Rumination Risks of Talk-Heavy Approaches

This episode breaks down the major misconceptions about ADHD treatment and clarifies what decades of research, major clinical guidelines, and leading experts actually recommend. Ryan and Mike explain why weekly talk therapy is not an evidence-based treatment for ADHD, why parent training and environmental structure are consistently shown to improve outcomes, and how parents can make informed decisions without getting pulled into common myths.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube

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[00:00:00] Start
[00:02:21] What clinical guidelines actually recommend
[00:05:27] Dr. Barkley’s research on effective ADHD treatments
[00:09:11] Evidence on CBT, DBT, and play therapy
[00:19:21] Why office-based therapy doesn’t translate to real-world behavior
[00:22:29] Rumination and how talk-heavy approaches can backfire
[00:31:19] Treatments with the strongest evidence (medication, parent training)⁠⁠⁠

Citations:

1. AAP Guideline (Parent Training + Medication as First-Line)Wolraich, M. L., et al. (2019). Clinical practice guideline for ADHD in children and adolescents. Pediatrics, 144(4), e20192528.

2. AACAP Treatment Parameter (Medication + Behavioral)Pliszka, S. R., & AACAP Work Group. (2007). Practice parameter for ADHD. JAACAP, 46(7), 894–921.

3. Barkley: ADHD as Performance DisorderBarkley, R. A. (2012). Executive functions. Guilford Press.Barkley, R. A. (2015). ADHD: Handbook for diagnosis and treatment (4th ed.). Guilford Press.

4. CBT Evidence (Adolescents/Adults, Not Young Children)Safren, S. A., et al. (2010). CBT vs relaxation for adults with ADHD. JAMA, 304(8), 875–880.Solanto, M. V. (2011). CBT for adult ADHD. Guilford Press.Langberg, J. M., et al. (2008). Organization skills intervention for adolescents. JCCP, 76(6), 967–982.

5. DBT-Informed (Pilot Trials, Emotion Dysregulation)Murray, D. W., et al. (2022). DBT skills group for adolescents with ADHD. J Attention Disorders, 26(11), 1421–1430.

6. Play Therapy (Insufficient Evidence)Hassan, R. A., & Shaker, N. S. (2014). CBPT for ADHD symptoms. Int J Psychology & Behavioral Sciences, 4(6), 221–229.

7. EF Skills: Experience-Based, Not Language-BasedBarkley, R. A. (2012). Executive functions. Guilford Press.

8. Rumination and ADHDOstojic, D., et al. (2021). Mind wandering and rumination in youth with ADHD. J Abnormal Child Psychology, 49, 1203–1216.Seymour, K. E., et al. (2014). Emotion regulation mediates ADHD-depression relationship. J Abnormal Child Psychology, 42, 611–621.

9. Time Blindness/Temporal ProcessingToplak, M. E., & Tannock, R. (2005). Time perception deficits in ADHD. J Abnormal Child Psychology, 33(5), 639–654.Barkley, R. A., et al. (2008). ADHD in adults: What the science says. Guilford Press.

10. Parent Behavior Training (Evidence-Based)Chronis, A. M., et al. (2006). Evidence-based treatments for children with ADHD. Clinical Psychology Review, 26(4), 486–502.Evans, S. W., et al. (2014). Evidence-based treatments for ADHD. JCCAP, 43(4), 527–551.

11. Medication as First-LineFaraone, S. V., et al. (2021). Stimulant effectiveness and safety. World Psychiatry, 20(3), 314–329.Swanson, J. M., et al. (2017). MTA study long-term outcomes. JAACAP, 56(3), 228–240.