Sunday, December 15, 2019

Comments by Michael W. Corrigan, EdD

Showing 36 of 36 comments.

  • I rarely reply to the comments section in my blogs, but today I just wanted to share some reflection. I feel a treatment center willing to pursue research determining if their efforts are effective, and agreeing to allow the results to be shared publicly, deserves nothing less. But regardless, I want to start by saying thanks for replying. And for the most part, your concerns and theories are legitimate.

    But to be clear, many of the critiques you put forward were answered in the blog and in the research report. The main point I was attempting to share, with today’s demand for evidence-based therapies, treatment centers similar to ATMC should try their best to produce evidence more objectively documenting the level of success they are experiencing or producing. Furthermore, relying on what I call “sample of one” anecdotal case studies, does not benefit an effort to improve such care nationally or provide enough evidence to discredit the findings of inferential statistical analysis utilizing more than one hundred cases.

    Such larger scale research or statistical analysis efforts are essential so that one doesn’t wrongly assume that a few negative or even positive reviews accurately reflects the overall success of a treatment center. Additionally, such research is beneficial for continuous improvement efforts, discovering what is or is not working, and most of all, helping clients feel more confident in their personal chances for success.

    But as I share in this blog, when working with individuals who have unfortunately entered this world of pharmaceutical reliance, there will always be the possibility of numerous clients not experiencing success, or for that matter, having a horrible experience. As I share in the blog, and as you share here, many of the challenges these folks face before entering treatment, will still be waiting for them once they leave the treatment center. But ATMC has treated more than 1,600 clients since opening their doors.

    We reached out to 300 who had been treated in the last several years. About 100 replied with complete data capable of being included in the analysis. And with discovering that 87.5% were able to reduce or end dependency all together, that means there are probably 200 additional individuals out there that might feel the treatment at ATMC was not effective. But such percentages also suggest that there are possibly 1,400 individuals who would disagree and instead share success stories of how ATMC helped them.

    Additionally, the blog explains that we did look at more than if they reduced the level of pharmaceutical drug use. More than 83.5% reported they also had experienced improved and sustained levels in the long lists of negative symptoms they were experiencing. More than 71.9% reported improved and sustained social relations and interactions. And more than 75% reported experiencing improved and sustained quality sleep patterns. So again while there might be some (16.5% to 28.1%) that did not experience such improvements beyond reducing their dependency on pharmaceutical drugs, 71.9% to 83.5% of the 1,600 would theoretically report good news connected to the help ATMC provided.

    Additionally, the survey allowed for qualitative feedback from the past clients. So much so, that I didn’t have enough room in the limited word count to include such information in the blog. And while a few reported shortcomings they experienced as well as dissatisfaction with some aspects of ATMC’s efforts, they also politely shared ways that ATMC could improve their efforts. Many, however, did report great satisfaction and shared their gratitude for the help ATMC provided… aka sharing what it was like at ATMC. Here are a few of the dozens shared:

    “Overall, I am grateful to ATMC for the care they provided and continue to provide.I have met a lifetime friend… and continue to Skype with her regularly since leaving ATMC. The love and care and so many aspects of the program are solid and extremely valuable.”

    “I loved the program. I was there for only a month…”

    “I would love to come visit! Maybe you folks could give me a job :)”

    Again, this blog mainly was intended to help treatment centers look at how pursuing a research agenda can be much more reliable and valid, accurately informative, than a few negative online reviews. It was also intended for those seeking help. I wanted to illuminate how to better determine what evidence is needed to help them make an educated decision on where they could find the best support that has the best potential for addressing their specific needs.

    In my experience working with ATMC, I have met numerous caring administrators and staff who just want to figure out how to improve what they are doing to increase their clients’ success. Is there room for improvement at ATMC? Of course there is. That is why they asked me to do the research.

    I greatly respect and appreciate Mad in America and their loyal readers. But I also believe in science. And while I admit within the blog the limitations this research encountered during this initial research effort, I stand behind the statistical results shared.

