Response to Wells and Fisher Letter

To the Editor: When we named our approach “meta-cognitive therapy” we were referring to the fact that our treatment aimed to help adults with ADHD develop a set of overarching or “meta” skills to guide their behavior with respect to time-management, organization, and planning (1, 2). These skills include cognitive and behavioral strategies to foster awareness of and appropriate allocation of time, initiate and sustain motivated behavior toward short- and long-term goals, and organize the physical environment so as to facilitate these objectives. The choice of this term was in keeping with a related “meta-awareness” approach to the treatment of ADHD, termed metacognitive remediation, previously used in the literature by one of the co-investigators in our group (3). We did not mean to imply that our treatment was related to the metacognitive therapy developed by Adrian Wells. We have since deleted this term from the descriptions of our work and from the title of our forthcoming treatment manual for therapists, which will be published as Cognitive-Behavioral Treatment for Adults With ADHD: Targeting Executive Dysfunction by Guilford.