Cognitive-behavioral therapies for hyperactive children: premises, problems, and prospects.

The impetus for the widespread use of CBT for children with attention deficit disorder (hyperactivity) is examined, followed by an evaluation of various facets of treatment efficacy. The many "unknowns" concerning treatment ingredients, targets of change, domain specificity, individual differences, palatability, and treatment-emergent side effects are then reviewed. The final section focuses on future directions, specifying some reasons for optimism despite the disappointing outcomes to date. Nontraditional uses of CBT are also proposed, including the implementation of cognitive strategies to counteract undesirable emanative effects of extant treatments and to facilitate drug discontinuance in children taking psychoactive medication.