title: Skills training groups for men with ADHD in compulsory care due to substance use disorder: a feasibility study.
abstract: Dialectical behavior therapy (DBT)-based skills training has been developed and previously evaluated for adults with ADHD in a psychiatric outpatient context. The aim of the present study was to evaluate the feasibility of DBT-based skills training as a voluntary intervention for men with ADHD in compulsory care due to severe substance abuse. Forty sufficiently detoxified men with ADHD in compulsory care due to life-threatening substance use disorder (SUD) were included in DBT-based skills training groups. Self- and staff-rating scales were administered before and after the treatment. The refusal rate was 42.9 %. Of those who started the DBT-based skills training, 70 % completed the treatment (attendance at ≥75 % of the sessions). The treatment acceptability was good. Both ADHD and psychiatric symptoms decreased from pre- to post-intervention in self-ratings, but not in staff ratings. The patients reported improved general well-being. The correlation between self- and staff ratings was poor. Motivation for voluntary nonpharmacological treatment was low in a compulsory care context. However, the results indicate that a DBT-based skills training program for adults with ADHD may be feasible for some patients with ADHD in combination with SUD in compulsory care, provided that considerable resources are allocated with adjustments to the target group and compulsory care context.
authors.affiliation: SiS Institution Hornö, Enköping, Sweden.|Department of Women's and Children's Health, CAP Research Center, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22, 11330, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Bihlar Muld
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Jokinen
authors.affiliation: Department of Women's and Children's Health, CAP Research Center, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22, 11330, Stockholm, Sweden.|Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Bölte
authors.affiliation: Department of Women's and Children's Health, CAP Research Center, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22, 11330, Stockholm, Sweden. Tatja.Hirvikoski@ki.se.|Habilitation and Health, Stockholm County Council, Stockholm, Sweden. Tatja.Hirvikoski@ki.se.
authors.forename: T
authors.initials: T
authors.lastname: Hirvikoski
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000628:therapy*; D001521:Behavior Therapy; D017831:Diagnosis, Dual (Psychiatry); D005240:Feasibility Studies; D006801:Humans; D008297:Male; D037141:Mandatory Programs; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011615:Psychotherapy, Group; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: ADHD; Behavior therapy; Compulsory care; Group therapy; Mandatory care; Skills training; Substance use disorder