Medication is highly effective for treating ADHD. But it can’t teach you skills for living successfully with the disorder. And it can’t help you overcome common co-occurring concerns such as low self-esteem. That’s where psychotherapy comes in.
Psychotherapy targets specific ADHD symptoms that interfere with daily life, such as disorganization, distractibility and impulsivity. It helps you better understand your ADHD and improve all areas of your life, including home, work and relationships.
But not all therapists are created equal. That’s why it’s important to do your research, and be selective. Below, two ADHD experts share their tips on finding a good clinician.
Starting Your Search
Begin your search by asking your primary care physician if they can suggest good therapists who specialize in ADHD, said Terry Matlen, ACSW, a psychotherapist and author of Survival Tips for Women with ADHD. “Sadly, most will come up dry, but it’s worth trying.”
Ask friends, family and anyone else who has ADHD for recommendations, according to Matlen and Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School. They both noted that word of mouth is a great way to find practitioners.
If you’re looking for a therapist for your child, consult other parents of kids with ADHD. Ask them if their child is making progress, Olivardia said. “Do they or their children feel understood and validated by the therapy?” Another option is to ask the school psychologist for recommendations, he said.
Check out organizations that advocate for ADHD, such as CHADD or ADDA, he said. For instance, you can call CHADD (800-233-4050) to find out if there’s a chapter in your area, Matlen said. “Most all chapters keep a list of clinicians in the area that are adult ADD savvy.” Matlen’s website also offers a professional directory.
If you’re already part of a local support group, ask if they have good recommendations, Olivardia said. Consider calling the closest teaching hospital, Matlen said. “Ask for the psychology or psychiatry department and find out who on staff works with adult ADHD.”
Refining Your Search
Olivardia suggested selecting two or three potential therapists, and meeting with all of them. Matlen also suggested briefly interviewing the clinicians over the phone. The key, according to both experts, is to figure out who you feel most comfortable with. It’s important you feel safe sharing your struggles and concerns with your therapist, Matlen said.
Questions to Ask
In addition to figuring out who you’re comfortable with, it’s important to find a clinician who has experience working with ADHD clients. As Matlen said, it doesn’t matter whether the professional is a physician, psychologist, social worker or nurse practitioner. Experience is king.
Matlen and Olivardia suggested asking these questions:
- How many patients with ADHD have you worked with in the last 5 years? “At least 10 patients would give you some assurance that they have seen ADHD manifested with different types of patients with different associated issues,” Olivardia said. However, if someone has treated fewer individuals, but has “a clear philosophy in ADHD treatment, exhibits personality traits that click with you and is up to date on the research,” they might be a better fit.
- Have you read ADHD research or attended conferences, seminars or workshops on ADHD? You want to confirm that your therapist is very knowledgeable about ADHD. “Ask if they are familiar with the works of Dr. Russell Barkley, Dr. Ned Hallowell [and] Dr. John Ratey,” Matlen said.
- How do you view ADHD? Some practitioners see ADHD as a “curse,” while others see it as a “gift,” Olivardia said. “Seek a therapist who can validate and treat the areas that may feel like a ‘curse’ while also highlighting and optimizing the strengths or the ‘gifts.’” Viewing ADHD as a curse can make a person with ADHD feel like they’re defective, while viewing ADHD as a gift may gloss over the difficulties ADHD symptoms cause, he said.
- How do you evaluate ADHD? You can’t accurately diagnose someone with ADHD with a checklist or screener, Matlen said. “The eval should last longer than 20 minutes and include a history, clinical observations, a meeting with someone familiar with the patient to corroborate the patient’s statements and history, and much more.”
- How do you treat ADHD? “Different styles will work for different people,” Olivardia said. However, the most effective approach is cognitive-behavioral therapy, “which focuses on addressing any negative self talk while developing strategies of action that are ADHD friendly.” This can include “re-fram[ing] who you are as a person with ADHD, and also gaining skills in various areas of your life [such as] relationships, work, parenting [and] time management,” Matlen said.
- What are your thoughts on medication for adult ADHD? “We know that, combined with therapy, [medication] is the most effective treatment. If they are anti-medication, and it doesn’t match your own philosophy, you might want to look elsewhere,” Matlen said.
Olivardia suggested asking these additional questions about therapy: “How do you deal with ADHD symptoms, which may present themselves in the actual therapy? For example, how do missed sessions get handled? What if I forget to do my ‘homework’? How do you manage when patients may be getting distracted in the therapy? How do you ‘mix it up’ for a patient to prevent boredom?”
Regarding warning signs that a therapist isn’t for you, “Your gut will guide you,” Matlen said. These are potential red flags:
- The therapist does all the talking, but doesn’t ask about your issues, Matlen said.
- They’re chronically late for your sessions, she said.
- They seem condescending or question whether your ADHD is real, she said.
- They don’t seem to “get” you, she said.
- They want to change you. “You are seeking help in changing behaviors and habits, but you are who you are,” Olivardia said.
- They’re rigid or inflexible, and believe they know what’s best, he said. “Granted, you are seeking them for their expertise, but remember they may be experts on ADHD but are not experts on you. You want to make sure the clinician is seeing you as a unique person who has ADHD.”
- You consistently feel worse after your sessions, Matlen said.
What do you do if there are zero clinicians who treat ADHD clients? “There are many gifted general therapists one can see, who would be open to learning more about ADHD,” Matlen said. If you find a therapist you’re comfortable with, ask if they’ll read books about ADHD. You might need to explain how ADHD affects adults, she said.
“The beauty of the Internet is that it now allows people from all over the world to access resources online,” Olivardia said. The ADHD websites above offer educational webinars and lectures, he said. You’ll also find helpful information on ADHD experts’ websites, such as Dr. Russell Barkley and Dr. Ari Tuckman.
Many ADHD coaches offer services using Skype or telephone, he said. And you might find an ADHD support group in your town.
It might take multiple sessions to figure out whether a clinician is a good match for you, but don’t waste months or even years with someone who isn’t, Matlen said. “Don’t give up in finding the right person. It takes some work but it will be worth it,” Olivardia said.