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GP Referral & Price
RMC
- Is NOT a tele-health only clinic
- clinicians are Full AADPA members
- Requires Blood Test, ECG, Blood Pressure, Urine Drug Test to be completed prior to the assessment.
- Reserves the right to postpone medication prescribing if the medical practitioner perceives there are physical complications or other co-occurring psychiatric disorders that may require treatment first.
Price
Cost to Client $1487.90
Medicare rebate $255.90
Fee $1750
2 to 3 hour clinical assessment
30 mins consultation with Psychiatrist
bulk billed follow-up progress call from Psychiatrist
GP Referral
A GP referral is required for all undiagnosed & diagnosed ADHD assessments.
Your GP will send your referral directly to us. RMC does NOT accept referrals directly from Clients
Booking Approach
Text message confirmation within 3 days of the clinic receiving your GP referral.
Phone call and text contact to book your appointment within 7-10 days of receiving your GP referral
Appointment Location
Video appointments available
In person appointments available from July 2026 onwards in Belconnen.
Clinical Assessment
1. Clinical Assessment
2 to 3 hours with either our GP Mental Health Specialist, Psychiatric Nurse or Social Work Practitioner.
This is a semi-structured interview.
All 3 clinicians have at least 17 years clinical experience each and consequently are skilled in exploring your challenges and differences in a relaxed and structured approach.
The philosophy of RMC is that the clinical assessment part, we hope, is an enjoyable, insightful and liberating experience for you.
The clinical assessment will also explore what is called a differential diagnosis approach, meaning your clinician will explore if other psychiatric presentations could also explain your challenges.
The clinical assessment will undertake a developmental history approach which will explore your current symptoms in your adolescence, if you are able to recall your pre-adolescent period and in your adult life.
These will explore challenges in the key areas of your life, such as education, work, intimate relationships, family relationships, social life, and hobbies. This will be viewed from the perspective of what are termed functional impairments.
The semi structured clinical interview will explore your challenges viewing this presentation as a possible executive functioning deficit disorder.
RMC practices a Neurodiverse Affirming assessment
We allow 3 hours for this aspect, typically the average duration is about 2.5 hours.
This aspect is a relaxed and yet structured approach which allows clients the freedom to engage in a conversation style assessment.
Our team are very aware that individuals with neurodiverse presentations may benefit from
movement and a comfort break from the assessment for a brief period.
For video consultations we encourage our Clients to be in a physical space where they feel safe and at peace
2. Psychiatric Consultation & Diagnosis
30 mins with Psychiatrist
3. Medication Support
check-in call from Dr Lewis
email helpdesk
phone review
clinical support to help with finding the correct dose Details
RMC practices a Neurodiverse Affirming assessment.
All of the self-report scales and questionnaires listed will have been emailed to be completed electronically many weeks prior to the clinical assessment.
These questionnaires are explored in detail in advance of your clinical assessment by the psychiatrist and mental health clinician. The results of these are reviewed in a clinical review meeting prior to your appointment and then discussed collaboratively with you during your detailed clinical assessment.
ADHD clinical assessment explores :
1. Executive Functioning
This investigation explores symptoms across Self Organisation, Self Restraint,
Self Motivation, Self Regulation of Emotions, & Self Management to Time.
Executive Functioning Challenges:
- Attention Regulation
- Difficulty with focused attention
- Difficulty sustaining attention
- Distractibility
- Hyperfocus (inconsistent attentional allocation)
- Impulsivity
- Verbal impulsivity
- Cognitive impulsivity (rapid, unfiltered thinking)
- Behavioural impulsivity
- Motivation and Task Engagement
- Procrastination
- Difficulty initiating tasks
- Planning and Organisation
- Difficulties with planning
- Difficulties with prioritisation
- Time Processing
- Time blindness (impaired time awareness and estimation)
- Working Memory
- Reduced working memory capacity
- Difficulty holding and manipulating information
- Emotional Regulation
- Difficulties with emotional regulation
- Rejection sensitivity
- Arousal and Restlessness
- Inner restlessness
- Sleep Regulation
- Insomnia
- Poor sleep hygiene
The clinical assessment uses :
*The Barkley Deficits in Executive Functioning Scale (BDEFS)
Semi Structured Clinical Interview.
