Effectiveness of the Cognitive–Functional Intervention for Adults (Cog–Fun A) in Assessing ADHD: A Retrospective Case Series

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.