From the Guidelines
Dialectical Behavior Therapy (DBT) is effective in treating ADHD, particularly for addressing emotional dysregulation and executive functioning difficulties, as evidenced by a recent study published in 2024 1.
Key Benefits of DBT for ADHD
- DBT provides skills in four key areas that benefit ADHD patients:
- Mindfulness (improving attention and focus)
- Distress tolerance (managing impulsivity)
- Emotion regulation (controlling emotional reactions)
- Interpersonal effectiveness (improving relationships often strained by ADHD symptoms)
- After treatment with DBT, patients showed decreased ADHD symptoms, improved neuropsychological functioning, and reduction of co-existing anxiety and depression 1.
Comparison with Other Treatments
- While not typically considered a first-line treatment for ADHD like stimulant medications, DBT works well as a complementary approach alongside medication management.
- A standard DBT program typically involves weekly individual therapy sessions, group skills training, and phone coaching as needed, usually lasting 6-12 months.
Recommendations for Implementation
- Patients should practice DBT skills daily between sessions and consider combining this approach with appropriate medication management under physician supervision.
- DBT is particularly valuable for those with ADHD who also experience emotional dysregulation, anxiety, or depression.
Evidence-Based Practice
- The most recent and highest quality study published in 2024 1 supports the use of DBT in treating ADHD, making it a recommended approach in clinical practice.
From the Research
Effectiveness of DBT in ADHD
- The study 2 found that a CBT/DBT programme was effective in reducing residual symptoms and improving quality of life in adults with ADHD who were poor responders to medication.
- The programme included individual therapy and weekly group therapy sessions, and significant improvements were observed in depression severity, ADHD severity, and mindfulness skills.
- Another study 3 evaluated the efficacy of dialectical behaviour group therapy (GPT) and methylphenidate (MPH) on emotional symptoms in adults with ADHD, and found that the GPT+MPH group showed smaller reductions in anxiety symptoms at week 13, but the differences disappeared at subsequent assessments.
Comparison with Other Treatments
- A study 4 compared the efficacy of methylphenidate and atomoxetine in improving symptoms, social functions, and quality of life among adults with ADHD, and found that both treatments were effective, but atomoxetine was superior in reducing hyperactive/impulsive symptoms at weeks 4-5.
- Another study 5 compared the efficacy of methylphenidate and atomoxetine on emotional and behavioral problems in youths with ADHD, and found that both treatments were effective, but methylphenidate was associated with greater improvements in aggressive behavior, somatic complaints, and conduct problems.
- A study 6 investigated the efficacy, safety, and tolerability of combined methylphenidate and atomoxetine pharmacotherapy in ADHD, and found that combined therapy enhanced the effectiveness of monotherapy, but was associated with common side effects such as irritability, appetite reduction, and palpitations.
DBT and ADHD Symptoms
- The study 2 found that DBT was effective in reducing ADHD symptoms, including inattention and hyperactivity, in adults with ADHD.
- The study 3 found that DBT was effective in reducing emotional symptoms, including anxiety and depression, in adults with ADHD, but the effects were not sustained over time.
- The study 2 also found that DBT was effective in improving mindfulness skills, which are often impaired in individuals with ADHD.