ASSESSMENT PROCESS 

Adult ADHD assessment 

1. Intake form, Developmental History form and consent forms sent out

2. Session One – Initial Interview to establish whether a comprehensive ADHD assessment is warranted. Risk assessment. Rapport building

3. Psychometrics – behaviour and rating scales  CONNORS ; Funtional impairment rating scales (WFIRS) – sent to client and others for validity; UPPS which helps to establish the clients individual ADHD pattern and DASS 21 to establish current level of anxiety and depression

4. Session TWO - Semi structured interview (DIVA – 5) (1.5 -2 hours)

This will also include 

• Educational history review. IQ/Cognitive assessment may be required if formal education cannot satisfy intellectual developmental deficits).
• Driving history and work history review.
• Diagnostic Interview x 2 (Client and a significant adult in their life) 

5. Assessment review

6. Report supplied to client, referring doctor and Psychiatrist (if medication is warranted)

7. Session THREE

• Feedback session to clearing explain the report, findings and moving forward.

Adult Attention Deficit Hyperactivity Disorder (ADHD) is a disorder of self regulation, especially executive attention (to goals and the future) as well as poor inhibition (effortful self restraint). It is a exhibited as a chronic unremitting pattern throughout life. 

ADHD is assessed by using the criteria outlined in the Dignostic Statistical Manual (Fifth Edition) (DSM-V).  

ADHD is a collection of behaviours that must be present 'often' and cause significant impairment in your functioning across environments - work, home, university, social.  

ADHD is a neurodevelopmental disorder - meaning its onset is during the developmental period. In the DSM V, this means ADHD must be present prior to age 12. However, it is now argued that ADHD behaviours can present much in late teens/young adult. (The prefrontal cortex does not fully develop until late 20's and ADHD is a higher cogntive funtion disorder). It has also been found that adult recall of the onset of childhood symptoms can be out by 3-5 years (Russell Barkly 2023). Women can present differently to men and may present accross the life span. Hormonal changes can effect the onset of ADHD symptoms in women. This includes hormonal changes during the onset of mensuration, miscarriage/pregnancy, perimenopausal and menopause. 

Many of the features that are prominant when you are a child are slightly different. Children with ADHD might climb the furntiture, but as an adult you might just fiddle or go from activity to activity - not quite finishing anything because you can't stay on task. 

Some features of ADHD in adults are more prominant -

Time blindness and task reorientation - losing track of time; getting distracted; not being able to reorientate to task. You might do the opposite and hyperfocus to the detriment of other activities. There is a strong impairment in time management. 

Emotion regulation - very strong, very quick emotional responses with poor "top down" emotional self regulation. The emotional response is often a normal, understandable emotions but there is impaired self restraint in expressing or and limited self soothing. There can be an up and down emotional volatility. Rejection Senstivity Dysphoria is when you have been primed for a negative response. You anticipate rejection and negativity. This can interfere with personal and professional relationships. It is not a trait of ADHD but it can be a very common feature and is treated with cognitive behaviour therapy. 

Self awareness and self monitoring is impaired. In other words, you don't notice what you are doing but people close to you can. 

Poor working memory - unable to hold a task in mind. Forget what you are doing. 

Psychoeducation - The more you know about what ADHD is the better. It is important that the information you are getting is evidence based. Psychologists are required to uphold certain standards including that of delivering evidence based information and therapies under a professionally enforceable code of ethics. 

Own your diagnosis - The best thing you can do for yourself, is to accept your diagnosis and work on ways to make you life more functional. When you have knowledge and understanding, you can begin to put steps in place to mitigate many of the alarming statistics that accompany ADHD. 

Environmental Considerations - Making changes to your work and home setting to promote better performance makes life easier to manage. It is important to understand that you can control what situations you expose yourself too and reduce the number of activating stressful events. Working with Cognitive Behaviour Therapy will help to address many of the thinking patterns around emotional triggers and help you to reframe the way you think. 

ADHD Coaching - together we problem solve your particular challenges and figure out solutions. We look at behaviour modifications, communication strategies, ways to manage time blindness, executive functioning skills...whatever is needed. We make use of apps, external reminders and keep trying until we get a combination that works for you. We look at work environments functioning and what sort of jobs suit someone with ADHD. We look at timeblindness and how to find ways of compating that.

Mindfulness and meditation - Developing a practice of mindfulness greatly increases your capacity to slow down and become present to your thought processes. I use a combination of mindfulness, visualisation and meditation. There are excellent programs available which I am happy to guide you through. Mindfulness will help you to have better stress and emotional control.

Lifestyle accomodations - Regular exercise, low processed food diet*.

Medications - over 80% of people who are diagnosed with ADHD will need medication. The combination of psychotherapy and medication is considered the gold standard treatment for ADHD. 

                    I take a  mindfulness multidynamic approach to ADHD treatment.