Mindfulness practice to improve treatment outcomes for individuals with Attention-Deficit Hyperactivity Disorder (ADHD): a quality improvement project in an intensive outpatient treatment program

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. While medications are a primary treatment, mindfulness-based interventions have shown effectiveness in improving attention, executive function, and emotional regulation. Despite its integration into cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), structured mindfulness implementation in outpatient programs remains inconsistent. An assessment of an intensive outpatient mental health program in the Pacific Northwest found that only 5-10 minutes of each four-hour therapy session was dedicated to mindfulness. This limited exposure may reduce the effectiveness of CBT and DBT, particularly for individuals with ADHD. Additionally, the program lacked standardized mindfulness education during orientation, potentially impacting patient engagement and treatment outcomes. This quality improvement project introduced a structured mindfulness training program. At orientation, patients received a standardized mindfulness education video, completed pre- and post-assessments on mindfulness awareness, and engaged in biweekly follow-up sessions. Primary outcomes included mindfulness practice outside therapy, changes in mindfulness attitudes, and ADHD patient program completion rates. A UCLA Mindfulness Education Center training video was incorporated at orientation to provide foundational mindfulness instruction. Mindfulness practice was reinforced through structured follow-ups during individual therapy sessions. Data collection focused on patient engagement, self-reported mindfulness use, and program completion rates. All newly enrolled patients (100%) received standardized mindfulness instruction. Mindfulness practice outside therapy increased from 0% to 100%, surpassing the goal of 30%. However, due to the limited data collection period and rolling admissions, the impact on ADHD patient completion rates could not be fully assessed. No significant change in mindfulness attitudes was observed, as the sole participant had prior mindfulness knowledge. Integrating standardized mindfulness education was feasible and well-received, leading program staff to expand mindfulness practice during therapy sessions. Future research should explore larger sample sizes, longer evaluation periods, and targeted ADHD screening to assess the long-term impact of mindfulness on treatment outcomes.