How To Treat ADHD The Non-Pharmaceutical Approach By John Stevenson
At Disability Credit Canada we make it one of our missions to advocate for our community by providing them resources. We have tools, like our Disability Tax Credit Calculator, and our Ultimate Disability Tax Credit Guide, to help guide people through the application process free of charge.
But we don’t stop there.
We also reach out to mental health advocates across Canada, and when we are able, we like to feature them, and the organization of their services on our blog. Today is one such day, and we are pleased to meet and interview John Stevenson of Zone Performance. John’s company works with many types of neurodiversity but has a specific focus on ADHD. We won’t spoil it for you- we will let John take it away!
1) Tell us a bit about yourself and your journey with ADD/ADHD?
My name is John Stevenson and I am a Health and Performance Psychologist at Zone Performance Psychology based out of Edmonton, Alberta, Canada. I currently work with a variety of elite performers in a variety of fields from surgeons, military personnel, law enforcement, financial traders, and Olympic and Professional Athletes. Consequently, I am always looking for the latest evidence-based strategies and tools that can help these clients develop and improve their brain performance (e.g., executive functioning, cognitive stamina, situational awareness, attention, working memory, visual information processing, etc.)
When I was the goaltending coach for the Ottawa Senators Hockey Club back in 2009 I was introduced to a Doctoral student at the University of Ottawa who was using Neurofeedback and Biofeedback to train Olympic athletes to better self-regulate themselves for the upcoming Vancouver 2010 Olympic Games. Margaret Dupree had advised me if I wanted to learn about Neurofeedback and how it could radically improve an athlete’s ability to focus and self-regulate their emotions I should check out the training offered by Dr. Michael and Dr; Linda Thompson at the ADD Centre in Toronto. It was at that point that I learned how a natural non-pharmaceutical approach like Neurofeedback could be used in so many applications to improve mental health such as anxiety, depression, concussions, and ADHD. As a result of this training, I went back to Edmonton and started a comprehensive assessment and treatment program that utilized Neurofeedback and Biofeedback to enhance the well-being of both my clinical and peak-performance clients.
2) Tell us about Zone Performance. What is its unique angle on ADD/ADHD Treatment?
Zone Performance takes a unique angle on its approach to ADHD not only in our treatment process as we are a non-pharmaceutical approach to treating ADHD but in our assessment process as well. Our assessment process is an in-depth process that combines subjective measures alone with objective measures in a holistic manner to gain an understanding of how someone is feeling, what symptoms they are experiencing, and why. Most people don’t realize that there are different types and presentations of ADHD, and our assessment process tells us which presentation an individual is experiencing and to what degree, which helps us create the best treatment option tailored to that individual. We utilize a lot of cutting-edge technology such as the Neurotracker, Senaptec, and Reflexion in our assessment and treatment regime. These types of Cognitive-Perceptual training systems in the past were only accessible to professional athletes and organizations.
The fact that we can bring this technology to the general public, particularly our young clients has been extremely powerful and fun to watch because they really enjoy this type of brain training. Likewise, many children and adults who have ADHD also have a sleep disorder—almost three out of four children and adolescents, and up to four out of five adults with ADHD. Not getting enough sleep, or needing to sleep at times that don’t mesh with school or work obligations, can have significant long-term effects. Once again we provide natural non-pharmaceutical methods that have been scientifically proven to provide our clients with a deep restorative sleep, which in turn, allows them to focus and better manage their emotions the following day.
Finally, I believe that Zone Performance brings a different treatment approach because we also address a number of significant Lifestyle factors that often are not addressed by the medical community at the time of the assessment and duration of the treatment such as screen time and the use of electronics on a daily basis, exercise, and their diet that have a significant impact on the client’s overall brain-functioning level.
At Zone Performance, we believe it’s not enough to provide an accurate diagnosis of ADHD by only using questionnaires and a clinical interview in the assessment process. We strongly encourage those who suspect that they may have ADHD to utilize a clinic that can provide objective measurements of a client’s Cognitive capacities and overall brain functioning. This is the reason why we use Continuous Performance Tests to assess and continually monitor our client’s progress as they go through our treatment program. For example, the IVA and TOVA, the two standardized computerized tests we administer, not only tell us what degree of ADHD we are dealing with, but what kind as well; the more inattentive presentation, the hyperactive presentation, or the combined presentation. These are the most widely used computerized tests for such factors as attention span, impulsivity, and variability of response time, which are among the key factors in Attention Deficit Disorder but are also factors in a number of other problems including learning difficulties, Tourette’s, anxiety problems, Asperger’s, dysphoria and even athletic performance. These tests involve pressing a button when a target appears on the screen and inhibiting that response when a non-target appears. Likewise, the QEEG Brain Map allows us to see and identify where and what type of brainwave dysregulation is occurring in the brain and how this is impacting brain functioning and is contributing to someone’s symptoms and how they are feeling.
