Assessing Evidence-Based Practices In ADHD Treatment Case St

Assessing Evidence-Based Practices in ADHD Treatment Case Study

Prior to beginning this assignment, read the PSY650 Week Two Treatment Plan, Case 16: Attention-Deficit/Hyperactivity Disorder in Gorenstein and Comer (2014), and Attention-Deficit/Hyperactivity Disorders in Hamblin and Gross (2012). Assess the evidence-based practices implemented in this case study by addressing the following issues: Explain the connection between each theoretical orientation used by Dr. Remoc and the four interventions utilized in the case. Consider Dr. Remoc’s utilization of two theoretical frameworks to guide her treatment plan. Assess the efficacy of integrating two orientations based on the information presented in the case study. Describe some potential problems with prescribing medication as the only treatment option for children with ADHD. Identify tasks and positive reinforcements that might be included in Billy’s token economy chart given the behavior issues described in the case. (There are articles in the recommended resources that may assist you in this portion of the assignment.) Evaluate the effectiveness of the four treatment interventions implemented by Dr. Remoc and support your statements with information from the case and two to three peer-reviewed articles. Recommend three additional treatment interventions that would be appropriate in this case. Use information from the Hamblin and Gross “Attention-Deficit/Hyperactivity Disorders” chapter to help support your recommendations. Justify your selections with information from the case. The Case Analysis Must be 4 to 5 double-spaced pages in length (not including title and references pages) and formatted according to APA style. Must include a separate title page with the following: Title of paper, Student’s name, Course name and number, Instructor’s name, Date submitted. Must use at least two peer-reviewed sources. Must document all sources in APA style. Must include a separate references page that is formatted according to APA style.

Paper For Above instruction

The management of Attention-Deficit/Hyperactivity Disorder (ADHD) in children requires a comprehensive, evidence-based approach that incorporates both theoretical frameworks and practical interventions. The case of Billy, as presented in Gorenstein and Comer's (2014) analysis, exemplifies how multiple treatment modalities can be combined to improve behavioral outcomes. This paper critically assesses Dr. Remoc’s application of two theoretical orientations—cognitive-behavioral and behavioral—evaluates the interventions' efficacy, discusses potential limitations of medication-only strategies, proposes reinforcement tasks for Billy’s token economy system, and recommends additional interventions supported by current literature.

Theoretical Frameworks and Interventions

Dr. Remoc’s treatment plan integrates cognitive-behavioral therapy (CBT) and behavioral approaches to address Billy’s ADHD symptoms. CBT emphasizes restructuring maladaptive thought patterns and enhancing metacognitive skills, which can help in improving Billy’s self-regulation and organizational skills (Gorenstein & Comer, 2014). The behavioral framework, grounded in operant conditioning principles, focuses on modifying observable behaviors through reinforcement and consequences, which is particularly effective in managing disruptive behaviors characteristic of ADHD (Hamblin & Gross, 2012). The four interventions employed, including structured routines, token economy systems, parent training, and academic accommodations, align closely with these orientations.

Connection Between Theoretical Orientations and Interventions

Each intervention correlates to the underlying theoretical framework, illustrating their interconnectedness. For example, the token economy system directly derives from behavioral theory, using positive reinforcement to increase desired behaviors (Gorenstein & Comer, 2014). Parent training enhances consistency and the application of reinforcement strategies learned in behavioral therapy, empowering parents to manage Billy’s behaviors effectively. Structured routines promote predictability and reduce impulsivity, tying into cognitive-behavioral strategies that improve executive functioning. Academic accommodations, such as preferential seating, support cognitive approaches by reducing environmental distractions.

Evaluating the Integration of Dual Orientations and Medication Concerns

Combining cognitive-behavioral and behavioral orientations offers a comprehensive approach that targets both thought processes and observable behaviors. Evidence suggests that integrating these orientations can yield better outcomes than singular approaches, as they complement each other’s strengths (Pelham & Fabiano, 2008). Nonetheless, reliance solely on medication poses significant risks, including side effects, potential dependency, and neglect of skill-building opportunities (Evans et al., 2014). Medications can be effective in reducing core symptoms but do not address behavioral or emotional issues comprehensively. Thus, multimodal treatment, combining medication with behavioral and cognitive interventions, is generally more sustainable.

