provided to patients either individually or in groups, involves systematically teaching patients specific behaviors that are critical for success in social interactions.4,5 Developed over 25 years ago, it is probably the most widely studied psychological Treatment method for individuals with schizophrenia, and there is an extensive literature documenting its efficacy.6 Family psychoeducation. The most important development in Psychosocial Treatment over the last two decades has been the emphasis on the positive effects of family participation in the Treatment process. Several different models of family intervention have been developed and tested.7,8 The different approaches to working with families share a number of common elements referred to as psychoeducation: a collaborative, respectful relationship with the family, the provision of information about schizophrenia and its Treatment, and teaching family members less stressful and more constructive strategies for communication and solving problems. A number of carefully controlled studies have shown that patients in families who receive this type of family therapy have better outcomes than patients with families who do not receive therapy, and that familymembers report less distress as well. Cognitive therapy. Antipsychotic medications are primarily effective for reducing positive symptoms, but even the new-generation medications are not highly effective for all patients. Recently, there has been increased interest in teaching patients coping strategies for controlling residual symptoms. A number of laboratories in the United Kingdom have reported very promising findings for interventions that employ cognitive behavior therapy techniques (eg, self-talk, rational analysis) to reduce distress associated with both hallucinations and delusions.9,10 Further research is warranted to explore the stability and generalizability of these approaches. Cognitive rehabilitation. As indicated above, schizophrenia is marked by neurocognitive impairments that have a significant impact on community functioning and are only partially ameliorated bymedication. Consequently, considerable effort has been devoted to development of cognitive rehabilitation programs to increase memory capacity, attention, and high level problem-solving skills.11,12 Most of these techniques employ repetitive practice on neurocognitive tasks using computers. The evidence to date documents that test performance can be improved, but it is yet to be determined if there is a real increase in cognitive capacity or, most importantly, if the effects generalize to the community.13 In conclusion, there is now a new generation of Psychosocial Treatment techniques that have yieldied very promising results. It is likely that, as more breakthroughs occur in the biological Treatment of schizophrenia (eg, the effects of clozapine on improving the functioning of Treatment refractory patients), psychological Treatments will assume an even more important rolein both facilitating the adjustment of patients, as they move from institutional settings to the community, and improving their quality of life.
Rebecca M Pasillas - One of the best experts on this subject based on the ideXlab platform.
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the 2009 schizophrenia port Psychosocial Treatment recommendations and summary statements
Schizophrenia Bulletin, 2010Co-Authors: Lisa B Dixon, Alan. S. Bellack, Faith Dickerson, Melanie E Bennett, Dwight Dickinson, Richard W Goldberg, Anthony F Lehman, Wendy N Tenhula, Christine Calmes, Rebecca M PasillasAbstract:The Schizophrenia Patient Outcomes Research Team (PORT) Psychosocial Treatment recommendations provide a comprehensive summary of current evidence-based Psychosocial Treatment interventions for persons with schizophrenia. There have been 2 previous sets of Psychosocial Treatment recommendations (Lehman AF, Steinwachs DM. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) Treatment recommendations. Schizophr Bull. 1998;24:1–10 and Lehman AF, Kreyenbuhl J, Buchanan RW, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated Treatment recommendations 2003. Schizophr Bull. 2004;30:193–217). This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the Psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. Our review process produced 8 Treatment recommendations in the following areas: assertive community Treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, Psychosocial interventions for alcohol and substance use disorders, and Psychosocial interventions for weight management. Reviews of Treatments focused on medication adherence, cognitive remediation, Psychosocial Treatments for recent onset schizophrenia, and peer support and peer-delivered services indicated that none of these Treatment areas yet have enough evidence to merit a Treatment recommendation, though each is an emerging area of interest. This update of PORT Psychosocial Treatment recommendations underscores both the expansion of knowledge regarding Psychosocial Treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
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The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements
Schizophrenia bulletin, 2009Co-Authors: Lisa B Dixon, Alan. S. Bellack, Faith Dickerson, Melanie E Bennett, Dwight Dickinson, Richard W Goldberg, Anthony F Lehman, Wendy N Tenhula, Christine Calmes, Rebecca M PasillasAbstract:The Schizophrenia Patient Outcomes Research Team (PORT) Psychosocial Treatment recommendations provide a comprehensive summary of current evidence-based Psychosocial Treatment interventions for persons with schizophrenia. There have been 2 previous sets of Psychosocial Treatment recommendations (Lehman AF, Steinwachs DM. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) Treatment recommendations. Schizophr Bull. 1998;24:1–10 and Lehman AF, Kreyenbuhl J, Buchanan RW, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated Treatment recommendations 2003. Schizophr Bull. 2004;30:193–217). This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the Psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. Our review process produced 8 Treatment recommendations in the following areas: assertive community Treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, Psychosocial interventions for alcohol and substance use disorders, and Psychosocial interventions for weight management. Reviews of Treatments focused on medication adherence, cognitive remediation, Psychosocial Treatments for recent onset schizophrenia, and peer support and peer-delivered services indicated that none of these Treatment areas yet have enough evidence to merit a Treatment recommendation, though each is an emerging area of interest. This update of PORT Psychosocial Treatment recommendations underscores both the expansion of knowledge regarding Psychosocial Treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
Howard Abikoff - One of the best experts on this subject based on the ideXlab platform.
