Facilitating success with ADHD at college
The need to address mental health at college is great and continues to grow. According to a 2018 report based on data from nearly 200 college campuses, the percentage of students seeking mental health treatment between 2007 and 2017 rose from 19 to 34%, and the percentage of those with mental illness diagnoses rose from 22 to 36%. But what treatment options are available for these college students, and specifically for those with ADHD? Dr. Antshel, Professor and Director of Clinical Training Psychology at Syracuse University, explains.
How can college students manage the emotional ups and downs of campus life?
I think when a lot of people in high school think about college, they automatically think about the academic side of things – they don’t spend as much time on the emotional and social challenges that might exist. There is support for this at college and it doesn’t necessarily have to be an (ADHD) expert that can help with this. University counseling centers are well equipped to know the ups and downs of life on campus and how best to manage them.
Teaching mindfulness is thought to help students – there’s an evidence base to suggests it can be effective. Also, using some of the skills from Dialectical Behavioral Therapy (DBT) which includes practice on how to tolerate distress, how to manage emotions in a more productive, adaptive way can be beneficial. We also talk with students about lifestyle interventions. Things like paying more attention to sleep, making sure you are physically active and engaging in physical exercise, and also paying attention to your diet. Having lots of caffeine in your diet, for example, which is, unfortunately, not unusual in college students, not just in those with ADHD, can impact levels of anxiety that can be associated with the condition. I think these lifestyle interventions are equally important, yet they don’t get the attention that they deserve.
Are there treatments and interventions for college students with ADHD?
The good news is that we have effective, evidence-based treatments and interventions for college students with ADHD. The bad news is that a large proportion of these college students aren’t utilizing them.
Numerous studies have demonstrated that Cognitive Behavioral Therapy (CBT) can be efficacious for college students with ADHD. CBT attempts to teach them skills like organization, planning and help them to avoid or reduce procrastination. CBT also focuses on emotion regulation – how to control your emotions such as anxiety, depression and the highs and lows of college life. CBT is often delivered in both a group format and one-to-one sessions, in which they reinforce the skills that were taught in the group. It is perhaps the most widely used, evidence-based therapy.
Another evidence-based treatment is medication, which certainly has benefits but also some constraints which need to be considered. The third evidence-based intervention is coordinating with the campus office and disability services. This will include the testing accommodations such as additional time on tests or a quiet, non-distracting environment, but it will also include tutoring, training on note-taking and how to be effective in study preparations. Students may also get copies of class notes which is also something that the Office of Disability Service coordinates.
What important role do College Counseling Centers play?
College Counseling Centers are well equipped with mental health providers and could also provide an additional source of support during the COVID-19 pandemic. In fact, utilizing College Counseling Centers seem particularly important in the COVID-19 re-entry process, given that heightened stress and anxiety are likely going to be common as students return to campuses. Mental health providers can play an important role to students, with but also without ADHD, by supporting them in maximizing social networks for emotional support, maintaining daily and weekly routines, and avoiding using drugs and alcohol as coping mechanisms.
What advice would you give to college students that may be struggling right now?
I think the most important thing is to reach out for help. As I alluded to, we have a number of interventions, services and accommodations on campus that can be effective. Yet, the majority of college students with ADHD use nothing except for extra time on tests. I would say to reach out for support, to get additional services to help enable you to really reach your potential. By the fact you have gotten yourself to college, you obviously are a bright, capable student. The last thing a college wants is attrition. Colleges are very focused on retention. That is why they offer a number of these services. Just connect with those on campus that can help, which is usually the Office of Disability Services or the Counseling Center – I cannot emphasize that enough.
In addition to the Office of Disability Services, college counseling centers are an additional resource. These counseling centers are well equipped with staff mental health providers and could provide an additional source of support during the COVID-19 pandemic. In fact, utilizing college counseling centers seems particularly important in the COVID-19 re-entry process. Heightened stress and anxiety are likely going to be common as students return to campuses. The mental health provision is likely to occur via telehealth (e.g., Zoom) and thus is associated with low risk of infection. Mental health providers are very likely to recommend maximizing social networks for emotional support, maintaining daily and weekly routines and avoiding using drugs and alcohol as coping mechanisms.
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