Friday, April 29, 2011

ADHD and the Concept of Recovery

Statement of the CHADD Professional Advisory Board (PAB)

In response to numerous stories about the relationship between ADHD and the concept of recovery, the CHADD Professional Advisory Board (PAB) approved the following statement on April 6, 2009.


Background

In 2002, then-president George W. Bush created the President's New Freedom Commission on Mental Health. The Commission's charge was "to study the mental health service delivery system, and to make recommendations that would enable adults with serious mental illnesses and children with serious emotional disturbance to live, work, learn, and participate fully in their communities." The Commission submitted its final report to the president in July 2003 in a report entitled, Achieving the Promise: Transforming Mental Health Care in America.

The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the United States Department of Health and Human Services (HHS), continued the work of the Commission when it published, Transforming Mental Health Care in America, Federal Action Agenda: First Steps in 2005. Prior to publishing this Agenda, SAMHSA consulted with other federal agencies and numerous experts, including mental health consumers, family members, providers, advocates, researchers, and others. This consultation resulted in a National Consensus Statement on Mental Health Recovery.

This statement identifies ten (10) fundamental components1 of recovery and defines the term as follows:

  • Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Relationship to ADHD

The concept of recovery may not be familiar to most families and individuals faced with the challenges of attention-deficit/hyperactivity disorder (ADHD). The term itself may also suggest a different meaning to health professionals whose primary work is not in a mental health setting. Nonetheless, there are numerous points of connection between recovery as defined above and the successful management of ADHD. In this context, it is important to understand both what recovery means and what it doesn't mean.

Here, recovery does not refer to a process that necessarily has a foreseeable endpoint. The individual who breaks a leg will typically go through a process of recovery from such an injury. At some foreseeable point down the road, the individual will be said to be fully recovered. This is typically not how recovery is used with reference to those facing mental health challenges, including many with ADHD. While some individuals with particular mental health challenges (including a subgroup of children with ADHD) are able to move to a condition of being recovered, for many individuals with mental health conditions, recovery is usually dynamic and ongoing, not fixed and static.

This applies to most adults with ADHD. For such individuals, recovery can best be understood as the ongoing management of ADHD symptoms. The two main hallmarks of mental health recovery are living a "meaningful life" and growing toward one's "full potential." For those with ADHD, these are not only applicable, but are also highly attainable. Despite the many challenges they face, resources exist that can help individuals with ADHD attain a level of well-being marked by independence, healthy interdependence, hope and personal satisfaction.

The bulk of treatment research on ADHD has focused on the condition in children, and the options for them have a strong evidence-base for symptom reduction. For many, the need for intervention persists over the long-term. Although ADHD has been less thoroughly researched in adults than in children, adults who have been correctly diagnosed with the disorder can still take advantage of whatever treatments best meet their needs. In addition to evidence-based interventions, there are those which have been shown to be "promising," and which may be experienced as effective by the individual. Working with one or several health and mental health care practitioners, adults with ADHD can learn to manage symptoms as they are expressed in their lives.

CHADD recognizes that ADHD is a condition that affects individuals "across the lifespan." This means that ADHD symptoms are usually experienced from one phase of life to the next, and that they extend to the various spheres of life during any particular life phase. Based on the notion that adults with mental health challenges should be empowered to exercise their right of self-determination, the concept and components of "recovery" have much to offer individuals with ADHD and all those who are a part of their lives.


1. These components are: self-direction, individualized and person-centered, empowerment, holistic, non-linear, strengths-based, peer support, respect, responsibility, and hope.

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