Finally, Cognitive-Perceptual Systems such as the Neurotracker and Senaptec not only provide objective measurements of working memory, sustained attention, brain processing speed, executive functioning, sensory integration, etc but numerous training exercises to systematically improve these skill sets.
Having multiple facets to our assessment process allows us to have a greater understanding of the factors that are contributing to someone’s symptoms and what approach would best suit them and their goals moving forward.
3) What are some of the things Zone specializes in?
Zone Performance not only specializes in ADHD but also offers comprehensive programs in Sports Psychology, Concussion Assessment and Rehabilitation, and Cognitive-Perceptual Training. Zone also offers counseling services.
4) How, and in what ways, do Zone’s treatments help those with ADD/ADHD?
Many people have heard the expression: “neurons that fire together, wire together”. Our primary ADHD treatment is an extension of that well-known phrase. Zone’s primary treatment provided for ADHD is called Neurofeedback. This is a non-invasive method of retraining the brain to correct patterns of brainwave dysregulation, thereby reducing troublesome symptoms and improving cognitive functioning. This is accomplished by rewarding the brain when it produces the patterns of brainwaves we would like to increase. Over time, this learning consolidates into neurological changes and subjective improvement. We also utilize Audio-Visual entertainment. It involves the repetitive presentation of rapidly blinking wavelengths of light that guide the brain into desired mental states. This alters electroencephalographic (EEG) activity since it involves promoting or suppressing brainwaves at certain frequencies (Joyce & Siever, 2000). When you are using AVE your EEG activity is being altered – As the AVE frequency changes, so does the frequency of brainwaves. You are being dissociated – When using AVE, you get drawn into the present moment and let go of thoughts relating to your daily hassles, hectic schedules, paying bills, worries, or anxieties and stop the unhealthy mental “chatter.” Dissociation involves a “disconnection” of self from thoughts and body awareness, as is experienced during deep meditation. Dissociation begins in four to eight minutes from properly applied AVE. Your limbic system is being stabilized – Your body is calmed, your breathing becomes rhythmic, your hands warm and your muscles relax. A number of neurotransmitters are being produced – People with depressed mood have low levels of serotonin and norepinephrine. AVE may be used to boost brain levels of serotonin, endorphins, melatonin, and norepinephrine to improve overall well-being. Increasing endorphins allows enhanced relaxation and calm while boosting norepinephrine and suppressing melatonin promotes improved alertness (Shealy, 1989). Your cerebral blood flow is being increased- Good levels of cerebral blood flow are crucial for proper mental health and cognitive functioning. Several mental health disorders are associated with inadequate cerebral blood flow, including anxiety, depression, attentional disorders, and many others. AVE has been shown to substantially and rapidly increase cerebral blood flow (Fox & Raichle, 1985).
We also use Cognitive-Perceptual training as a treatment program. Cognitive perceptual training may be the help you need to overcome neurological trauma.
Individuals who have neurological deficits or trauma, whether mild or severe, may experience cognitive and perceptual difficulties. Cognitive perception includes, aside from the senses listening, seeing, smelling, tasting, and feeling, the way in which we deal with information. While perception refers to ways of obtaining information from our environment, cognition describes processes such as remembering, learning, solving problems, and orientation. Researchers have found that 75-90% of children with learning disabilities present with motor difficulties, which often are accompanied by perceptual deficits.
Cognitive and perceptual rehabilitation is indicated when a patient or client presents with deficits in these areas during medical, physical therapy, or occupational assessments. Difficulties may appear in fine and visual-motor performance, motor planning abilities, and/or sensory integration. The individual may remember events incorrectly and have difficulty perceiving new information. In addition, he or she may have inappropriate responses to sensory input due to deficits in sensory processing.
Zone Psychology has partnered up with Neurotracker, Senaptec, Fitlight, and Vizual Edge to provide a variety of cutting-edge technologies that not only the eyes but the brain as well. The biggest discovery in the history of neuroscience is neuroplasticity; the brain’s innate ability to adapt to environmental demands through functional reorganization, increasing pathway efficiency, and growing new neural networks. In terms of cognitive demands, neuroplasticity is a major factor in any individual’s potential. In principle, the process is similar to how muscles improve to meet performance demands when put under physical stress. However, in the case of the brain, improvements can occur more sustainably, on much shorter time scales, and with much longer-lasting effects.
Finally, our counselors teach Mindfulness so that our ADHD clients effectively learn how to self-regulate themselves on a daily basis to observe and manage their thoughts, feelings, and actions, which in turn allows them to be more present and improve their self-awareness and their ability to focus.
5) Knowing that research suggests multi-nodal treatment, which can include medication, what are the benefits to non-medical therapies?
While Zone’s platform is providing a non-pharmaceutical approach to treating ADHD, this does not mean that we are against pharmaceutical treatments. We believe that there is a time and a place for medication, however, we do believe that ADHD medications have the propensity to be overused.
