Department of Psychiatry

Penn Behavioral Health

Penn Adult ADHD Treatment and Research Program Turns 20!

The University of Pennsylvania's Adult ADHD Treatment and Research Program was originally established during a meeting on March 8, 1999. Psychiatrist Dr. Anthony Rostain, who had previously launched the Children's Hospital of Philadelphia's ADHD program, which remains a leader in the field of childhood and adolescent ADHD, approached psychologist, Dr. J. Russell Ramsay about the prospect of starting an adult ADHD specialty clinic in their department. Rostain envisioned a program offering a two-pronged intervention approach of pharmacotherapy and psychosocial treatment, namely cognitive-behavioral therapy adapted to adult ADHD. Seeing as Ramsay was (and continues to be) on the clinical staff at the Center for Cognitive Therapy at PENN, Rostain reached out to him for a potential collaboration (most likely because none of the other clinical staff had any interest in ADHD).

The initial task before accepting any referrals was to hammer out the components of a comprehensive diagnostic evaluation. After discussions and consultations with colleagues from within and outside of PENN who had some experience with ADHD, an evaluation framework was set. In the ensuing years, the evaluation has undergone various additions, deletions, and other revisions but is still consistent with its initial framework and function.

The team has grown over the years from a two-person operation to include an intake coordinator; a medication consultation and treatment arm that is staffed by advanced psychiatry residents who receive year-long supervised training with Dr. Rostain; and a psychosocial treatment arm staffed by advanced pre-doctoral clinicians in clinical psychology, who also handle the comprehensive diagnostic evaluation arm of the program as part of a year-long practicum experience, supervised by Dr. Ramsay. In fact, many of these trainees have gone on to use archival and other clinical data gathered through the program for their doctoral dissertation projects. More recently, in what has become the third intervention arm, Lisa Joy Tuttle, an Adult ADHD Coach, has established a Mindful Self-Management course, an 8- to 12-week psychoeducational skills-based class that is composed of a hybrid of executive function and cognitive-behavioral coping skills.

Individuals seeking assessment and clinical services through the program undergo a comprehensive evaluation that involves a host of ADHD symptom and comorbidity inventories (including both self- and other-reports), structured clinical interviews (including SCID-5), and a brief testing battery. Results and recommendations are reviewed during a feedback session (including recommendations for individuals whose presentation does not support an ADHD diagnosis) and are summarized in a written report. Treatment options provided by the program as well as referral options to colleagues in the Greater Philadelphia region are provided. Dr. Rostain is also a certified evaluator with both Major League Baseball and the National Football League for their therapeutic use exemption programs.

By J. Russell Ramsay, Ph.D. ~ Reprinted from the APSARD Blog (June 28, 2018)


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