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social functioning in children with adhd treated with long term methylphenidate and multimodal Psychosocial Treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Richard Gallagher, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Simcha PollackAbstract:ABSTRACT Objective To test that methylphenidate combined with intensive multimodal Psychosocial intervention, which includes social skills training, significantly enhances social functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and methylphenidate plus nonspecific Psychosocial Treatment (attention control). Method One hundred three children with ADHD (ages 7–9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive (1) methylphenidate alone, (2) methylphenidate plus multimodal Psychosocial Treatment that included social skills training, or (3) methylphenidate plus attention control Treatment. Assessments included parent, child, and teacher ratings of social function and direct school observations in gym. Results No advantage was found on any measure of social functioning for the combination Treatment over methylphenidate alone or methylphenidate plus attention control. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions In young children with ADHD, there is no support for clinic-based social skills training as part of a long-term Psychosocial intervention to improve social behavior. Significant benefits from methylphenidate were stable over 2 years.
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symptomatic improvement in children with adhd treated with long term methylphenidate and multimodal Psychosocial Treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Gabrielle Weiss, Simcha PollackAbstract:Objective: To test the hypotheses that in children with attention-deficit/hyperactivity disorder (ADHD) (1) symptoms of ADHD, oppositional defiant disorder, and overall functioning are significantly improved by methylphenidate combined with intensive multimodal Psychosocial Treatment compared with methylphenidate alone and with methylphenidate plus attention control and (2) more children receiving combined Treatment can be taken off methylphenidate. Method: One hundred three children with ADHD (ages 7–9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to (1) methylphenidate alone; (2) methylphenidate plus Psychosocial Treatment that included parent training and counseling, social skills training, psychotherapy, and academic assistance, or (3) methylphenidate plus attention Psychosocial control Treatment. Assessments included parent, teacher, and psychiatrist ratings, and observations in academic and gym classes. Results: Combination Treatment did not lead to superior functioning and did not facilitate methylphenidate discontinuation. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions: In stimulant-responsive children with ADHD, there is no support for adding ambitious long-term Psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms. Significant benefits from methylphenidate were stable over 2 years. J. Am. Acad. Child Adolesc. Psychiatry,
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academic achievement and emotional status of children with adhd treated with long term methylphenidate and multimodal Psychosocial Treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Lily Hechtman, Howard Abikoff, Rachel G. Klein, Joy Etcovitch, Brian Greenfield, Gabrielle Weiss, Chara Respitz, Joan Kouri, Carol Blum, Karen FleissAbstract:ABSTRACT Objective To test the hypothesis that intensive multimodal Psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with methylphenidate combined with nonspecific Psychosocial Treatment (attention control). Method One hundred three children with ADHD (ages 7–9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive one of three Treatments: (1) methylphenidate alone, (2) methylphenidate plus Psychosocial Treatment that included academic remediation, organizational skills training, and psychotherapy as well as parent training and counseling and social skills training, or (3) methylphenidate plus attention control Treatment. Children's function was assessed through academic testing, parent ratings of homework problems, and self-ratings of depression and self-esteem. Results No advantage was found on any measure of academic performance or emotional status for the combination Treatment over methylphenidate alone and over methylphenidate plus attention control. Significant improvement occurred across all Treatments and was maintained over 2 years. Conclusions In stimulant-responsive young children with ADHD without learning and conduct disorders, there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment. Significant short-term improvements were maintained over 2 years.
