Most mental health professionals know this frustrating scenario: You’ve successfully diagnosed an adult with ADHD, perhaps prescribed medication, but your client still struggles with executive functioning in daily life. They’re organized during sessions but can’t maintain systems at home. They understand CBT concepts intellectually but can’t implement them consistently.
Clinical Bottom Line: SaskADHD Skill Training launches in November 2025 as a structured 10-session ADHD skills program that bridges the gap between diagnosis and functional improvement. Led by experienced therapists using evidence-based protocols specifically adapted for ADHD presentations.
What makes this clinically significant:
- Uses externalized executive function strategies proven effective for ADHD neurology
- Group format leverages peer modeling and accountability mechanisms
- Includes outcome tracking and relapse prevention protocols
- Available via telehealth with insurance coverage through NIHB and Métis Nation Saskatchewan
The Treatment Gap We’re All Seeing
Recent meta-analyses show that while stimulant medications improve ADHD symptoms in 70-80% of adults, functional impairment often persists. Clients may have better focus but still struggle with organization, emotional regulation, and social communication. Individual therapy helps, but the skill-building component often gets overshadowed by processing past trauma or managing current crises.
This is where structured skills training fills a crucial gap. Chris de Feijter’s SaskADHD Skill Training represents what many of us have been advocating for: specialized group intervention that targets executive functioning deficits systematically rather than hoping clients will generalize individual therapy insights to daily life.
The Neuroscience Behind Group Skills Training
ADHD brains benefit disproportionately from what researchers call “environmental scaffolding”—external structures that compensate for executive function deficits. Traditional individual therapy, while valuable, can’t replicate the peer accountability and observational learning that occurs in group settings.
SaskADHD Skill Training uses this principle deliberately. Participants don’t just learn techniques; they observe others implementing them, troubleshoot together, and create accountability partnerships that extend beyond session time.
Clinical Framework and Evidence Base
Session Structure: CBT Meets Executive Function Training
The 10-core-session framework follows established cognitive-behavioral protocols while incorporating ADHD-specific modifications:
Phase 1 (Sessions 1-3): Psychoeducation and Metacognitive Awareness Rather than generic ADHD education, this phase uses individualized symptom mapping. Participants complete detailed executive function assessments and learn to identify their specific deficit patterns. The mindfulness component focuses on developing attention regulation rather than general relaxation.
Phase 2 (Sessions 4-6): Externalization and Environmental Design This is where SaskADHD Skill Training diverges significantly from standard CBT approaches. Instead of relying on internal cognitive strategies, participants learn to create external systems that manage executive functions. Think of it as assistive technology for executive dysfunction.
Techniques include time-based task management (not just scheduling), energy-based prioritization systems, and what SaskADHD Skill Training calls “ADHD-proofing”—designing environments that work with ADHD neurology rather than against it.
Phase 3 (Sessions 7-8): Emotional Regulation and Cognitive Restructuring Standard CBT techniques modified for ADHD presentations, including specific protocols for Rejection Sensitive Dysphoria, perfectionism cycles, and the emotional dysregulation that often accompanies executive function challenges.
Phase 4 (Sessions 9-10): Social Skills and Maintenance Communication strategies designed for ADHD challenges (interrupting, attention drift during conversations), plus comprehensive relapse prevention protocols.
Optional Advanced Modules
Sleep Optimization Module: Addresses ADHD-specific sleep disorders including delayed sleep phase syndrome and how sleep disruption amplifies every other ADHD symptom.
Advanced Emotional Regulation Module: For participants with significant emotional dysregulation, incorporating elements from Dialectical Behavior Therapy that have shown efficacy with ADHD populations.
Clinical Outcomes and Research Foundation
What the Research Shows
Group skills training for adult ADHD consistently outperforms individual skills coaching in randomized controlled trials. A 2023 meta-analysis of 15 studies found effect sizes of 0.68 for functional improvement and 0.71 for quality of life measures—considered large effects in psychotherapy research.
SaskADHD Skill Training incorporates outcome measurement protocols, tracking both symptom improvement and functional gains using standardized assessments including the ADHD Rating Scale and the Weiss Functional Impairment Rating Scale.
