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Just 1 in 4 ADHD Kids Gets Drugs Plus Psychotherapy

Just 1 in 4 ADHD Kids Gets Drugs Plus Psychotherapy

A new independent study finds that at best, only one-quarter of children treated with medication for attention-deficit/hyperactivity disorder (ADHD) also receive psychotherapy.

RAND Corporation researchers reviewed utilization patterns among children with commercial insurance and discovered psychotherapy intervention is far lower in many parts of the country.

The findings have been published as a research letter in JAMA Pediatrics.

Researchers say the study is the first to document the substantial variation in receipt of talk therapy among U.S. children treated with ADHD medication — discovering a variation of more than sixfold across counties.

For many children with attention-deficit/hyperactivity disorder, medication alone can manage symptoms. But evidence shows that some affected children do better and can take lower doses of stimulant medications when they receive behavioral therapy along with ADHD drugs.

“Treatment of ADHD in children generates lots of controversy, primarily because of potential for overuse and abuse of stimulant medications,” said Dr. Walid F. Gellad, the study’s lead author.

“We wanted to find out among those who receive ADHD medications, how many are also receive billed psychotherapy services? The answer is few, but it actually depends on where you live.”

Using a large commercial claims database, researchers examined records of more than 300,000 children aged 17 and younger from 1,516 counties across the U.S. who had received a prescription for medication for ADHD. Sparsely populated counties were not included in the study.

The researchers looked at how many children receive some amount of talk therapy along with medication, and also examined the supply of licensed psychologists in the counties studied.

Less than a quarter of those prescribed ADHD drugs received any talk therapy in the same year they received medication, 13 percent had at least four therapy visits and seven percent had eight or more therapy visits.

And in 200 U.S. counties, fewer than one in 10 children getting ADHD medication received any talk therapy.

“In areas of the country where rates of use are so low, it indicates that many kids with private insurance who could benefit from therapy are not receiving it,” said Gellad, who also is affiliated with the VA Pittsburgh Healthcare System and the University of Pittsburgh School of Medicine.

The percentage of children who received therapy along with medication was lower in those counties with fewer licensed psychologists, but didn’t always reflect the number of available psychologists.

For example, Sacramento County in California and Miami-Dade County in Florida have the same number of licensed psychologists per capita.

Yet almost half the children with ADHD in the California county received therapy along with drugs, compared to only about 20 percent of those in the Florida county.

Source: Rand Corporation

Rx ADHD photo by shutterstock.

Just 1 in 4 ADHD Kids Gets Drugs Plus Psychotherapy

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Just 1 in 4 ADHD Kids Gets Drugs Plus Psychotherapy. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 23 Sep 2014)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.