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Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal Psychosocial Treatment : Methylphenidate and multimodal Psychosocial Treatment in ADHD
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Richard Gallagher, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Simcha PollackAbstract:Objective: To test the hypotheses that in children with attention-deficit/hyperactivity disorder (ADHD) (1) symptoms of ADHD, oppositional defiant disorder, and overall functioning are significantly improved by methylphenidate combined with intensive multimodal Psychosocial Treatment compared with methylphenidate alone and with methylphenidate plus attention control and (2) more children receiving combined Treatment can be taken off methylphenidate. Method: One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to (1) methylphenidate alone; (2) methylphenidate plus Psychosocial Treatment that included parent training and counseling, social skills training, psychotherapy, and academic assistance, or (3) methylphenidate plus attention Psychosocial control Treatment. Assessments included parent, teacher, and psychiatrist ratings, and observations in academic and gym classes. Results: Combination Treatment did not lead to superior functioning and did not facilitate methylphenidate discontinuation. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions: In stimulant-responsive children with ADHD, there is no support for adding ambitious long-term Psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms. Significant benefits from methylphenidate were stable over 2 years.
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Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation
Journal of abnormal child psychology, 2000Co-Authors: Karen C. Wells, William E. Pelham, Ronald A. Kotkin, Betsy Hoza, Howard Abikoff, Ann Abramowitz, L. Eugene Arnold, Dennis P. Cantwell, C. Keith Conners, Rebecca Del CarmenAbstract:The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement Treatment study of children, and the largest psychiatric/psychological Treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial Treatment vs. their combination for Treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed Treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial Treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial Treatment alone; Combined Treatment). Psychosocial Treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child Treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of Treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.
Martin B. Keller - One of the best experts on this subject based on the ideXlab platform.
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Psychosocial Treatment prescriptions for generalized anxiety disorder panic disorder and social phobia 1991 1996
American Journal of Psychiatry, 1999Co-Authors: Robert M. Goisman, Meredith G. Warshaw, Martin B. KellerAbstract:OBJECTIVE: Pharmacologic prescriptions for anxiety disorders have changed significantly in the last decade. This article investigates whether Psychosocial Treatments, as reported by 362 subjects in the Harvard/Brown Anxiety Disorders Research Program from 1991 to 1996, changed as well. METHOD: Subjects were interviewed in 1991 and 1995–1996 to determine which Psychosocial Treatments (behavioral, cognitive, dynamic, or relaxation or meditation) they had received. RESULTS: The percentage of subjects who received each type of Psychosocial Treatment either declined or remained the same from 1991 to 1995–1996. Dynamic psychotherapy remained the most frequently used method of these four. The percentage of subjects receiving any such method declined. CONCLUSIONS: Behavioral and cognitive Treatment, two empirically validated forms of psychotherapy, were less frequently used than dynamic psychotherapy, which lacks such validation. All use of verbal Treatment methods declined from 1991 to 1995–1996.
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Psychosocial Treatment Prescriptions for Generalized Anxiety Disorder, Panic Disorder, and Social Phobia, 1991–1996
The American journal of psychiatry, 1999Co-Authors: Robert M. Goisman, Meredith G. Warshaw, Martin B. KellerAbstract:OBJECTIVE: Pharmacologic prescriptions for anxiety disorders have changed significantly in the last decade. This article investigates whether Psychosocial Treatments, as reported by 362 subjects in the Harvard/Brown Anxiety Disorders Research Program from 1991 to 1996, changed as well. METHOD: Subjects were interviewed in 1991 and 1995–1996 to determine which Psychosocial Treatments (behavioral, cognitive, dynamic, or relaxation or meditation) they had received. RESULTS: The percentage of subjects who received each type of Psychosocial Treatment either declined or remained the same from 1991 to 1995–1996. Dynamic psychotherapy remained the most frequently used method of these four. The percentage of subjects receiving any such method declined. CONCLUSIONS: Behavioral and cognitive Treatment, two empirically validated forms of psychotherapy, were less frequently used than dynamic psychotherapy, which lacks such validation. All use of verbal Treatment methods declined from 1991 to 1995–1996.