2. Clinical Interview
This activity is conducted using the :
*DIVA-5, The Diagnostic Interview for ADHD in adults
*Camouflaging Autistic Traits Questionnaire (CAT-Q)
*Rejection Sensitivity Dysphoria Questionnaire
*Difficulties in Emotion Regulation Scale (DERS-16)
3. Functional Impairment
Functional impairment is central to ADHD and consequences and difficulty functioning in certain areas of daily life are for the most part what triggers the request for an ADHD assessment.
This activity is explored using :
*The WEISS Functional Impairment Rating Scale .
Impairment typically occurs across Family, Work, Education, Life Skills, Self Esteem, Relationships
4. Mental Health Disorders
General Anxiety, Depression and Social Anxiety can also be present with ADHD.
Usually they occur as a consequence of untreated ADHD and often reduce when the benefits of ADHD medication occur, improving concentration, focus, starting and finishing tasks, and reducing distractability and procrastination.
An evaluation will consider whether the symptoms belong to ADHD,
another mental health condition, another physical health condition,
or if they represent more than one disorder, which can also be the case.
ADHD can be present with other mental health disorders.
The clinical assessment uses the:
SCID-5, The Structured Clinical Interview for DSM-5.
Screening for:
Trauma, Bipolar Mood Disorder, Borderline Personality Disorder, and
Anxiety & Depression are explored at a diagnostic level.
Evidence based diagnostic measures are used.
Our clinicians will explore any of these presentations in further detail if they identify a history that aligns with the DSM-5 criteria.
Insomnia is also explored.
A detailed Suicide Risk assessment, current and prior history is explored
5. Not part of the RMC assessment
Our diagnostic approach does not include :
neuropsychological tests (additional information)
*RMC clinicians each have at least 17 years experience in complex mental health and are
highly skilled in exploring neuro divergent presentations, in a neuroaffirmative approach.
Their clinical experience lens itself to exploring symptoms, consequences and strengths across the
lifespan without the need for additional reports.
The Psychiatric Consultation
Psychiatrists are specialists in diagnosing, and treating the range of adult
mental health and psychiatric disorders.
The Psychiatrist confirms the diagnosis of ADHD.
Psychiatrists are trained in understanding how medication works on the brain and body and any interactions or potential complications between different medications.
Dr Lewis will collaboratively discuss ADHD medication:
- How it works.
- Long & short acting.
- Benefits & effectiveness.
- Explore the results of your ECG, urine drug screen and blood pressure test results.
- Review your Blood Test results to exclude any possible medical conditions that may be leading to difficulty with attention and short term memory.
- Review all medications you are prescribed with the aim of assessing if there are potential side-effects.
RMC uses the following evidenced based self-report questionnaires.
See ADHD diagnostic frameworks.
ADHD Diagnostic Assessments:
• The Adult ADHD Self Report Scale (ASRS-V1.1).
• DIVA diagnostic interview for adult ADHD (DIVA-5)
• Barkley Deficits in Executive Functioning Scale (BDEFS-SF)
• Weiss Adult ADHD Functional Impairment Rating Scale (WFIRS)
• Difficulties in Emotional Regulation Scale (DERS-16)
• Rejection Sensitivity Dysphoria Scale (RSD)
• Camouflaging Autistic Traits Questionnaire (CATQ)
Psychiatric Measures:
• DSM-5 multi-disorder screening scale (explored in the session)
• Beck Depression Inventory (BDI)
• Mood Disorder Questionnaire (MDQ)
• The General Anxiety Disorder Severity Scale (GADSS)
• Brief Trauma Screening (BTQ)
• Adverse Childhood Experiences Questionnaire
Risk Assessment:
• Columbia-Suicide Severity Rating Scale (C-SSRS) active and lifetime.
