Keys to Success in ADHD Treatment

Clinicians who treat children with attention-deficit/hyperactivity disorder (ADHD) face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the number of successful treatment outcomes has not increased. Instead, treatment is characterized by high rates of discontinuation, poor adherence to quality indicators of care, and lack of documented improvements in long-term outcomes.¹

One missing ingredient in suboptimal ADHD treatment may be insufficient partnering between families and treatment providers. Here we briefly review relevant health care concepts of partnering. We then describe a process of family-partnered ADHD treatment and identify strategies for strengthening the partnership at each stage of the process.

Patient activation, empowerment, and patient-centered care

Several concepts enhance our understanding of effective partnerships with families: patient activation, patient empowerment, and patient-centered care.^2-6 In a clear departure from paternalistic power structures still common in much of medicine, these concepts emphasize equal partnerships between clinicians and patients or families. The Institute of Medicine of the National Academies has emphasized the importance of patient-centered care that is grounded in respect and sensitivity to patient preferences, needs, and values, and that recognizes families as equal partners with mental health or other human service professionals.^5,6

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