    Sincerely, I am sorry to hear about your friends, and can only hope they have found or will find the help they need. But critiquing a treatment center based solely upon a personal case you might be aware of, and dismissing the bigger picture findings reflecting what combining 100+ individuals actually provides, is not going to help the field move forward on finding the best way to help folks kick the meds, and more importantly enjoy a better life.

    Many individuals cannot make such progress on their own. The great friend I lost was one of them. And please forgive me, but I believe we need to help the centers trying to do some good, do even better.

  • Academic, thank you for the thoughts and insights. If folks read my book they will understand that I understand and agree behaviors such as inattention or hyperactivity or anger issues or a whole host of other behavior issues can be and quite often are a challenge to raising children and helping them develop into healthy young adults. And I also feel that many should seek professional help if their children have major issues. But all I am trying to do is get folks to first and foremost focus on getting more holistic or behavior focused help from people and experts who don’t start by assigning a mental disorder to get paid and writing a prescription. Take autism for example. Most start with getting help that focuses on the child’s needs. The last thing they do is ask for drugs.

    Also I am trying to point out that you can’t have a sound statistical analysis, whether it be a correlational or means analysis, if your independent or dependent variables are not measured with a reliable and valid instrument. Adhd is often the dependent variable in many studies claiming drugs helped. Also in the research course I teach I warn people to beware of the c-word and p-word. Cause and prove. If anyone claims their research proves something or shows a direct cause, unless they have replicated findings from sound experimental research using valid assessment, they are overselling the results.

    Again I appreciate the whole discussion all have provided today and for keeping the discussion civil. Although presenting conflicting views might seem like an attack to some, This should be something both sides of the debate should be able to discuss freely. This way concerned adults can hear both sides of the story, read the contrasting research, and make up their own minds. But right now no such research explaining the dangers of drugs or the lack of a valid assessment are shared in most offices kids go to get diagnose.

  • Please buy my book excederin. I think you will find I am not a conspiracy theorist. At one point I believed adhd was a serious issue for our youth. And then I researched the topic for years and discovered far too many questions to give it much credit. It’s hard to provide all of the evidence you seek with a short blog and video. But if you and others take the time to read the mass of research on adhd, in nearly every peer-reviewed study you will find that the authors disclose which pharmaceutical companies they have done paid work for. Take the coveted mta studies for example. I think they had two whole authors not reporting direct compensation from the pharmaceutical industry. And while your are at it Maybe explore how big pharma
    contracts with Madison Avenue marketing gurus to hire ghostwriters to sign on as authors to justify inhouse research completed by drug companies that the ghostwriter had little to do with. Look at how much the open payments report documents as payments to doctors if you want specific names. I’m not saying all doctors treating kids for the behaviors associated with adhd are evil, but from my research and
    firsthand experience I can tell you nearly every community has an adhd clinic where that is all they do. And by that I mean they diagnose every kid that walks in the door as adhd something. And they prescribe a drug for them to make the child behave more normal. This is not right in my opinion. Thanks for your input to the discussion today.

    Surely

  • I agree, we should never stop seeking science behind what we do not understand.

    But they have been seeking such science to justify drugging kids for 60 years and still have not found enough to support what they claim related to ADHD. I’m fine if we continue on 60 additional years or more, but there are a few things I feel are important to consider.

    First, I am not sure we are reading the same study. Smalley and colleagues at UCLA seem to find that while there may be some differences, there are also some very peculiar similarities… http://newsroom.ucla.edu/releases/new-thinking-revealed-about-adhd-43193

    Second, without a validated statistical assessment to serve as a way to actually document who does or doesn’t have adhd, as well as a way to more precisely measure the severity of a supposed disease or mental disorder, how can a piece like that even get published. In my world, where I do not own a pharmaceutical company, reliable and valid assessments are a requirement for peer reviewed publication. But somehow they use brain scans (real science) to measure differences between kids with or without adhd and yet they use “feelings” to assess if the kids actually have ADHD. Seems like a major limitation to all of the ADHD studies.

