Getting Help for ADD

The following page is designed to help you find and evaluate a specialist who can determine whether you have ADD and what can be done to help you.  

Click here to search for professional help in your geographic area.  Some ADD specialists are listed on right hand side of the Home page of this site. 

The Training of ADD Specialists

There is no special training or experience required for professionals to represent themselves as ADD specialists.  Some practitioners who call themselves "specialists" have had a lot of training and experience; others have had little or none.

As part of their training in their basic area of expertise, such as medicine or psychology, many professionals do receive some education in the evaluation and treatment of ADD.  However, most professional training in Adult ADD is carried out in one or two day seminars or at medical or psychological meetings.  There are relatively few specialists who have spent even a month in full time training in ADD, and most training is directed towards the evaluation and treatment of children with ADHD. Given these circumstances, it is important to evaluate the professionals' overall education and experience as well as their training.

Types of ADD Specialists

Adult ADD specialists are usually either physicians or psychologists, but social workers, nurses, coaches, and other professionals may also specialize in the diagnosis and treatment of the disorder.

Physicians
Physicians are graduates of medical or osteopathy school and usually have three or four years of specialized clinical training after graduation. 

·        Those who evaluate and treat Adult ADD are generally specialists either in psychiatry, pediatrics, neurology, or internal medicine.  They are trained to recognize other medical or mental health disorders while carrying out an evaluation consultation for ADD.  This may be important since symptoms that look like those of ADD are sometimes caused other disorders.

·        Physicians are licensed to prescribe medications  Research has conclusively shown that the most effective treatment for most people with ADD is medication. For this reason, a physician should probably be on your treatment team.

·        In some states, nurse practitioners, usually working with physicians, can prescribe medication.  In certain circumstances, a psychologist or other professional who is expert in ADD can provide guidance and recommendations to a family physician about the use of medication to treat a patient's ADD.

Psychologists
Psychologists usually have a graduate degree in clinical psychology

·        They have at least a few years of supervised clinical training after they receive their degree.

·        They must qualify for a state license to practice. 

·        They have often been trained to carry out psychological tests for ADD. 

·        They cannot prescribe medications.

Social workers
Social workers have at least two years of graduate training in social work and must qualify for a state license to practice.

Coaches
There is no training requirement for a person to identify him or herself as a coach, although there are training programs that do provide certificates and degrees in coaching.  There is usually no state licensure requirement to do coaching.

Guidelines for finding an ADD specialist

The guidelines below may help you find a competent ADD specialist to evaluate and possibly treat you.  Following the guidelines is no guarantee that your evaluation and treatment will be successful or that the specialist you see will be competent.  But they will increase your chances of success.

Here are the steps.

Step 1. Get the names of a few ADD specialists in your area

Try to get at least a few names to start with.  If possible, get the names of ADD specialists from more than one source. 

·        Ask your doctor or another a health care professional you trust for names.

·        Phone your local hospital's department of psychiatry or pediatrics and ask the secretary of the chairperson of each department for names of ADD specialists.

·       Call your local Mental Health Center and ask for the names of Adult ADD specialists in your area.

·        Check ADD sites on the internet for names.

·        Look in the yellow pages of your phone book under physicians, social workers, psychologists, or coaches.  See if any advertise that they specialize in ADD.

You can use the Google Search Box below to find an ADD specialist.  After "Adult Attention Deficit Disorder" enter the name of a city near you, and the kind of specialist you are looking for (Psychiatrist, Psychologist, Coach, Therapist, etc).  If you search using the box below, you will exit this site and go to Google.  Add AdultADD.info to your bookmarks/favorites before you do your search if you may want to return here in the future. 

Good luck in finding a competent professional who can be of help to you!

Step 2.  Check out the qualifications of the people on your list, then select one or two who seems best suited to evaluate ADD.

As in any field, some people are smarter, more responsible, more patient-oriented, or more knowledgeable than others.  Get as much information about the specialists on your list as you can.  Ask your doctor if he or she is familiar with any of the people on your list personally, professionally or by reputation.  

Step 3.  Call the offices of the "finalists" on your list and ask a few questions.

If you will be relying on insurance to help pay for the evaluation or treatment, check that visits to the professional you have called will be covered.  If your insurance is through a managed care plan, and you are willing to see only a doctor who is in your plan, the first question to ask is whether the doctor is in your plan's “provider network”.  If he or she is not, try to find out if benefits to pay for a provider who is "out-of-network" are available through your plan. 

Keep in mind that some excellent doctors do not participate in some (or any) managed care plans.  While you may have to pay a deductible and a larger co-payment for an out-of-network provider than you would if you saw someone in your plan, there may not be a good ADD specialist in your plan.

Ask the secretary (or the provider) if the provider specializes in the diagnosis and treatment of adult ADD.  In some smaller communities, you may not be able to find a specialist and may have to see someone with less experience and knowledge, but if you can find a specialist, you will probably be better off.  If the person you are speaking to does specialize in ADD, you might ask some more questions.   For example:

·        How has long the person has been evaluating and treating ADD.  It is preferable to see someone who has evaluated and treated many patients with ADD over a period of years.