Simcha Pollack - One of the best experts on this subject based on the ideXlab platform.
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symptomatic improvement in children with adhd treated with long term methylphenidate and multimodal Psychosocial Treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Gabrielle Weiss, Simcha PollackAbstract:Objective: To test the hypotheses that in children with attention-deficit/hyperactivity disorder (ADHD) (1) symptoms of ADHD, oppositional defiant disorder, and overall functioning are significantly improved by methylphenidate combined with intensive multimodal Psychosocial Treatment compared with methylphenidate alone and with methylphenidate plus attention control and (2) more children receiving combined Treatment can be taken off methylphenidate. Method: One hundred three children with ADHD (ages 7–9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to (1) methylphenidate alone; (2) methylphenidate plus Psychosocial Treatment that included parent training and counseling, social skills training, psychotherapy, and academic assistance, or (3) methylphenidate plus attention Psychosocial control Treatment. Assessments included parent, teacher, and psychiatrist ratings, and observations in academic and gym classes. Results: Combination Treatment did not lead to superior functioning and did not facilitate methylphenidate discontinuation. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions: In stimulant-responsive children with ADHD, there is no support for adding ambitious long-term Psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms. Significant benefits from methylphenidate were stable over 2 years. J. Am. Acad. Child Adolesc. Psychiatry,
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social functioning in children with adhd treated with long term methylphenidate and multimodal Psychosocial Treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Richard Gallagher, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Simcha PollackAbstract:ABSTRACT Objective To test that methylphenidate combined with intensive multimodal Psychosocial intervention, which includes social skills training, significantly enhances social functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and methylphenidate plus nonspecific Psychosocial Treatment (attention control). Method One hundred three children with ADHD (ages 7–9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive (1) methylphenidate alone, (2) methylphenidate plus multimodal Psychosocial Treatment that included social skills training, or (3) methylphenidate plus attention control Treatment. Assessments included parent, child, and teacher ratings of social function and direct school observations in gym. Results No advantage was found on any measure of social functioning for the combination Treatment over methylphenidate alone or methylphenidate plus attention control. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions In young children with ADHD, there is no support for clinic-based social skills training as part of a long-term Psychosocial intervention to improve social behavior. Significant benefits from methylphenidate were stable over 2 years.
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Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal Psychosocial Treatment : Methylphenidate and multimodal Psychosocial Treatment in ADHD
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Howard Abikoff, Lily Hechtman, Rachel G. Klein, Richard Gallagher, Karen Fleiss, Joy Etcovitch, Lorne Cousins, Brian Greenfield, Diane Martin, Simcha PollackAbstract:Objective: To test the hypotheses that in children with attention-deficit/hyperactivity disorder (ADHD) (1) symptoms of ADHD, oppositional defiant disorder, and overall functioning are significantly improved by methylphenidate combined with intensive multimodal Psychosocial Treatment compared with methylphenidate alone and with methylphenidate plus attention control and (2) more children receiving combined Treatment can be taken off methylphenidate. Method: One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to (1) methylphenidate alone; (2) methylphenidate plus Psychosocial Treatment that included parent training and counseling, social skills training, psychotherapy, and academic assistance, or (3) methylphenidate plus attention Psychosocial control Treatment. Assessments included parent, teacher, and psychiatrist ratings, and observations in academic and gym classes. Results: Combination Treatment did not lead to superior functioning and did not facilitate methylphenidate discontinuation. Significant improvement occurred across all Treatments and continued over 2 years. Conclusions: In stimulant-responsive children with ADHD, there is no support for adding ambitious long-term Psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms. Significant benefits from methylphenidate were stable over 2 years.