    Third, it makes perfect sense to me that when we look at brain differences between kids who differ slightly on such common behaviors, could we not just say kids that act a little different with less conformity have brains that have not yet given in? Are we not just studying different levels of creativeness or communication traits? Why can’t we study the difference of brains and how kids develop without trying to tie it to a profit center for a mental disorder that let’s face it, is based on the most simplistic symptoms.

    Let’s study how best to help all kids and not more reasons for medication or labels.
    And quit calling me Surely.;-)

  • It’s possible B, and I am not denying or underestimating… I just hope that some of the stronger media personalities some day overcome whatever is keeping this news from being of importance.

    But at the same time I think the ADHD our media suffers from is just as bad. From day to day they seem to randomly focus on what ever the hot topic of the day is… ebola… isis… elections… it’s almost as if you need multiple tragic events to get any air time. And I wish that upon no children.

    Perseverance has always been my m.o.

    I watched the mountain top removal effort get very little air time or attention… but the Sierra Club and their army has made amazing inroads to getting national attention regularly. Just borrowing from Mary Ann Hitt’s playbook. Form a team and “keep on playing”.

    And yes I quote Caddyshack often.

  • It’s a good question I have thought about often. And I don’t have the answer. But I think real awareness and meaningful discussion can lead to them not being able to overlook it much longer. I just wish they could realize there are some drugs that are helpful and then there are others that are not. I don’t see much tv advertisement for ADHD drugs. So if they could realize that addressing this issue doesn’t equate to attacking the whole pharma industry, then maybe we can get somewhere.

  • Thanks again Erin!

    And yes, I am serious about doing nationwide conferences/symposiums/Truth Talks… whatever you want to call it… I think offering a day of numerous expert testimonies delivered energetically and with sincerity is exactly what is needed. Through hosting such events via a larger metropolitan-focused approach we can reach hundreds if not thousands of concerned parents and educators (as well as other professionals) in each city. Given some of the local news’ stories I see, I have a feeling this will lead to local media coverage in major markets. And with enough coverage from larger metro markets who are open to the supposed controversial stance we take, then slowly we might get a few brave major national media networks and personalities to report on the effort. Yes you Bill Maher, Jon Stewart and Diane Rehm.;-) And if we can start getting some major networks to share how what we say is only common sense and the truth, supported by research and real stories that have not gone through the ADHD drug makers R&D Marketing department, we might start getting a lot more folks to listen.

    SO let me know. Keep on keepin on!

  • Sorry Stephen (and Richard). I agree it is a good point and of course extreme behaviors can be a sign of or result of many forms of abuse experienced or witnessed. I cover such situations (once again) in my book. For example, couldn’t such extreme behaviors also be a “normal” reaction to a child finding out their father has left home, abandoned them? I wasn’t intentionally ignoring it. I was just sitting here nursing the flu bug and politely replying to the constructive point Richard made about my blogs.

    The fact that many mental health issues might be related to abuse or not-so-wonderful family dynamics would be/should be something any caring and qualified professional would consider and explore before using the catch-all ADHD diagnosis. But I also think such professionals equally should consider how ADHD-like behaviors for a much larger percentage of kids might be due to something much less serious than abuse issues; aka simple developmental delays, parenting styles, boring classrooms, etc. The connection to abuse, however, is just one more reason why so many need to stop accepting the 10 minute diagnosis at pediatricians offices or ADHD centers as fact… and get real help from mental health professionals that explore the child’s whole social system they live within. In other words, seek help from those that want to help the whole child, the family, and avoid those that immediately want to take you to the “there’s something seriously wrong with your child’s brain” stage.