Sleep:
Insomnia rating scale
Resources on YouTube about ADHD
The Importance of Grieving the diagnosis of ADHD
This video talks about how grief can present shortly after a diagnosis of ADHD. Grief for possible missed opportunities in all areas of life, as a consequence of ADHD.
This video the Grief of Wasted Time explores this is more detail.
- Sleep Disorders & ADHD video by Professor Kooji
- Starting & Completing tasks with ADHD Video by Dr Saline
- Avoidance, procrastination & ADHD video by Dr Saline
- Causes of ADHD By Dr Russell Barkley Video
- Why ADHD is so impairing Dr Russell Barkley video
- Introduction to ADHD By Dr Tracy Marks YouTube
- Dr Thomas Brown Video Oppositional Defiant Disorder in Boys
- Dr William Dobson video on Executive Functioning
- Dr Thomas Brown video Time Management & ADHD
- Dr Ari Tuckman video ADHD as a disorder of Self Regulation
- Dr Russell Barkley video ADHD as a Motivation Deficit Disorder
- Dr Russell Barkley video Inner Restlessness & ADHD
- Russell Barkley video ADHD & Caffeine
- Dr Russell Barkley Video Men with ADHD
- Resources for managing disregulation, shame & anger video
- Executive Functioning ADHD & Executive Functioning Video Dr Russell Barkley
- Causes of ADHD Dr Russell Barkley Video
- Why ADHD is so impairing By Dr Russell Barkley video
- Rejection Sensitivity & Borderline Personality Disorder & ADHD Video By Dr Sanil Rege
- An ADHD guide to Emotional Dysregulation & Rejection Sensitivity Dysphoria By Dr William Dodson Video
- Rejection Sensitivity & Social Anxiety By Dr Sharon SalineVideo
- Hyperfocusing Video by Dr Russell Barkley
- Perfectionism Dr Sharon Saline video
- Sleep & ADHD Video By Dr Russell Barkley
The RMC approach to ADHD
ADHD as a disorder of Executive Functioning
Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience significant challenges in self-management, including organisation, planning, initiating and completing tasks in a timely manner, shifting between activities, self-monitoring, and inhibiting responses.
Article: A second mental health presentation along with ADHD
These skills are collectively described as executive functions (EFs), which can be viewed as “those self-directed actions needed to choose goals and to create, enact, and sustain actions toward those goals” (Barkley, 2012).
When executive functions are impaired, individuals typically struggle with reduced productivity, inefficiency, missed deadlines, poor planning, disorganisation, “careless” errors, and frequent loss or forgetting of items. For some—particularly those with the combined presentation of ADHD—reduced inhibitory control can also manifest as emotional dysregulation and inappropriate verbal or physical behaviour in interpersonal contexts.
Over the lifespan, these difficulties contribute to repeated failures to achieve goals personally, academically, and occupationally. Such persistent struggles often increase the risk of secondary anxiety and depression, which are highly prevalent in adults with ADHD.
Clinical Framing: Executive Functioning Deficit Disorder
Our diagnostic clinical assessment is undertaken through a semi-structured clinical interview, which explores ADHD symptoms as manifestation of executive functioning deficits.
ADHD is understood as a neurodevelopmental disorder characterised by executive dysfunction, impairing the brain’s ability to select, monitor, and regulate behaviour in pursuit of goals.
Executive dysfunction affects:
- Task management and planning
- Time awareness and scheduling (time blindness)
- Goal setting and persistence
- Concentration and resistance to distraction
- Working memory, organisation, and self-monitoring
- Self-inhibition and attentional shifting
From this perspective, ADHD is best conceptualised as a disorder of self-regulation rooted in EF impairment.