Clinical Considerations for Referral
Ideal candidates present with:
- Confirmed ADHD diagnosis with persistent functional impairment
- Stable medication regimen (if using pharmacological treatment)
- Ability to participate in group video conferencing
- Sufficient emotional stability for skills-focused rather than therapy-focused intervention
Contraindications include:
- Active substance use disorders
- Untreated major depression or anxiety disorders
- Significant personality disorders that would disrupt group dynamics
- Current crisis situations requiring intensive individual support
Implementation and Access Details
Insurance and Coverage Realities
SaskADHD Skill Training’s coverage through NIHB and Métis Nation Saskatchewan represents a significant advancement in ADHD treatment access. Prior authorization typically requires:
- Confirmed ADHD diagnosis from qualified provider
- Documentation of functional impairment
- Evidence that skills training is appropriate intervention level
Private insurance coverage varies dramatically. Some carriers classify it as “psychological services,” others as “educational intervention.” Recommend clients obtain pre-authorization in writing.
Technology and Platform Considerations
Delivered via the STG Clinic telehealth platform, which includes interactive features like breakout rooms, polling, and screen sharing. The technology accommodates ADHD attention challenges through frequent format changes and engagement strategies.
Sessions are recorded (with consent) for participants who miss sessions, addressing the reliability challenges that many ADHD clients face with consistent attendance.
Professional Development and Training Model
The Clinical Team Approach
Chris de Feijter brings both clinical expertise in CBT and specialized training in adult ADHD presentations. The SaskADHD Skill Training model could serve as a template for other regions looking to implement similar services.
Key elements include:
- Master’s or doctoral-level clinicians with ADHD specialization
- Structured curriculum with flexibility for individual needs
- Outcome measurement and quality assurance protocols
- Integration with referring providers for continuity of care
Implications for Practice
This program represents a shift toward specialized, diagnosis-specific group interventions. Rather than generic skills groups, we’re seeing more targeted approaches that address the unique neurological and functional profiles of specific conditions.
For referring clinicians, this creates opportunities for more comprehensive treatment planning. Individual therapy can focus on trauma processing, family dynamics, or career concerns while structured skills training addresses the executive function deficits that often underlie daily life struggles.
Research and Quality Assurance Framework
Outcome Measurement Protocol
SaskADHD Skill Training includes standardized outcome measurement using validated instruments:
- Pre/post/follow-up administration of ADHD Rating Scale-IV
- Weiss Functional Impairment Rating Scale for real-world functioning
- Custom measures for specific skills (organization, time management, emotional regulation)
- Participant satisfaction and program completion rates
Continuous Improvement Model
Regular outcome review allows for program modifications based on participant response. This creates an evidence base for what works specifically in the Saskatchewan healthcare context and could inform similar programs elsewhere.
Clinical Recommendations and Referral Process
Assessment and Preparation
Before referral, ensure clients have:
- Comprehensive ADHD evaluation with differential diagnosis
- Stable mental health status appropriate for group intervention
- Realistic expectations about skills training versus therapy
- Technical capability for video conferencing participation
Integration with Ongoing Treatment
Skills training complements rather than replaces individual therapy. Many clients benefit from concurrent individual sessions to process the emotional aspects of implementing new systems and addressing longstanding patterns of shame or frustration around executive function challenges.
Follow-up and Maintenance
SaskADHD Skill Training includes booster session options and alumni support groups. Referring clinicians should plan for integration of learned skills into ongoing treatment and regular assessment of skill maintenance over time.
Looking Forward: Implications for ADHD Treatment
SaskADHD Skill Training represents what many of us hope to see more of: evidence-based, diagnosis-specific interventions that address functional impairment directly rather than hoping skills will develop as a byproduct of general therapy.
The virtual delivery model also addresses access issues that have historically limited specialized ADHD services to urban centers. Rural and remote clients can access the same quality of specialized intervention.
For the field, this points toward more sophisticated understanding of how to match intervention type to client needs. Not every ADHD client needs intensive individual therapy; many need structured skills training with peer support and accountability.
The SaskADHD Skill Training November 2025 launch will provide valuable data on implementation, outcomes, and the feasibility of delivering specialized ADHD services via telehealth in the Canadian healthcare context.
Program Contact: Chris de Feijter, STG Clinic Saskatchewan
Website: saskadhd.com/adhd-skill-group/
Coverage: NIHB and Métis Nation Saskatchewan approved; private insurance varies
Clinical information based on published research and program documentation. Refer to original sources for complete inclusion/exclusion criteria and outcome data.