The landscape of ADHD diagnosis in adults is evolving, with a growing emphasis on careful assessment, objective confirmation, and collaborative care. At Foresight, we recently held a Continuing Education Program panel discussion to explore trends, diagnostic approaches, and the crucial role of communication between therapists and psychiatry providers in diagnosing and treating adults with ADHD.
The Rise of Overdiagnosis and Its Impacts
An emerging trend in the landscape of adult ADHD is increasing concern regarding overdiagnosis. While increased awareness is positive, it can lead to misdiagnosis if not approached with care. The consequences of an inaccurate diagnosis can be substantial, potentially weakening the therapeutic alliance if a diagnosis later changes due to testing, which may cause clients to feel misled or lose trust. Therefore, a careful assessment is paramount before a definitive diagnosis.
Approaching Suspected ADHD in Therapy
At Foresight, we encourage therapists to approach suspected ADHD as a possibility rather than a certainty. This helps support a more thorough diagnostic process that includes psychiatric evaluation and objective testing. It also reduces ambiguity for clients. For example, clients may feel confused or unsettled if a therapist offers an ADHD diagnosis but psychiatry or objective testing indicates something different. To avoid this, our focus is on delivering a transparent and aligned assessment process informed by comprehensive, evidence-based practices.
To optimize clinical outcomes, beneficial skills work can begin regardless of a definitive diagnosis. Using language that empowers clients and positions psychiatry as a partner in care is highly effective. For instance, therapists can say, “If having a definitive diagnosis is important for you, psychiatry can help with that process,” or “Our goal is to make sure we understand what is really going on so you get the most accurate care.”
Discussing Testing with Clients
When ADHD is suspected, we normalize the need for a complete workup and recommend a psychiatry referral when appropriate. This may include objective testing using the IVA-2 CPT (Integrated Visual and Auditory Continuous Performance Test, Version 2). At Foresight, we also emphasize transparency so clients understand every step of the process. Therapists help explain the purpose and process of objective testing. Outside testing can also be submitted for review or an outside psychiatry provider can refer a patient for testing.
Typical wait time for testing is approximately two weeks, allowing clients to move through the diagnostic process efficiently and understand their next steps.
The Role of Objective Testing: Why IVA-2 CPT?
Objective, computer-based data plays a critical role in supplementing psychiatric evaluations. This type of testing assesses attention deficits in a measurable way, supporting diagnostic clarity by determining whether ADHD should be confirmed or excluded. The IVA-2 CPT, specifically, offers superior specificity and comprehensive data by utilizing a simultaneous bimodal presentation of auditory and visual stimuli, enhancing the validity of the results. It provides insights into sustained attention, response control, attentional processing speed, working memory, visual and auditory processing, and the presence of hyperactivity and impulsivity.
Reviewing Results
It’s important for both the care team and the client to understand the potential outcomes of IVA-2 testing, especially if the results differ from what the client expected. Once results are available, psychiatry reviews them with the client first, and the therapist then follows up to support the client’s understanding and incorporate the findings into ongoing care, when appropriate.
A collaborative approach between therapy and psychiatry ensures safe, coordinated, and accurate client care, ultimately strengthening the therapeutic alliance.
If you or someone you love feels that ADHD is impacting the ability to function in daily life, or you are a clinician seeking testing for a client, visit our website to learn more.
