Periodical Title

Journal of Adolescent and Family Health


University of Tennessee at Chattanooga

Place of Publication

Chattanooga (Tenn.)


August 2018


Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects children and adolescents. Treatment guidelines of the American Academy of Pediatrics (AAP) recommend that stimulant medication and/or behavioral modification approaches be used in managing this chronic condition. Unfortunately, research suggests that the current standard of medical care consist largely of stimulant medication used in isolation and that behavioral modification treatments are largely inaccessible to families of children and adolescents with ADHD. This stems from the fact that the primary care clinic typically serves as the first point of contact for patients and families with behavioral health concerns, such as ADHD, and the fact that families face barriers when attempting to access behavioral health specialists (i.e., social workers, counselors, psychologists) such as stigma, transportation/location barriers, and reluctance to seek care outside of the “primary care medical home”. Fortunately, a recent systematic review (Shahidullah, Carlson, Haggerty, & Lancaster, 2018) identified models which integrate behavioral health providers into the primary care clinic to provide care in a way that side-steps many of the access barriers that families face when seeking out behavioral health care. These models demonstrate promise in increasing access to evidence-based treatments, such as behavioral modification, for ADHD. This is important as there are numerous limitations to the use of stimulant medication such as side/adverse effects, lack of long-term efficacy studies, and family reluctance to use this treatment. This commentary discusses implications for these integrated behavioral health models in providing a solution to the current standard of primary care management of children and adolescents with ADHD.


Adolescent health services; Families -- Health and hygiene


primary care, youth, ADHD, integrated care, collaborative care, pediatrics

Document Type