Importance: Adults with attention deficit hyperactivity disorder (ADHD) experience executive function (EF) impairments that affect their daily life and quality of life (QoL). Clinical guidelines recommend combining pharmacological and nonpharmacological treatments. The Cognitive–Functional Intervention for Adults (Cog–Fun A) is a metacognitive, occupation-based intervention that has shown preliminary efficacy, but more practice-based research is needed to evaluate its implementation.
Objective: To examine (1) the effectiveness of the Cog–Fun A on QoL and EF of adults with ADHD and (2) the demographic and clinical predictors of reliable change on QoL postintervention and intervention adherence.
Design: Retrospective case series.
Setting: Community.
Participants: One hundred fifteen adults ages 19–70 yr (39.1% men).
Intervention: Participants received 24 1-hr weekly sessions addressing self-awareness of strengths and ADHD-associated executive deficits through education and analyses of individual occupational experiences, strategy acquisition, and implementation within an occupational goal attainment context.
Outcomes and Measures: The Adult ADHD Quality-of-Life Scale, to assess QoL; and the Behavioral Rating Inventory of Executive Function–Adult Version (BRIEF–A), to assess EF.
Results: Among 107 participants, posttreatment scores showed significant improvements in all QoL domains and EFs. Clinically significant QoL changes occurred in 45% of the participants, with 34% meeting reliable change criteria. No demographic variables predicted these changes. Female gender, frequent pharmacological treatment, and lower baseline BRIEF–A scores predicted intervention completion.
Conclusions and Relevance: Cog–Fun A may offer an effective, metacognitive, occupation-based nonpharmacological treatment of adults with ADHD; however, further research is recommended.
Plain-Language Summary: The Cognitive–Functional Intervention for Adults (Cog–Fun–A) may offer an effective metacognitive occupation-based nonpharmacological intervention for adults with attention deficit hyperactivity disorder (ADHD). Adults with ADHD often struggle with cognitive impairments that impede their ability to manage their life roles. Although treatments such as medications and therapies are available, there is a need for practical interventions that directly address daily life difficulties. This study aimed to examine whether the Cog–Fun–A intervention improves quality of life and cognitive functioning for adults with ADHD. The results showed that 107 of 115 participants completed the intervention and that 45% of the participants demonstrated clinically significant improvement. Women, frequent medication users, and those with better initial cognitive scores were more likely to complete the intervention. The Cog–Fun–A may offer an effective, function-based treatment for adults with ADHD, but more research is required.