    But no matter if we accept the 1 in 5 abused research you share,… or the 1 in 10 suffering child maltreatment, or the 1 in 16 suffering sexual abuse or 1 in 10 witnessing family violence that others share… it all goes back to the fact that the environments our children live in often hold more responsibility (blame) for ‘abnormal” behaviors related to ADHD and other disorders than the medical, biological or even genetic claims so many are trying to sell.

    I’m sure I missed something, but I’m going back to the couch now to sleep.

  • Thanks Fred! But please don’t worry too much about me. One thing a not so perfect childhood gave me was a thick skin and an inability to ever walk away from a disagreement.

    But as October, the month for pharmaceutical companies like Shire to sponsor organizations like ADDA and CHADD to make fraudulent claims, also known as ADHD awareness month, I could not agree more with you that we need an army.

  • Thanks “Someone Else” and Richard for your input.

    Maybe this is why my wife (a marriage and family therapist) and I don’t receive as many invites to cocktail parties as we used to.;-) If only the “real housewives” could get a copy of my book to discuss during one of their many cocktail parties, then we could set a new worldwide trend for redirecting alcohol-induced armchair diagnosing sessions.

    Richard, thanks for the critique as well. With my blogs I am probably guilty of not clarifying that kids do exhibit signs of maladaptive behaviors. And many of these behaviors go well beyond “normal” behavior. One reason is that I have a hard time writing a short blog (yes I am passed the denial stage), and often in order to share the full synopsis of what I think and feel I run out of room. If you read my book however, you will find that the second half is focused on ways to approach addressing and fixing such serious behavior issues. Getting enough sleep (e.g., setting and sticking to a realistic bed time for kids) is just one of the important components to establishing the structure kids need to behave and think properly. Limiting exposure to electronics is also important. I also think a good dose of mother nature (i.e. being outside) is essential. And most of all increasing quality time with parents, using Love and Logic as my friends Dr. Charles and Jim Fay call it, cannot be overlooked. While some of the more serious and extreme behaviors might be due to something medical or biological, I still believe many of these conditioned/learned behaviors can be reprogrammed with time and hard work.

    But I am probably overdue to write a blog on what else parents and educators can do to overcome behavior issues.

  • Eugene, Thanks for your reflection that hits the mark so eloquently and accurately. I greatly appreciate the support and I do believe you will enjoy the book; given nearly everything you state is discussed to some degree in the book. My goal in the book, unlike the blogs, is to discuss every piece of the puzzle so parents and educators (and even mental health folks), can piece all of puzzle together. We have to figure out something over here to break through the resistance for those not wanting to hear or believe that drugging kids is bad or at the least counteract the marketing propaganda running this out of control band wagon.

  • Tyler (and any others possibly feeling like Tyler), I truly feel for your situation. Believe it or not, I experienced many years when I was young and even as an adult when I felt extreme stress, anger, abandonment, alienation, unmanageable distraction, and so many other debilitating thoughts. For many years I made the wrong decisions as to how to deal with such challenges, which just lead to many more challenges. Not to sound cheesy, but the journey to finding the answers was never easy nor short.

    For me as an adult the best temporary cure is to fly fish on a quiet stream away from everything as often as I can. I also try to keep myself busy researching and reading on topics that capture my interest. For me the answer also rests in regular exercise and spending as much quality time as possible with my wife, kids, siblings and close friends; taking time to recognize all of the good I have around me and not focusing on the issues that cause such negative feelings.

    My intent is to not belittle the unfortunate challenges many adults like yourself face related to mental health issues. My goal is to get adults to think about how the diagnosis of ADHD truly relates to children. My goal is to show how the symptoms of ADHD are the same behaviors all children are learning how to manage; which does not equate to a disorder. As my book details, the use of medication often results in such behaviors remaining into adulthood and sometimes getting worse.

    I did not write this book, that admittedly denies the existence of ADHD in children, to personally attack you. I write this blog and my book to help kids not have to go through years of medication that according to research performed through funding by the NIMH can instantaneously cause brain damage that is often permanent.

