Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided.
Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that continues into adulthood for the majority of cases (Barkley, Murphy, & Fischer, 2008). Prevalence rates of ADHD in adulthood are estimated to be 5% in the U.S. and other countries (Willcutt, 2012). This often lifelong condition is characterized by pervasive impairment in multiple domains, including but not limited to academic, occupational, relational, mental health, and self-concept (Matheson et al., 2013 and Stein, 2008). Pharmacotherapy (e.g., stimulant medication) is a mainstay of treatment; however, many patients continue to experience impairment or insufficient symptom reduction despite treatment (Safren, Sprich, Cooper-Vince, Knouse and Lerner, 2010, Wilens et al., 1998 and Wilens et al., 2002). In addition, in clinical practice some patients desire to minimize use of medications, and seek alternative or complementary approaches.
Relative to many other forms of psychopathology in adulthood, there has been less research on the effectiveness of nonpharmacological treatment options and fewer empirically based treatment guidelines for clinicians treating ADHD in adults. Among available nonpharmacological treatment options, mindfulness meditation training has received increasing clinical interest and empirical support. The aim of this review is to (a) provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, (b) describe the current state of the empirical basis for mindfulness training in ADHD, (c) summarize a specific mindfulness meditation program designed for adults diagnosed with ADHD, and (d) discuss future clinical and research directions in this area. Two case study examples are also provided to demonstrate particular clinical issues relevant for practitioners. First, however, we provide a brief introduction of mindfulness.
Overall, current empirical studies support the rationale for application of mindfulness to ADHD, show that mindfulness is a feasible and well-accepted intervention in ADHD samples, and provide promising preliminary support for its efficacy. However, more methodologically rigorous trials are needed, particularly larger randomized controlled trials and assessment of long-term effects with ecologically valid measures. In addition to being a standalone treatment, mindfulness can be integrated with CBT for adults diagnosed with ADHD, which is an area that warrants future treatment development. We describe a particular mindfulness training program for ADHD in adulthood in an attempt to stimulate further interest and discussion among clinicians and researchers, and ultimately to provide patients with more effective treatment options.
