Integrated multimodal therapy of children with attention-deficit hyperactivity disorder

Attention-deficit hyperactivity disorder (ADHD) affects about 3-9% of children in the United States. It is a complex, multidetermined ailment that causes profound difficulty not only for the children but also for their families and those in the broader social environment (e.g., schools). Although medication helps an ADHD child's day-to-day functioning, it is less effective in producing long-lasting improvement when used alone. The author therefore discusses the rationale and techniques for multimodal treatment, including the use of education, cognitive-behavioral therapy, behavior modification, and structural and dynamic therapy, as well as medication. He emphasizes that the use of multiple modalities produces therapeutic benefit greater than the sum of each modality's contribution. The author's basic premise is that psychodynamic understanding is crucial in determining how to combine various therapies and make them mutually facilitative.