There are many downsides to medication that some people are not aware of. For example, in some individuals, ADHD medication can help with improved focus but also increase anxiety and paranoia due to beta wave dysregulations. Some people also experience adverse effects from medication such as suppressed appetite, slow growth in children, and induced sleep issues. Finally, medications solve an issue rather than addressing the cause. Medications work for the time that they are administered, however, when one stops taking the medication they may be back to the beginning in regards to their symptoms and focus issues.
Neurofeedback and Cognitive-Perceptual training address the root causes of ADHD by addressing brain wave dysregulation and attempting to re-train pathways in a natural, non-pharmaceutical way to see symptom resolution and overall improvement. Barring any physical or emotional trauma, the improvements seen after these types of therapies are permanent. Aside from feeling possible slight fatigue after a neurofeedback session, there are no significant adverse effects felt from this form of therapy. One of the biggest benefits of Mindfulness, Neurofeedback, and Cognitive-Perceptual training is the fact that clients learn how to self-regulate their brain without being dependent on a substance for the rest of their lives.
6) What types of problems do people with ADD/ADHD experience? What do they come to you for help with?
People with ADHD often experience difficulty maintaining focus, and sustained attention, and can have short-term memory and working memory difficulties; however, due to the fact that there are different presentations of ADHD, some individuals may experience different symptoms. Some individuals struggle more with auditory processing, whereas others struggle more with visual processing.
Focus, memory, and attention are the main areas people would like to see improvement in when they come in with ADHD. These symptoms can impact school performance as well, so many individuals also wish to see improvement in grades and overall academic performance.
Aside from the Cognitive concerns (e.g., focus, working memory, executive processing, etc.) we also have a lot of clients who really struggle with the ability to self-regulate their emotions. Comorbid issues such as anxiety, depression, ODD, and learning disorders often occur when someone has ADHD, and often our clients are looking for assistance in terms of addressing and managing these issues without the use of medication.
7) What advice would you give to someone who is struggling with or has a loved one struggling with ADHD?
Our main piece of advice would be to remind that person that ADHD is something that you have, not something you are. ADHD is not your identity and it does not mean that you will never be successful. There are many professional athletes, business moguls, doctors, scientists, and psychologists with ADHD. Don’t let a diagnosis become your identity and make you lose faith in your own potential.
8) What are the benefits of early intervention and treatment?
The primary benefit is Self-Esteem and Confidence. It’s often the case that once our clients learn how to self-regulate their attention and emotions and improve their overall brain functioning they feel much more optimistic about all facets of their life. The other big factor when it comes to early intervention and treatment it the brain is more malleable at younger ages. Consequently, the neuroplasticity of the brain and the rewiring that takes place is generally speaking much easier to do when the client is younger in age. Finally, the research clearly shows that Untreated ADHD can cause problems throughout life. People with ADHD tend to be impulsive and have short attention spans, which can make it harder to succeed in school, at work, in relationships, and in other aspects of life. Adults who have ADHD but do not know it are at much higher risk than the general population for serious problems. Mood disorders, extreme sadness, and anxiety often occur when ADHD goes undiagnosed. Even if these conditions are treated, the underlying problem, if left untreated, leads to other problems. To prevent this from happening, refer to our ADHD Test & Self Assessment, and maximize the chances to diagnose it as early as possible.
9) Is Zone Expensive? What options do you have for those who may want the treatment but can’t afford it?
Initially, it may appear that our assessment and treatment program is expensive. However, the upfront costs of our program are significantly lower than the long-term costs of taking medication for a lifetime. Likewise, compared to other clinics across North America that provide similar services to us our pricing is significantly lower than the competitive market. Unfortunately, our High-tech equipment and standardized tests are very expensive to purchase and there is a significant cost to us each time we run these programs, so we need to offset those business costs in our pricing. We are a private clinic and we do not receive any funding from the government at the Provincial and/or Federal level. A full ADHD Assessment at Zone is $800.00 which includes a follow-up appointment. Psychoeducational assessments can cost as much as $1200-$2000, so comparatively, we are not as expensive.
We do offer different payment plans to help with the cost of Neurofeedback and Cognitive -Perceptual treatment and we do direct billing with the insurance providers who will let us directly bill on the client’s behalf. We also provide receipts and invoices for those who are with providers who do not let us directly bill on the client’s behalf. Further, we do provide a subsidized student rate when completely necessary for students who really want treatment but are struggling financially.
Our Gratitude
We’d like to thank John for taking the time to share some insights about ADHD and some of the varied and alternative treatments that can be offered to those looking to understand and treat their condition.
Private institutions like Zone Performance are not often covered by Government Health Care, however, that’s where things like the Federal Disability Tax Credit and the Child Disability Tax Credit come in handy. If you or someone you love is struggling with ADHD, they may qualify for the Disability Tax Credit, which is designed to assist Disabled Canadians and their families offset the cost of seeking additional treatment.
Disability Credit Canada has helped thousands of Canadians advocate for the Tax Credits they are eligible for. With over a 95% approval rating, we have a no-win, no-fee guarantee. Call us today for a FREE Assessment for your case.