Misleading Terminology
The term “Attention Deficit” is misleading, as it obscures the broader self-regulatory impairments that characterise ADHD. Similarly, “Hyperactivity”—while valid in describing childhood behaviour—does not capture the adult presentation. Adults are not “hyperactive” in the same way as an 8-year-old boy; instead, impulsivity better reflects the adult clinical profile. Impulsivity has clear potential for negative consequences in decision-making, relationships, and occupational functioning.
Gender Bias and Diagnostic Inadequacy
Current diagnostic criteria and terminology are insufficient and discriminatory when applied to women and adolescent girls. Symptoms in these groups often manifest less in disruptive behaviour and more in internalised difficulties such as disorganisation, emotional dysregulation, rejection sensitivity, and cognitive/verbal impulsivity. These differences have contributed to widespread under-recognition and late diagnosis in women.
A more accurate diagnostic approach reframes ADHD as a broader Executive Functioning Self-Regulation Deficit Disorder, particularly in women, encompassing:
- Emotional dysregulation and rejection sensitivity
- Cognitive, verbal, and behavioural impulsivity
- Persistent executive functioning challenges across domains
Executive Functioning
Brown, T. E. (2006). Executive functions and attention deficit hyperactivity disorder
Attention is an incredibly complex, multifaceted function of the mind. It plays a crucial
role in what we perceive, remember, think, feel, and do, and it is not just one isolated
activity of the brain. The continous process of attention involves organising and setting
priorities, focusing and shifting focus, regulating alertness, sustaining effort, and regulating
the mind’s processing speed and output. It also involves managing frustration and
other emotions, recalling facts, using short-term memory, and monitoring and self-regulating action.
These 6 key areas make up what is thought of as executive functioning.
Cluster 1. Activation
Organising, prioritising, and getting started on tasks
- Trouble organising tasks and materials
- Chronic procrastination, waiting until urgency/punishment to start
- Difficulty following instructions and keeping track of tasks
- Daydreaming or rushing through work
Cluster 2. Focus
Focusing, sustaining, and shifting attention
- Difficulty sustaining focus, especially for boring tasks
- Easily distracted by external or internal stimuli
- Trouble shifting between tasks when required
- Reading comprehension issues (re-reading to retain meaning)
Cluster 3. Effort
Regulating alertness, sustaining effort, and processing speed
- Good at short bursts, but struggle with long-term sustained effort
- Slower processing and reaction time
- Difficulty completing tasks consistently or on time
- Sleep regulation problems: staying up late, difficulty waking, daytime drowsiness
- Trouble persisting when tasks get harder
Cluster 4. Emotion
Managing frustration and modulating emotions
- Not recognised in DSM-5, but very common in ADHD
- Emotional reactions feel overwhelming and hijack attention
- Struggles with frustration, anger, disappointment, worry
- High sensitivity to criticism, irritability, unhappiness
Cluster 5. Memory
Using working memory and accessing recall
- Forgetfulness in daily routines (losing items, forgetting instructions)
- Hard to hold multiple things in mind while working
- Good recall for distant memories, poor short-term recall
- Struggles retrieving learned information when needed
Cluster 6. Action
Monitoring and self-regulating behaviour
- Impulsivity in speech, actions, and thoughts
- Poor context monitoring (noticing social cues)
- Trouble adjusting behaviour in real time
- Restlessness, interrupting, careless mistakes, disruptiveness
- Difficulty regulating pace (too fast/too slow)
Functional Impairment in ADHD
Functional Impairment in ADHD
Functional impairment in adult ADHD frequently impacts an individual’s overall quality of life. A thorough clinical assessment therefore explores the different areas where these impairments may emerge.
At RMC, our diagnostic approach includes the Weiss Functional Impairment Rating Scale – Self Report (WFIRS-S).
