Interventions That Improve the Workplace

¶ … Interventions That Improve the Workplace Behavior of Adults With ADHD Introductory Chapter

Examination Of Interventions That Improve The Workplace Behavior Of Adults With ADHD

The purpose of the research in this study is to examine interventions that improve the workplace behavior of adults with Attention Deficit Hyperactive Disorder (ADHD).

Attention deficit hyperactivity disorder (ADHD) is reported in the work of Adler, Spencer, Stein, and Newcorn (2008) to be generally viewed as a disorder that is of a pediatric nature with symptoms disappearing in adulthood. It is specifically reported that the percentage of adults in the U.S. with ADHD is approximately (~4%) but those who do have ADHD are not aware of this and the result is that studies involving self-reporting of adults with ADHD are ill-informed due to lack of participation of these individuals in research studies.

There is reported as well to be "a high prevalence of mood and other co-morbid disorders in adults with ADHD [which] can also complicate diagnosis and treatment." (Adler, Spencer, Stein, and Newcorn, 2008, p. 7) Arising from what are symptoms characterized by "restlessness" in the adult with ADHD are complications in the work environment which demands not only "talent and drive" but needing as well the ability to focus and attention to detail combined with organizational skills and speed. (Adler, Spencer, Stein, and Newcorn, 2008, paraphrased)

There are reported to be five criteria for adult ADHD in the DSM-IV states that there must be the "presence of six out of nine inattentive symptoms and/or hyperactive/impulsive symptoms over the past 6 months. Patients with six of nine inattentive symptoms have the inattentive subtype of ADHD. Patients with six of nine of the hyperactive/impulsive symptoms have the hyperactive/impulsive subtype of ADHD. This is the inattentive subtype of ADHD. Patients with six of nine of both symptom types have the combined subtype." (Adler, Spencer, Stein and Newcorn, 2008, p. 8) (2) Age of Onset: Patients must have onset of at least some symptoms before 7 years of age. (3) Some impairment from the symptoms must be present in two or more settings, such as the work, school or in social settings. (Adler, Spencer, Stein and Newcorn, 2008, p. 8) (4) It is reported that the impairment "…must be significant and fall in the realm of social, academic, or occupational deficit." (Adler, Spencer, Stein and Newcorn, 2008, p. 8) (5) It is stated as well that the symptoms "…should not be better accounted for by another mental health disorder. If the symptoms of ADHD only appear during the active phase of another mental health disorder, they should be coded for that disorder and not ADHD." (Adler, Spencer, Stein and Newcorn, 2008, p. 8)

ADHD symptoms are inclusive of the following stated symptoms: (1) easily distracted; (2) always late; (3) always forgetting; and (4) in general highly disorganized. It is clear that all of these characteristics would be problematic in the work environment. However, there is good news in that there are methods that can be used to mitigate these difficulties in the work place such as those related in the work of Nancy Rate, EdM, and ADHD coach and author.

The methods of coping with the skills lacking in adults with ADHD are related to be in the area of organizational changes in the specter of the adult with ADHD as they navigate the daily tasks of life. People with ADHD have problems in the work environment related to the following: (1) management of time; (2) paying attention and listening closely; (3) ability to follow directions; (4) ability to attend to details; (5) arriving at work on time; (6) speaking in turn and letting others speak; (7) remaining still; (8) emotional control; and (9) managing anger. Therefore, if these difficulties are to be mitigated in practice the study must be informed of what specific strategies work best in adults with ADHD.

While this sounds easy in theory, in reality with so few adults with ADHD actually identified with ADHD and yet it being the most common co-morbid disorder among the population the study of this population is within itself problematic. There are estimated to be approximately 10 to12 million adult individuals in America with ADHD, which is reported to translate to approximately $77 billion in income losses each year. Adults with ADHD are lower wage earners than their peers who do not have ADHD.

Purpose and Significance of the Research

This study examines the use of mitigation strategies for assisting adults with ADHD perform better in the work environment. The express purpose of the research in this study is to identify the best practice mitigation strategies that adults with ADHD can use to mitigate work environment related problems with such as being late quite frequently, problems with focus and organization, as well as other problems that are behaviorally related such as anger management. The significance assigned to the research in this study is that related to the benefits that adults with ADHD and the practice community would certainly derive from the information disseminated in this research initiative. As well, this study intends the best practice methods of identifying adults with ADHD among the yet large unidentified populations of adults in America.

Methodology

The methodology in the present study is qualitative in nature. Qualitative research is objective and interpretive in nature and the findings will be presented in a descriptive format although there will also be quantitative findings presented as well. The study will be comprised of an extensive and exhaustive review of literature in this area of inquiry including professional and academic peer-reviewed material such as is located in journal articles, professional magazines and in online journals and libraries.

Overview

The work of Robinson (2009) published in the Professional Counseling Digest reports that the there is a "dramatic…potential negative impact on worker productivity, retention, and satisfaction" due to ADHD among adults. (p. 1) Drug therapy for ADHD among adults is little researched however, it is stated to be found "evident that when providing counseling interventions for adults with ADHD" that vocational counseling is important as is personal counseling for these adults attempting to thrive in today's highly competitive work environment. (Robinson, 2009, p. 1) In addition, intervention strategies are reported in the literature and specifically in the work of Clay (2013) entitled "Easing ADHD Without Meds" published in the American Psychological Association Monitor on Psychology February 2013 Issue 44, No. 2 which states that interventions exist other than medications and that these interventions are promising. This particular study while focused on children and adults reveals that oftentimes while the child with ADHD appears "hyperaroused" that these children, both with and without ADHD demonstrate hyperactivity when they are actually fatigued. Ramsay (2010) reports on psychosocial interventions for individuals with ADHD and cites these interventions to be inclusive of: (1) psychoeducation; (2) cognitive behavioral therapy; (3) educational accommodations; (4) treatments for relationship difficulties; and (5) financial management. (2010)

Psychosocial treatments specifically for adults with ADHD are stated to include: (1) ongoing strategies for difficulties in coping; (2) medical profile including listing of adverse effects of medication use due to cardiac or other medical issues; (3) refusal of patient to take medication when adequate information is presented to patient that should address these concerns. (Ramsay, 2010, paraphrased)