Cognitive behavioral therapy (CBT) is an increasingly popular option for managing ADHD, either as a supplement to ADHD medication or as a replacement.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects the way you regulate focus and behavior. The characteristics of ADHD fall into three categories:
Education, medication, and therapy are all approaches that can help manage your ADHD symptoms. Cognitive behavioral therapy (CBT) is a type of therapy that examines how thought affects behavior and emotions.
CBT can help teach you to recognize which thoughts cause unwelcome actions and feelings, and how to replace them with better-serving ones.
CBT for ADHD can be an effective treatment option for children. It can teach them coping strategies and skills to more successfully self-regulate.
For instance, a CBT therapist may suggest a child with ADHD use a planner to write down important tasks as a way to promote better organization. Older children might find a cellphone app more convenient and use other useful tools like timers, alarms, and calendars on their phones.
CBT can also help young people manage emotions. Living with ADHD may feel stressful at times, particularly for those who hear regular criticism from adults and peers. In fact, it’s estimated that around
CBT strategies for ADHD can help ease the impact of anxiety by reducing the power of demoralizing thoughts, including:
- assuming other people think poorly of them
- paying more attention to mistakes than successes
- blaming themselves for occurrences out of their control
- seeing only the negative
- feeling inferior when focusing on another person’s strengths
- believing that a single mistake cancels all the good they’ve done
- using “always” or “never” to describe negative occurrences, like “I always forget my lunch”
Imagine a child with ADHD at recess feeling like they’re to blame when a second child is sullen and doesn’t want to play.
CBT helps this child remember it might not be their fault: The second child might have another reason for their mood, like fatigue, hunger, or disappointment from an unknown cause.
CBT can also help make task completion easier for children with ADHD. Cleaning their room might feel overwhelming and make them feel like it will “take forever!” CBT can teach them how to break large jobs into smaller tasks. For example, picking up clothes first when cleaning their room.
Therapy combined with medication is often the most successful approach in treating ADHD. This is because medication works quickly to reduce the impact of symptoms. Meanwhile, therapy takes longer to work but teaches skills children can use throughout life.
A 2015 research review clarifies that stimulant medication can be very effective, but only while taken. Therapy, on the other hand, results in long-term improvements in decision making, problem-solving, planning, organizational skills, and more.
Evidence suggests that CBT for ADHD may help manage common ADHD symptoms in adults.
A 2019 study involving 124 participants addressed whether CBT works better alone or with medication to manage ADHD.
Researchers concluded that while CBT helps both with and without medication, it tends to be most effective when paired with medication for supporting time management, organizational skills, and other self-regulating skills.
People with ADHD may experience challenges with organization and time management. CBT may be able to help with this.
How CBT can help manage ADHD
Imagine you have an event planned for a week away. You think to yourself, “I’ll prepare the day before.”
That day arrives, and you find yourself short on time and scrambling to get ready. The event doesn’t run as smoothly as you’d hoped, and you feel stressed and anxious as a result.
It’s the “now/not now” thinking common with ADHD that has interfered with your planning efforts. This means you may have a tendency to view time as either now (the tasks immediately requiring completion) or not now (everything else), no matter how useful it may be to prepare further in advance.
CBT may help you identify and adjust this way of thinking.
Instead, you might think, “I’ll make a list right now of everything I need to do to prepare for the event.” From that list you could create a schedule for the week that gives you enough preparation time. The event runs smoothly, helping reduce your stress and anxiety.
CBT may not cover all areas needed for treating ADHD. For example, CBT may not be able to increase your attention span in the same way medication is able to. However, it may be able to help you direct your focus in more productive ways.
While medication may make it easier to pay attention, CBT can be useful in helping you choose what to pay attention to. CBT treatment may be able to help identify how to best prioritize tasks and for developing better organizational skills.
Are you often late leaving the house? It may be because you need a better system for remembering when you placed your car keys. Identifying the issue helps you solve it, such as by designating a spot for your keys.
CBT isn’t the only type of therapy available for ADHD. Some other options include:
- Parent training. The American Academy of Pediatrics recommends parent training in behavior management for preschool aged children with ADHD symptoms. They also suggest providing this training to both parents and teachers for students with ADHD in high school.
- Family therapy. Because ADHD is a condition that can affect all household members, family therapy may help family members work together to reduce the impact of ADHD symptoms for everyone involved.
- Social skills training. The impulsivity symptoms often associated with ADHD may interfere with how children relate to their peers. Social skills training can teach children important social abilities like sharing, turn-taking, and responding appropriately to teasing.
- Psychodynamic therapy. A psychodynamic therapist can help children examine how their childhood experiences affect present-day functioning, as well as how to improve their self-awareness and self-esteem. Children may also learn how to express their feelings more effectively.
- Dialectical behavior therapy. Dialectical behavior therapy is a type of CBT that works to regulate emotions and teach behavior regulation skills.
CBT can be an effective option for managing ADHD for both children and adults. It may help to improve important life skills, including organization, time management, problem-solving, and more. Studies have also indicated that CBT can help reduce the anxiety that often accompanies ADHD.
Although CBT does not offer as fast an effect as medication, this form of treatment can teach skills that last long after therapy is complete. Medication, in contrast, works only while taken. For this reason, many doctors recommend using medication and CBT together.
In addition to CBT, behavior management training and family therapy are a couple of examples of therapy that may also help manage ADHD symptoms.
Since everyone is unique, consider speaking with a doctor to find out what course of action is best for you (or your child) for managing ADHD.