    Also I am not a clinician, so please don’t ask me for formal alternative diagnosis via the internet. As my friends who come to me for advice would confirm, all I typically do is suggest they go actively volunteer for an organization assisting the needy and less fortunate. The human experience for all is never easy. Sometimes a healthy distraction can provide much benefit and what we need to reflect more clearly.

    It’s amazing how such experiences can help us to reframe how we view our lives. Suddenly our problems seem to diminish in severity when we realize what others are up against. Years of volunteering and helping troubled youth helped me realize that it was quite fine to be far from perfect. Though our character might have flaws, we have the ability to help others realize a better life, and in the process help ourselves.

    Some visitors to this site would not recommend any type of mental health therapy. If the experts those folks have seen were not qualified, thoughtful and/or caring individuals I understand why they feel that way. But I do think there is good help in mental health. I don’t think, however, the answer is necessarily found by assigning labels from the great big book of everything wrong with us (DSM). For many experiencing mental health issues the causes are not necessarily due to chemical imbalances or unproductive neuron pathways or whatever. Instead, sometimes, the answers often rest within exploring the parts of our personal social systems that connect and unfortunately sometimes contribute to the symptoms associated with such labels often assigned. What we realize through the systems approach is that there are some things we need to get rid of in our lives and we often need to add some new parts as well. But these are just a few of my thoughts as to how to cope with this thing we call life.

    Please understand, my goal is to help adults realize that kids need something besides a label and medication. They need help in shaping their social systems. They need structure, discipline, sincere empathy, love (yes lots of love), creative academic assistance, possibly behavior modification, and much guidance and support to develop the life-skills they need. Kids need a lot from us adults. Unfortunately in America our schools are too often focused on preparing kids for a life of tests rather than the tests of life. Unfortunately such focus leads to increased pressure to go down the ADHD label and drug route.

    Tyler, your perspective provides us with much to think about. How do we help those that still fight with such severe symptoms in adulthood? Is it Adult ADHD or something else? But this (a healthy and civil discussion platform) is what I think Mad in America does offer. Although you might not find all of the answers here, and few insights you don’t want to hear, MiA’s caring contributors (bloggers and people like yourself), offer many helpful insights as to what to avoid but also alternatives to the norm that might hold great potential. Please keep reading and seeking answers, but don’t think I do not understand or sympathize with your situation.

  • Thank you for all of the interesting comments, support, questions and even a few jabs… that have gotten this blog off to a good start today. But all you need is love…isn’t that how the song goes? And yes Love and sincere empathy are several of the key ingredients to raising healthy children.

    As I state in my book,just because I am focused on showing how research and common sense do not support the adhd diagnosis, this does not mean that I think all of the disorders in the DSM are not valid. I think many diagnoses (the majority) in the DSM(such as those related to truly severe chronic depression, schizophrenia…) are real and many individuals can benefit greatly from therapy related to the diagnosis. But as to the discussion of what is “real”, that will have to wait, because I have a plane to catch back east this morning.

    There are some wonderful people working in the the mental health field, and like any other profession… there are also many not so wonderful people. To be clear, I am against using the, a, diagnosis that simply describes how every child acts “often” to some degree… and then use that label to justify medicating children with dangerous drugs for years to come.

    If as an adult you want to accept the ADHD diagnosis, seek therapy, and take such drugs, or micro-nutrients or other alternatives, by all means it is your prerogative. I hope that all adults challenged by mental health issues can find “good” help, a more supportive network of good friends and family, and figure out what makes them feel better about themselves and life.

