Only One-quarter of US Children Taking ADHD Stimulants Get Any Psychotherapy

Rob Wipond
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Most US children and youth diagnosed with ADHD are taking stimulant medications, but less than one-quarter are receiving any amount of concurrent psychotherapy of any kind, according to a “Research Letter” published in JAMA Pediatrics.

University of Pittsburg researchers used a large commercial claims database covering 1,516 US counties to identify children who filled a prescription for an ADHD medication, were continuously enrolled in an insurance plan in 2010, and had been involved in psychotherapy.

The researchers identified 301,530 children receiving ADHD medication, of which 24.5% had at least some therapy visits in 2010. Rates of therapy varied widely across counties, from 6.3% to 38.1%, and the frequency of psychotherapeutic visits was often very low.

“We found that only one-quarter of commercially insured children in our sample receiving ADHD medication received any concurrent therapy services,” wrote the researchers. “In almost 200 US counties, fewer than 1 in 10 children receiving ADHD medication received therapy.”

“While medication-only treatment is consistent with guidelines for school-aged children, it may not represent the optimal treatment for many patients,” the researchers suggested. “The geographic variation in receipt of therapy, despite adjustment for clinical characteristics, may be explained not only by psychologist supply but also by parent, child, or pediatrician preferences for or comfort with nonpharmacologic care.”

Coincidentally, an article this month in The Lancet Psychiatry discussed ongoing questions and concerns about the high rates of ADHD diagnosing and medicating in the US, and referenced the findings of a Center for Disease Control study. “The CDC officials reported that in 2012, about 1660 children younger than 4 years received a diagnosis of ADHD, 760 of whom had a claim filed for an ADHD drug. This report was released only months after the CDC reported in November, 2013, that about 2 million more Americans aged 4—17 years received an ADHD diagnosis in 2011 than in 2003, and that more than two-thirds of these patients received drugs for the disorder.”

Geographic Variation in Receipt of Psychotherapy in Children Receiving Attention-Deficit/Hyperactivity Disorder Medications (Gellad, Walid F. et al. JAMA Pediatrics. Published online September 22, 2014. doi:10.1001/jamapediatrics.2014.1647)

US authorities attempt to quantify ADHD prevalence in toddlers as treatment debate continues (Granovetter, Michael. The Lancet Psychiatry, Volume 1, Issue 4, Page 262. September 2014.
doi:10.1016/S2215-0366(14)70366-9

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

9 COMMENTS

    • Many of these kids are ending up in drug treatment centers. Just goto a 12 step addiction recovery meeting near any treatment center and start asking people if they were drugged as kids for so called ADHD, almost a majority I found say yes. Then they rattle of the names of other psychiatric drugs and the labels they got as the ‘side’ effects the stimulants pile up.

      The defenders of child drugging are real good at blaming the victims by saying stuff like its only the kids who “abuse” the ADHD drugs that have problems but the child drugging industry is the one that introduced them to getting high on amphetamines at an early age in the first place !!!!

      I hate to say it but just writing this is making me crave that Dexadrine/Adderal high . It’s the best pill high ever but of course that’s my fault I am obviously and “addict” right ? All the blame goes on me and none of it on the people manufacturing and pushing stuff that I never would have been exposed to in the first place of course.

      What a scam, first the child drugging industry teaches kids what getting high is , then when they become addicted adults the psych industry teach those adults to blame themselves for there addictions. My fault, my bad DNA or what ever the latest medical fraud is the reason I am an “addict”.

      That blame the victim strategy is effective too, when “addicts” start point fingers at doctors and psych pharma treatment has a sneaky way of calling that not taking responsibility or calling it denile and crap like that.

      • One of the first things that happens when anyone goes to treatment for drug and alcohol abuse is they get shuffled off to the doctor to usually emerge with an SSRI that rarely has any effect on post accute withdrawal anxiety/depression and another drug off label for sleep.

        Psychiatry, the worlds largest pill pushing operation by far calling the shots in the addictions field, of course they say child drugging does not lead to addictions over and over despite the evidence.

    • I did and it just makes me unable to act older than 14 if I stop them. Literally, hyper, immature, loud, rude and cracking inappropriate jokes. They did at 18 and I went to drugs. My mom had me on dexedrine at age 5. Major dependency to them too. I don’t know why they call it something else. I take a lot less than before and plan to get off of them but some kids lose it, some have schizophrenia and some of us make it in life but I am to the point where I am done. these drugs make you dull and emotionless after awhile and the calm and quiet thing is weird.

  1. Psychotherapy can be almost as damaging as bad drugs. Many of us ‘former patients’ have had terrible experiences with therapists. We have gone in, begging for help, baring our souls . . . and receive less than nothing in return. So many psychotherapists are in it just for power plays of their own. We have been screamed at, degraded, told we were ‘unloveable’, and have basically been blamed for causing whatever problems which caused us to seek out therapy in the first place. The damage this would cause a child in a psychotherapist’s office boggles my mind.
    The problem is that if you have a problem, our society has the knee-jerk reaction of saying: “Go get therapy”. This has to end. What has to start is a realization that too many psychotherapists are very abusive, & power-hungry. Besides drugs & psychotherapy, there should be alternatives for children (& adults) to get help. Perhaps peer-support groups, where there is ‘openness’ and trust as basic guidelines. That no one is to be degraded, or shamed.

    • Actually now when I think about it the most helpless, pathetic “therapists” were the ones who had both MD psychiatrist and psychology degrees (it’s quite popular where I live). Those who had only a psychology degree were somewhat more empathic and reasonable even though they didn’t seem to have an idea on how to help me and had an annoying manner of talking to you (I think they’re taught to speak to you as if you were a little child or about to burst into tears, which drives me mad every time).

      • I have always had issues with LICSW social workers as therapists. There are different vibes and some of their approaches are a lot like eugenics in the way they talk to you. The condescending Kindergarten teacher voice is old too. They always talk crap to doctors too. I see a psych nurse practitioner who does both with me for that reason.

  2. Good point rewritten. Fortunately, I was very lucky with therapists and had some good ones. I think one in particular was trying to tell me that antidepressants were bad news. Unfortunately, I wasn’t ready to listen.

    Anyway, therapy can be very valuable if you find the right person. Unfortunately, finding him/her is a whole other issue.

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