This scale captures the individual’s perspective on their own functioning across seven domains:
- Family (8 items)
- Work (11 items)
- School (10 items)
- Life Skills (12 items)
- Self-Concept (5 items)
- Social (9 items)
- Risk (14 items)
A functional impairment occurs when an individual’s available resources are insufficient to meet the demands of their environment. These resources include:
- Internal resources – e.g., the ability to concentrate, remember, and inhibit impulses
- External resources – e.g., support from family, teachers, or colleagues
As people age, environmental demands (academic, occupational, financial, and social) typically increase in number, scope, and complexity. When resources fall short, impairments emerge.
Because each person’s profile of internal and external resources is unique, the timing of impairment onset varies. Some individuals may show impairments early in childhood, while others may not experience significant functional difficulties until later in adolescence or adulthood.
At RMC, we place strong emphasis on exploring your lived experience of impairment: how it has shown up in your daily life, and when it first emerged for you. For some, this may become apparent only in adulthood—especially as independence and responsibility increase.
Co-occurring Disorders
Functional Impairment in ADHD
More than two-thirds of individuals with ADHD have at least one other coexisting condition. The symptoms of ADHD—constant motion and fidgetiness, interrupting and blurting out, difficulty sitting still and need for constant reminders, etc.—may overshadow these other disorders.
But just as untreated ADHD can present challenges in everyday life, other disorders can also cause unnecessary suffering in individuals with ADHD and their families if left untreated. Any disorder can coexist with ADHD, but certain disorders tend to occur more commonly with ADHD. ADHD may coexist with one or more
Disruptive behaviour disorders
40 percent of individuals with ADHD have
oppositiona defiant disorder (ODD). ODD involves a pattern of arguing; losing one’s temper; refusing to follow rules; blaming others; deliberately annoying others; and being
angry, resentful, spiteful and vindictive.
Among individuals with ADHD, conduct disorder (CD) may also be present, occurring in 27 percent of children, 45–50 percent of adolescents and 20–25 percent of adults with ADHD. Children with conduct disorder may be aggressive to people or animals, destroy property, lie or steal things from others, run away, skip school or break curfews. Adults with CD often exhibit behaviors that get them into trouble with the law.
Learning disorders
Up to 50 percent of children with ADHD have a coexisting learning disorder, whereas 5 percent of children without ADHD have learning disorders. Learning disorders can cause problems with how individuals acquire or use new information such as reading or calculating. The most common learning disorders are dyslexia and dyscalculia. In addition, 12 percent of children with ADHD have speech problems, compared with 3 percent without ADHD.
Sleep disorders
One-quarter to one-half of parents of children with ADHD report that their children suffer from a sleep problem, especially difficulties with falling asleep and staying asleep. Sleep problems can be a symptom of ADHD, may be made worse by ADHD or may make the symptoms of ADHD worse.
Anxiety
When it is ADHD & not anxiety video
Up to 30 percent of children and up to 53 percent of adults with ADHD may also have an anxiety disorder. Patients with anxiety disorders often worry excessively about a number of things (school, work, etc.) and may feel edgy, stressed out, tired and tense and have trouble getting restful sleep.
Mood disorders
Bipolar and ADHD treatment for combined presentations
In adults, approximately 38 percent of ADHD patients have a co-occurring mood disorder. Mood disorders are characterized by extreme changes in mood. Children with mood disorders may seem to be in a bad mood often. They may cry daily or be frequently irritable with others for no apparent reason. Mood disorders include depression, mania and bipolar disorder.
Approximately 14 percent of children with ADHD also have depression, whereas only 1 percent of children without ADHD have depression. In adults with ADHD, approximately 47 percent also have depression. Typically, ADHD occurs first and depression occurs later. Both environmental and genetic factors may contribute.
Up to 20 percent of individuals with ADHD may show symptoms of bipolar disorder, a severe condition involving periods of mania, abnormally elevated mood and energy, contrasted by episodes of clinical depression. If left untreated, bipolar disorder can damage relationships and lead to job loss, school problems and even suicide.