    In my forthcoming book I provide all kinds of different holistic and common sense ways to address such issues with children. Many of the problems related to the supposed ADHD “symptoms” (aka unfortunate normal challenges to raising children who act like children), however, are systemically connected to issues with parenting and schooling and the environments the kids spend every day. So the problem is not necessarily internal (in the child’s brain), but quite often also (and quite possibly) heavily due to external issues. Which might explain why they can’t seem to find strong research findings supporting a biological or genetic link to ADHD. Because ADHD is in the eye of the beholder. Some day I will do a blog down these lines as well.

    btw- Depending on what studies and numbers you look at, in the USA the average percent of kids diagnosed ADHD is more like 11% according to recent CDC numbers, and in certain regions the percentages are over 20% for young boys.

  • Well John, as a researcher I never use the p-word or c-word; prove or cause. So I am not sure I will ever prove it you. More on that another day. But I do hope my research and words also support the label of “fab” in your mind in time.

    To yours and Steve’s questions, the answer is yes. Yes that Dr Sami Timimi and I probably offer similar advice and hold some similar views. In fact, you will find Part II of my book is focused on alternatives and ways to help parents not feel the need to accept labels or drugs; which includes a systems based approach incorporating the parents, siblings and educators. I strongly recommend avoiding stigmatizing labels with our youth, and the gov’t catchall categories of IEPs and 504s.

    And Steve, I think you will find the longitudinal and semi-historical research I share to build the case for debunking adhd goes back fairly far. And the deeper I dug the more I kept wondering how so many have forgotten what we learned about these drugs decades ago. But the latest 2009 MTA study provided results equally supportive if not more in my mind to just good old talk therapy and behavioral modification programs for kids; instead of drugs.

    Thanks for your input gents.

  • And btw- just because I didn’t delve into every first hand experience (within this first blog post) that I have had with ADHD does not mean I do not have first hand experience. I understand more deeply than you can imagine how challenging this thing called ADHD can be. So please don’t think I do not care. The whole reason I wrote this book and agreed to the blog is major sign of how much I do care; especially for kids.

  • Thanks for sharing your thoughts and part of your personal story. I fully understand why my views will cause similar reactions to many good people like yourself. There are parts of what you share that I agree with; especially the part where clinicians and practitioners should consider the 16 categories and other disorders listed as “Differential Diagnoses”. And you are correct, that the rush to judgment, for example pediatricians providing a diagnosis of ADHD during the first short doctor’s visit, is contributing most definitely to over diagnosis and misdiagnosis. How could they account for such alternative answers to such behaviors in such a short time?

    But I politely disagree with your belief that validity is not a problem.

    First point, check this link out, http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml.

    The NIMH has major issues with the validity of measurement used for diagnosing many disorders listed in the DSM.

    For decades, numerous respected international health organizations (e.g., International Narcotics Control Board and World Health Organization) and even the US Congress have expressed similar concern as to if prescribing drugs for such a questionable diagnosis is warranted or safe. Unfortunately, the propaganda campaign fueled by those behind the ADHD movement has quite successfully distracted millions of parents and educators from discovering the real facts.

    The research, however, documents that this whole movement to paint inattention and hyperactivity-impulsivity in children as a disease or some sort of abnormality of the brain is just a hoax growing further out of control. If there were real evidence suggesting such claims of a hoax are wrong, after close to 60 years of the pharmaceutical companies marketing stimulants for children and the American Psychiatric Association trying to justify this label for kids, pro-ADHD experts wouldn’t continually state in publications such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that “no real causes have been identified for ADHD”, “no biological marker is diagnostic for ADHD”, “brain scans still can’t confirm ADHD’s existence”, or “tests of attention, executive function, or memory… are not sufficiently sensitive or specific to serve as diagnostic indices [measurements identifying ADHD].”

    If pro-ADHD experts had real evidence ADHD is a disease or chronic condition, one would actually test for ADHD using a real medical test (e.g., blood test, DNA, or brain scan). Instead most still only use a pencil or pen to put a check mark on a simple piece of paper next to a few of the 18 common behaviors associated with ADHD that all children exhibit often to some degree.

    I urge to read my whole argument when the book comes out, and as I share parts of the argument in this blog.