Counseling Service - Lewis & Clark

Attention-deficit hyperactivity disorder (ADHD) 

Attention deficit hyperactivity disorder is often referred to as ADD or ADHD.   Symptoms can include difficulty concentrating or focusing, being easily distracted, and impulsivity.   The disorder may be experienced either with or without symptoms of hyperactivity. 

Both counseling and medical interventions have been shown to be helpful with Attention Deficit Hyperactivity Disorder (ADHD).   Some students also benefit from receiving academic accommodations for ADHD, such as extended testing time or a reduced-distraction testing environment.  At Lewis & Clark, the Student Accessibility office coordinates requests for academic accommodations for ADHD.  They can also provide students with tips about how to manage their ADHD, study effectively, take tests, and succeed in the academic environment.              

The Counseling Service provides limited assessment and treatment resources, as well as referrals to community providers. Counseling staff can meet with students, assess their needs, and discuss options for getting help.  Because we have only a limited number of psychiatry appointments each week in the Counseling Service, we are not able to meet the needs of all students who might want to be assessed and treated with medication for potential ADHD.   At the outset of each semester, we set aside a certain number of appointments to evaluate students for ADHD.  When those appointments are full, we refer students who need ADHD assessment to off-campus providers.  

For medication treatment to be effective, the diagnosis of ADHD must be accurate.  In order for us to begin medication treatment for ADHD, we require a thorough assessment that includes information from different sources.  This process is consistent with professional standards for ADHD evaluation.  It generally takes several weeks, at a minimum. The assessment process is as follows:           

Step One:  Initial Assessment Appointment.  All students seeking evaluation or treatment for ADHD will be required to speak with a counseling staff member for an initial assessment (usually lasts about 45 minutes) to determine whether a referral into one of our ADHD treatment slots is in order, or whether a referral to an off-campus evaluator or treatment provider would be more appropriate. 

Step Two:  Review of previous assessment or treatment records.   Review is required for students who have been assessed or treated for ADHD in the past and who want to use records of that assessment or treatment as a basis for medication treatment in the Counseling Service.  Students who have been treated for ADHD in the past should have records of their treatment (including results of psychological or psycho-educational testing, if available) sent to the Counseling Service (Attention:  Dr. Kara Powers).  Our psychiatrist, Dr. Powers, will review the records and determine what, if any, additional assessment might be needed.   Depending on the documentation she reviews, she may require any or all of the assessment measures below in order to confirm the ADHD diagnosis.  An appointment with Dr. Powers will not be scheduled until she has received and reviewed these records. 

Step Three:  Excepting some students who have strong ADHD documentation from a previous provider and who thus do not need further assessment (see Step Two above), all students who wish to be evaluated for potential ADHD must come to the Counseling Service and:

  1. Complete symptom and mental health questionnaires.
  2. Sign release of information forms to allow for Counseling staff to access relevant academic records (e.g., grades from high school and college) and standardized testing results (e.g., SAT/ACT, GRE, and LSAT scores).
  3. Sign release of information form to allow 1) a symptom questionnaire to be sent to a parent or guardian who took care of the student during childhood; and 2) a brief interview with the parent or guardian.  Counseling Service staff will mail these instruments to the parent/guardian, requesting that the instruments be mailed back.  A cover letter will ask the parent/guardian to contact our office and schedule a phone meeting with our psychiatrist.  This meeting will be scheduled after the student’s clinical assessment—see Step Four below.  Note:  Sometimes it may not be possible or advisable for a parent or guardian to participate in the assessment. If this is true in your case, please advise our secretary who will consult with Dr. Powers about assessment alternatives.
  4. The student will be scheduled for a 45-minute psychiatric evaluation with our psychiatrist.   This appointment will typically occur two or more weeks from when the student completes the above questionnaires, to allow time for the parent/guardian questionnaire to be returned.  It is the student’s job to be sure that the parent/guardian has completed the questionnaire and has returned it to the Counseling Service before the date of the psychiatric evaluation. 

Step Four:  Our psychiatrist will meet with the student for psychiatric evaluation.  If Dr. Powers determines that psychological testing is indicated, she will provide information about off-campus referral options. 

Step Five: Our psychiatrist conducts the interview with the parent/guardian.

Step Six:  Once Dr. Powers has spoken with the parent/guardian and has reviewed all necessary assessment data, she will meet with the student for a follow-up appointment (typically 20 minutes).  She will discuss the findings of the evaluation with the student, and will make treatment recommendations, which may include medication.