A Hands-on Training Course in ADHD Diagnosis and Treatment

The non-profit REACH Institute offers high impact training for health care professionals in the diagnosis and treatment of ADHD (attention deficit hyperactivity disorder).  This course is designed for family physicians, pediatricians, GPs, nurses and nurse practitioners, psychiatrists, and neurologists (as well as child and adolescents psychiatrists who want to be “at the top of their game” in delivering the latest scientifically proven treatments for ADHD.  Led by Peter S. Jensen, MD, NIMH lead investigator of the NIMH multisite MTA Study and author of over 300 peer-reviewed articles and chapters, and author/editor of over a dozen books for researchers, clinicians, and parents, this course brings together four crucial components in diagnosing and treating ADHD, and achieving optimal outcomes for children and families.

These four components of ADHD knowledge and skill are 1) accurate ADHD diagnosis using reliable rating tools, 2) state-of-art medication titration and medication monitoring, selection among available agents based on treatment targets and environmental demands, determine which of the various psychostimulants or non-stimulants should be used initially, determining necessary methods for maximizing benefits and reducing medication side effects, 3) individualizing an ADHD treatment plan for each child and family, including the role of parental treatment preferences, and 4) learning how to deliver behavioral therapy that helps children (and families) learn skills that medication cannot teach, such as social skills, improved parent-child relationships, peer relationships and social skills, improved self-esteem, responsibility-taking, and self-monitoring,

1. ADHD Assessment Diagnosis

Students learn the differential diagnosis of ADHD, and how to clearly differentiate it from often over-diagnosed bipolar disorder.  This ADHD training course assists health care practitioners in identifying the DSM symptoms and impairments related to the ADHD diagnosis.  Practice in using and scoring ADHD symptom rating scales is provided, helping clinicians discriminate between the three ADHD diagnostic subtypes (Inattentive, Hyperactive, and Combined), not just to help evaluate the child, but also to educate and improve therapeutic communications and the treatment alliance between the health care professional and the child and family.  Appropriate use of other symptom rating scales are also included in this ADHD training course, such as depression, anxiety, oppositional defiant and conduct disorders, bipolar disorder, learning disability, and Aspergers.  All rating scales for each of these disorders are provided for free and continuing use with your patients.  Students also learn when psychological and neuropsychological testing is needed, and how to interpret testing results for your use in helping parents develop an school individualized treatment plan.

Comprehensive and complete ADHD assessment methods also require that the health care practitioner develop expertise in interviewing skills, and learn how to elicit sensitive information such as parental abuse and harsh parenting methods, become skilled in developing a therapeutic alliance so that parents are able to adequately provide an thorough medical and psychosocial history.  These skills are taught and modeled in engaging lectures, and further consolidated through skills practice exercises, role-plays, and small group learning formats.

2. ADHD Medication Management

Surprisingly, even many experienced clinicians remain confused and uncertain how ADHD medications should be titrated, how titration can be done easily during the first month to increase parental “buy in”, and how full adherence to the treatment plan is achieved.  This ADHD training course provides medical health care professionals the essential knowledge and skills about which medications should be selected next if the first or second medication treatment trial fails, and how to counsel parents and help them overcome fears or resistance to use of medication or a mental health referral. Correct choice of medication often depends on time of day dosing effects, and requires that practitioners use duration of action information about the medication classes and formulations to choose among agents.  Prescribing medication optimally also requires that prescribers learn and master the general principles and necessary skills for managing side effects. In this ADHD training course, practitioners learn to apply specific methods for optimal monitoring of medication benefits, effects, and side effects.  All of these ADHD treatment management skills are taught and further reinforced through the various training course methods – role-plays, skills practice, and small group learning.

3. Individualizing  ADHD Treatment Plans

One problem many medical professionals face is learning how to optimally tailor their intervention plan to each child and family so that it works for that specific family.  For example, ADHD medication adherence is a problem for 50% of families, but few clinicians are aware of how to deal with this, and how to encourage families to candidly describe their fear, anxiety, and guilt that often undermine treatment adherence.  Another problem faced by many health care professionals is that some families do not fully take on the challenges of addressing and managing their child’s ADHD, hoping that somehow “the doctor will do it,” perhaps with magic pills.  They may have problems taking time out in their busy schedules, in partnering with their child’s teacher or working collaboratively with schools, educating themselves (with your guidance, using tools that you provide) about problems such as obtaining an individualized educational plan (IEP) or 504 Plan, learning and exercising their educational rights, and/or in advocating for their child.

Other problems related to individualizing treatment plans for attention deficit hyperactivity disorder relate to essential skills for all physicians treating ADHD: 1) selecting the optimal medication, 2) titrating the medication to best dose effects, 3) implementing strategies to minimize common side effects such as sleep, appetite, and “rebound”, or problems with weight loss and growth retardation; 4) determining when to offer and support “drug holidays” in summer or on weekends, 5) choosing alternative medications when the initial medication is either ineffective or has too many side effects; 6) individualizing the ADHD treatment when the child has comorbid disorders such as anxiety, depression, oppositional defiant or conduct disorder, tics or Tourettes, or severe mood dysregulation, irritability, and temper problems.

This ADHD training course also guides students in using teacher and parent rating scales to track treatment response, individualize the child’s treatment plan for specific problems at home or school or in special areas of functioning (social skills, academic performance, parent-child relationships), how to use rating scales to increase parent, child, and teacher understanding of ADHD and participation in the treatment plan, and how to use them to maximize treatment outcomes.

4. Behavioral Therapy Training

The fourth component of the ADHD training course consists in learning how to deliver behavioral therapy that helps children (and families) learn what medication cannot teach, specifically social skills, improved parent-child relationships, peer relationships and social skills, improved self-esteem, responsibility-taking, and self-monitoring.  Specific behavioral therapy techniques taught and practiced for delivery and teaching to parents are: 1) choosing behavioral targets, 2) measuring and reinforcing appropriate child behaviors and reducing inappropriate or undesirable behaviors; 3) paying positive attention and strengthening the parent-child relationship, 4) delivering effective commands to a child, and 5) the use of time out.

Finally, all four of these essential treatment components are applied and practiced with specific cases, and students learn when each treatment should be applied.  This course is ideal for many current practitioners – pediatricians, family practitioners, GPs, psychiatrists and neurologists, most of whom were  were not trained during graduate school in ADHD medication or behavioral therapy procedures. This course is of value for all qualified healthcare practitioners, with or without previous psychotherapy experience. Training is available that is accredited for continuing education. Students learn how to work with children and families, using a combination of hands-on practice of skills, engaging lectures that are applicable to your daily work, role-play, experiential exercises, small group practice sessions, video demonstrations, and skills practice exercises. The total training period is up to 12 months, done using distance learning methods and conference calls in small peer learning groups.  For more details about how to register for this program, go to the "About Us" webpage, and contact the REACH Institute's Executive Director, Lisa Hunter Romanelli, PhD