Assessment and treatment of planning skills in adolescents with ADHD

Planning problems are described to be prominent in the daily lives of adolescents with ADHD (Barkley, 2004) and may cause comorbid conditions and impairments (Safren, 2006). Therefore the central aim of this thesis was to assess planning skills of adolescents with ADHD and to investigate whether these planning skills can be enhanced using cognitive behavioral therapy (CBT). Chapter 2 suggests that even though adolescents with ADHD show planning problems as compared to typically developing (TD) adolescents according to their parents, not all adolescents with ADHD have planning deficits and these deficits may not be visible on all (neuropsychological) measures. Chapter 3 and 4 showed that adolescents receiving either CBT aiming at planning skills (Plan My Life; PML) or CBT not aiming at planning skills (Solution Focused Treatment; SFT) improve on ADHD- and comorbid symptoms as well as associated impairments up to one year after treatment with large effect sizes. Even though adolescents receiving PML showed less parent-reported planning problems three months after treatment as compared to those receiving SFT (chapter 3), one year after treatment no differences between treatments were observed (chapter 4), indicating either that it is not necessary to aim CBT at planning skills. Finally, chapter 5 showed that personalized treatment allocation with regard to these two CBTs is not necessary, because the effects of both CBTs were comparable for most adolescents. Yet, for one subgroup of adolescents with ADHD, those with comorbid anxiety symptoms but low depression, PML did appear the treatment of preference.