·        What portion of their practice is made up of patients with ADD.  The larger the portion, the better.  Many ADD specialists have only 10% to 25% of such patients in their practice.

·        How many times do they see someone in order to decide whether the person has ADD.  No more than two visits are usually required.  However, many other disorder such as hyperthyroidism, anxiety, sleep apnea, or hypomania, may mimic ADD, and in more complicated cases, medical or other tests may be needed.

·        Will you have to take special tests to make the diagnosis. The diagnosis of ADD is most often made solely by taking a history.  If information can be obtained from the patient's family or a friend or co-worker, it helps a great deal since people with ADD are often unaware of the full extent of their symptoms. The situation is similar to that of a person who is hard of hearing who may not fully appreciate how severe his hearing disorder is, while those around him can judge it more accurately.

Psychological tests, neuropsychological tests, or computerized tests rarely need to make the diagnosis of ADD.  They should be done only if there are specific questions that need to be answered.  Some psychological tests, like the subtests of the IQ test or certain neuropsychological tests, may be useful for answering questions like whether there are learning problems present, what kind of memory problems the patient is having, how severe they are, etc.

Continuous performance tests use computers to measure certain psychological capabilities. It is unlikely that they will be of great value in making the diagnosis. However, repeated over time, they may be helpful in measuring the effectiveness of the treatment.

·        How much will it cost to do the evaluation?  This will depend on a number of factors: if you are seen within a managed care network, you will usually have to pay only a small co-payment (from $5 to $25).  If seen outside a network, your fee for the evaluation may run from $100 to $500 or more depending on where you live, who you see, how long the evaluation takes, etc.  Psychological testing, which may cost up to $2,000 or even more, is usually not necessary for making the diagnosis or shaping the treatment plan. However, testing may be helpful if there are serious questions about the diagnosis or if there are learning problems in addition to the ADD.

·        Will the person who is doing the diagnostic interview will also carry out treatment for ADD if it is indicated.  It will probably save you time and money to have your evaluation done by someone who can carry out your treatment, if it is indicated.

·        What is the provider’s general approach to treating adults with ADD.  Research strongly suggests that the most effective treatment for ADD is psychostimulant medication.  In the largest study done to date, involving hundreds of children with ADD, medication accounted for 90% of the improvement that occurred with treatment, while extensive behavior therapy, counseling, and coaching together accounted for only 10% of the improvement.  So medication should always be seriously considered as a component of the treatment of ADD.

Still, there may be good reasons not to take medication.  It is not helpful to everyone; it may be contraindicated because of some medical problem;  there are some risks to taking any medication.  Nevertheless, it is generally useful to see a specialist who is familiar with the effects of medications and who can either prescribe them him or herself or has a medical colleague with whom he can collaborate if you need medication.

Some professionals are specialists in psychotherapy, which can help a person deal with some of the interpersonal problems that are often caused by ADD.    It can also be useful in dealing with depression or anxiety or other psychological problems that may be present.  It can also help people and their families adapt better to the limitations that ADD imposes on them.  However, psychotherapy alone is only rarely an effective treatment for ADD.

Step 4.  After you have learned what you can about the providers you are considering seeing, select the one about whom you feel the most confident and comfortable and make an appointment. 

·        Write down the appointment date and time.

·        Write down the provider’s address and phone number.

·        Write down directions to the office.  (If possible drive by the office building before the day of your appointment to make sure you know the way there.)

·        Write down the fee and the payment method.

·        Write down how long the visit should be expected to take.

·        If someone who knows your symptoms well can accompany you to the appointment, ask the professional whether it would be helpful if that person came with you to provide some observations about you.

Step 5.  Get to the appointment at least ten minutes early.  

It will save you time and possibly money (by reducing the number of visits required) if you do a little homework before your appointment.  Write down the following information:

·        A list of all medications you are taking, including the doses and reasons for taking each.

·        A list of all medications you have ever taken for ADD or other psychological problems. Include the dates taken, doses, effects, and side effects.

·        A list of all doctors you have seen for evaluation and treatment of ADD or other psychological problems, with their addresses and phone numbers if possible.

·        A description written by someone who knows you well of the symptoms of possible ADD you are having.  Sometimes ADD may prevent you from seeing your problem clearly.  A description of your symptoms written by a family member or co-worker can often help the specialist understand the nature of your problem more readily.

Step 6.  At the end of the diagnostic sessions, if the professional suggests that you need treatment and that he or she can carry out that treatment, think about how you feel about the person.  If you are not comfortable, trust your feelings.  It may be difficult, more costly, and time consuming, but in certain circumstance, you may want to get a second opinion. 

Step 7.  But if you are comfortable, make sure the treatment will be what you expect. The biggest source of dissatisfaction with treatment is conflicting expectations of the patient and the provider. So get the following information:

·        The overall plan for your treatment.  What should you expect of the provider during the sessions and what will the provider expect of you.

·        The frequency of the sessions.

·        The length of each session.

·        The fee for the sessions and how you will be billed and pay for it.

·        The provider’s policy regarding charges for missed or canceled appointments.

·        When you might expect to see improvement.

If you follow these steps, you will be most likely to get the proper diagnosis and treatment for your ADD.  And that could make an enormous difference in your life.