Cognitive-Behavioral Therapy for ADHD in College: Recommendations “Hot Off the Press”

ADHD leads to impairment across the lifespan including during the college years. An increasing number of studies document the academic, social, and psychological impairments associated with the disorder in college (DuPaul, Wey-andt, O'Dell, & Varejao, 2009). Yet, until very recently, there were no published studies on cognitive-behavioral treatment approaches specifically tailored to college students with ADHD. Over the past year, however, four research groups have published work on skills-based cognitive-behavioral treatments for this population. My goal in this article is to briefly summarize these findings and to identify key recommendations for clinicians working with college students with the disorder that emerge across studies. In addition, I will integrate findings from basic research on ADHD and memory strategies that my colleagues and I have recently completed and make the case for inclusion of these strategies into skills-based ADHD treatments for college students. It is now fairly well established that skills-based, cognitive-behavioral treatment (CBT) approaches can be effica-cious for adults with ADHD (Knouse & Safren, 2014). Depending on one's interpretation of the American Psychological Association Division 12's criteria for empirically supported treatments, based in particular upon the studies conducted by Safren and colleagues (2010) and Solanto and colleagues (2010), CBT for adult ADHD meets criteria as at least a " probably efficacious treatment. " Across studies, teaching adults with ADHD to consistently use specific compensatory behavioral skills (e.g., organization and planning) and to recognize and cope with the thinking patterns that block the use of those skills has been shown to reduce the impact of symptoms. Likewise, specific training in the use of organization and planning skills has been shown to help the functioning of both children (Abikoff et al., 2013) and adolescents 2012) with ADHD in the academic setting. Yet only recently have studies of specific applications with college students been published, although the subject has been covered in the clinical practice literature (e.g., Ramsay & Rostain, 2006). Importantly, these recent studies are adaptations of existing skills-based CBT approaches for adults more generally. There are good reasons to predict that modifications to general adult protocols for ADHD treatment would be necessary to achieve optimal results, including the unique developmental context of emerging adulthood (see Fleming & McMahon, 2012, for a review) and the heavy cognitive and organizational load that students must carry. Each of these research groups has taken an independent course in adapting existing interventions, and thus examining these studies …