Evidence-Based Talk Therapies for ADHD
Several types of talk therapy have been found to be effective in treating ADHD symptoms in adults. These include:
Cognitive Behavioural Therapy (CBT): CBT is a type of talk therapy that focuses on changing negative patterns of thought and behaviour. It has been found to be effective in treating ADHD symptoms by helping individuals develop strategies for managing impulsivity, improving time management, and reducing distractibility.
Mindfulness-Based Cognitive Therapy (MBCT): MBCT is a form of CBT that integrates mindfulness meditation practices into the therapy. It has been found to be effective in reducing symptoms of ADHD and improving attention and executive functioning.
Acceptance and Commitment Therapy (ACT): ACT is a type of talk therapy that helps individuals identify their values and commit to actions that are in line with those values. It has been found to be effective in improving ADHD symptoms by increasing mindfulness and reducing negative self-talk.
Coaching: While there is less evidence for coaching than the above-listed therapies, it is an emerging treatment that is growing, especially in the US. It is a type of talk therapy that focuses on practical strategies for managing ADHD symptoms in daily life. It has been found to be effective in improving time management, organization, and goal setting.
In my own practice, I mostly use ACT, which is a behavioural therapy that focuses on experiencing and accepting difficult emotions and thoughts and choosing to pursue a rich and fulfilling life in spite of them. It is different from CBT in that it does not try to dispute the accuracy or value of negative thoughts. Behavioural strategies of CBT are usually interchangeable with ACT and have long been my preferred way of approaching mental health difficulties.
One of the most significant challenges that individuals with ADHD face is the damage to self-esteem, self-confidence, and overall mental health. This can be particularly true for those who have struggled for years with symptoms that have gone unrecognized or untreated. Additionally, research has shown that individuals with ADHD are at a higher risk of developing other mental health disorders. The three most common co-occurring conditions are depression, anxiety disorders, and substance use disorders. Another common challenge for people with ADHD is difficulties with emotional regulation. This can manifest as intense emotions that are difficult to manage, leading to outbursts, impulsivity, and poor decision-making. While emotional dysregulation is not a core criterion for ADHD, it is an associated feature that affects many individuals with the condition (see my blog post on emotional dysregulation for more information). Therapy can play a role in helping individuals with ADHD address these co-occurring mental health difficulties.
I am a strong advocate for ADHD treatment. Stimulant medications have been shown to have the greatest efficacy in treating ADHD symptoms. Therefore, I often encourage my clients to prioritise optimising their medication regimen as the first step in managing their ADHD. In addition to stimulant medication and therapy, individuals with comorbid mental health conditions such as anxiety or depression may find antidepressant or other psychotropic medication to be helpful in managing mental health symptoms. A person should not expect to come off their antidepressant once they find the right dose of stimulant medication as a matter of course (I have been told on more than one occasion of GPs recommending this to their ADHD patients). Stimulant medication is not a panacea for all ADHD-related difficulties.
If you have ADHD and would like to pursue therapy for this and/or related difficulties, I would suggest trying to find an ADHD-informed therapist.