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ADHD Treatment and Counseling Requirement
Attention Deficit Hyperactivity Disorder (ADHD) is a psychiatric diagnosis based on criteria defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This diagnosis is a neurodevelopmental disorder that affects one’s abilities in attention and hyperactivity/impulsiveness. Throughout this document, this disorder will be referred to as ADHD although other terms used for the disorder include “Attention Deficit Disorder” or “Attention Deficit Disorder without Hyperactivity.”
In order to be eligible for stimulation medication (i.e., Adderall, Vyvanse, Concerta, Ritalin, Dexedrine, Metadate, or generic varieties) at UMB Student Counseling Center (SCC), students must provide documentation of a psychological evaluation for ADHD. This evaluation must meet the criteria outlined in the ADHD Documentation Guidelines document.
Students who receive medication management services from SCC must participate in counseling, either with an SCC counselor or outside counselor. If you receive counseling from an outside therapist, your SCC psychiatrist will need you to complete a release of information for your psychiatrist to communicate with your therapist.
Access to Psychiatric Services
The UM Student Counseling Center provides psychiatric and medication evaluations as well as medication management. If you are seeking these services, you must first schedule an intake evaluation with a counselor. You are required to first meet with a counselor for a complete evaluation before making an appointment with a psychiatrist. Your counselor determines the level of care that best fits your needs. If your counselor determines that the Counseling Center is an appropriate setting for your treatment, you would be eligible for psychiatric services. Routine medication evaluations may require an additional 1-3 weeks to meet with a psychiatrist after the initial intake evaluation with the counselor.
If your counselor determines that your needs exceed the Counseling Center's scope of services, she/he will refer you to an outside provider. You will be expected to make and keep an appointment with an outside provider within a reasonable period of time, and your counselor will assist you with the process.
If you receive medication services from the Counseling Center, there is no limit to the number of medication evaluation and management sessions and they are not counted against the 12 session/year limit of counseling sessions.
Medication Management Limitations Related to Telemental Health: Telemental health refers to the provision of mental health services from a distance using live interactive video teleconferencing. Clinicians utilizing telemental health to provide therapy must comply with the relevant licensing laws in the jurisdiction where the provider is physically located when providing care and where the patient is located when receiving care. In the United States the jurisdictional licensure requirement is tied to where the patient is physically located when he or she is receiving care, notwhere the patient lives (Turvey et al., 2013) or used to live. Thus if a student is receiving teletherapy the therapist must be licensed in the state where they are located and in Maryland (where the student is located). If the therapist does not comply with these requirements we do not acknowledge these services as meeting criteria for outside counseling. In these cases the student must find another local therapist (Turvey, C., Coleman, M., Dennison, O., Drude, K., Goldenson, M., Hirsch, P., ... & Malik, T. S. (2013). ATA practice guidelines for video-based online mental health services. Telemedicine and e-Health, 19(9), 722-730).
After you have been seen for your initial psychiatric evaluation, please schedule your next medication follow up appointment before leaving the office. If you don't, you may have to wait longer to be seen than advised by your psychiatrist. Your prescription will last only until your next visit with the psychiatrist.
If you no-show or late-cancel a medication follow up session, you may run out of medications before the next available appointment. If you miss your appointment, reschedule immediately. Most psychiatrists are in the Counseling Center only one day a week. If you call for assistance on a day your psychiatrist is not in the office, he/she will not be able to provide you with services that day. Depending on the situation, it is possible that a consulting psychiatrist might be able to assist.
Your treating doctor puts together a treatment plan that includes frequency of visits and will ask you to make an appointment to see her/him within a certain amount of time (always three months or less). You will usually receive a reminder call the day before your appointment. However it is your responsibility to make and keep your appointments, whether or not you receive a reminder call.
Frequent late cancellations or no-shows negatively impact your treatment and may lead to discontinuation of services and a referral to an outside provider.
Running Out of Medication
It is your responsibility to monitor any supply of medication prescribed for you. You must meet with your psychiatrist at least one week in advance of using your last dose of medication. Keep close track of your medications so that you do not run out.
If the covering psychiatrist provides you with a prescription, he/she may give you only enough medication to last until your next appointment with your psychiatrist. Your health insurance may or may not cover more than one prescription during the same month. You may have to cover the difference out of pocket. Some medications cannot be called in for a refill. The wisest practice is to make and keep appointments as directed.
Refills for medication prescriptions that you have not kept track of out are not considered to be emergencies. It is your responsibility to plan in advance to make sure that your medication supplies are adequately taken care of.
Requests to Change Psychiatrists
If you wish to transfer your care to another psychiatrist, you are required to first speak with your current psychiatrist to discuss the reasons for your request. If your psychiatrist is not in the office when you call, please leave a message for her/him to return your call. If you cannot wait to speak to your psychiatrist, you must speak with your primary counselor, if you are receiving counseling services at SCC. If your counselor is unavailable, you must speak with the Director. Depending on the situation, you may or may not be permitted to transfer to another psychiatrist.
Limitations to Psychiatric Services
Students who receive medication management services from SCC must participate in counseling, either with an SCC counselor or outside counselor. If you receive counseling from an outside therapist, your SCC psychiatrist will need you to complete a release of information for your psychiatrist to communicate with your therapist. Additionally, you will be required to check-in with a SCC case manager, at minimum twice per academic year, to ensure all paperwork is up to date and to review your treatment plan. We will also ask that you confirm your ongoing attendance and participation in counseling using the Provider Coordination of Treatment form.
If your psychiatrist prescribes you medication and you do not take it (or do not take it as prescribed), or if you do not receive concurrent counseling when your psychiatrist requires it, your medication management services will be discontinued and you would be provided with referrals to an outside psychiatrist.
Returning after Discontinuing Services
If you have not met with your psychiatrist for a period of 6 months or more, you may be required to schedule another full intake appointment with your primary counselor and or psychiatrist. It may take 3-6 weeks before your psychiatrist is able to meet with you.
Use of Alcohol and Recreational Drugs
Use of alcohol or recreational drugs interferes with the action of the medication that your psychiatrist prescribes. In addition, with certain medications, the effects of any amount of alcohol or recreational drugs use can be dangerous. If you are prescribed medication, you will be expected to refrain from use of these substances. Also, please let us know if you are taking any new medications. Sometimes there are interactions.
Abruptly Stopping Medication
Abruptly stopping most medication results in unpleasant physical sensations, such as nausea, dizziness, flulike symptoms, as well as edginess and possibly depression. It will be far easier on you if you come in and discuss a way to taper your meds with your doctor.