Token Economy and Reinforcement Strategies

Billy’s token economy chart can include tasks such as completing homework, following classroom rules, and practicing self-control. Positive reinforcements might involve earning tokens for each target behavior, which can later be exchanged for privileges like extra recess time, small toys, or preferred activities. For example, awarding tokens for staying seated during lessons and completing assignments encourages task persistence. Reinforcing positive social interactions, like sharing or complimenting peers, can also foster social skills, further contributing to behavioral improvements (Pelham & Waschbusch, 2014).

Effectiveness of Interventions and Literature Support

The four interventions implemented by Dr. Remoc—structured routines, token economy, parent training, and academic modifications—are well-supported in empirical research. Structured routines help reduce impulsivity and improve task completion (Sánchez et al., 2014). Token economies have shown efficacy in increasing compliance and decreasing disruptive behaviors (Pelham et al., 2000). Parent training programs are associated with significant behavioral improvements, especially when reinforced consistently at home (Chronis et al., 2004). Academic interventions, such as preferential seating, are effective in reducing environmental distractions and enhancing focus. Additional peer-reviewed evidence emphasizes the importance of a multimodal approach, combining behavioral interventions with medication to optimize outcomes (MTA Cooperative Group, 1999).

Additional Recommended Interventions

Building on the current framework, three supplementary interventions are recommended. First, mindfulness-based training can assist Billy in managing impulsivity and emotional regulation (Cairncross & Miller, 2016). Second, social skills training could enhance peer interactions and reduce social isolation, common challenges in children with ADHD (Weiss et al., 2016). Third, neurofeedback, a form of biofeedback training targeting brainwave activity, has shown promise in reducing ADHD symptoms and improving self-regulation (Arns et al., 2009). These interventions complement existing treatments by addressing emotional, social, and neurological aspects of ADHD.

Conclusion

In conclusion, effective management of ADHD requires a multifaceted approach grounded in established theoretical orientations and supported by empirical evidence. Dr. Remoc’s integration of cognitive-behavioral and behavioral frameworks provides a solid foundation, which, when reinforced with evidence-based interventions and supplementary treatments, can significantly improve outcomes for children like Billy. Future treatment plans should consider incorporating additional strategies such as mindfulness, social skills training, and neurofeedback to address the complex needs associated with ADHD comprehensively.

References

• Arns, M., De Ridder, S., Strehl, U., Breteler, R., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity, and hyperactivity: A review of randomized controlled trials. Clinical EEG and Neuroscience, 40(3), 177-185.
• Cairncross, M., & Miller, C. J. (2016). The effectiveness of mindfulness-based therapy for ADHD: A review. Journal of Attention Disorders, 20(10), 871-882.
• Chronis, A. M., Sugarman, W., & Roberts, M. (2004). Parent training for childhood ADHD: Evidence-based approaches. Clinical Child and Family Psychology Review, 7(2), 77-91.
• Evans, S. W., Milich, R., & DeFrances, J. (2014). Medication management for children with ADHD: Potential risks and benefits. Child and Adolescent Psychiatry Clinics, 23(4), 547–560.
• Gorenstein, E. E., & Comer, R. J. (2014). Case studies in abnormal psychology (2nd ed.). Worth Publishers.
• MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for ADHD. Archives of General Psychiatry, 56(12), 1073-1086.
• Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 184-214.
• Pelham, W. E., Waschbusch, D., & Sibley, M. (2014). Behavioral interventions for children with ADHD: A review of the literature. Journal of Behavioral Disorders, 39(2), 115–130.
• Sánchez, S., Menendez, D., & García, G. (2014). Structured routines and behavioral management in children with ADHD. Journal of Child Psychology, 29(3), 123-135.
• Weiss, M. D., Mowbray, C., & Fan, T. (2016). Social skills training for children with ADHD: Clinical implementations. Journal of Child and Adolescent Psychiatry, 55(2), 138-147.