Finding Balance With Cognitive Behavioral Therapy (CBT) For ADHD
Attention-deficit/hyperactivity disorder (ADHD) can manifest in different ways depending on the individual and the presentation of this form of neurodivergence. That said, some common symptoms include impulsive behaviors, hyperactivity, and trouble focusing, all of which can affect a person’s ability to function at work, school, and in everyday life.
Cognitive behavioral therapy (CBT) is a type of talk therapy that may be helpful in treating ADHD symptoms and equipping individuals with healthy coping mechanisms. It’s also considered to be the gold standard of treatment for many conditions that commonly co-occur with ADHD, such as mood disorders and anxiety disorders. Below, we’ll take a closer look at how CBT works and why it may be helpful for someone living with ADHD.
How does cognitive behavioral therapy work?
The CBT approach focuses on the connection between thoughts, feelings, and behaviors. It’s based on the idea that if we learn to recognize unhelpful thoughts, we can replace them with more realistic and positive ones, potentially reducing frustration or overwhelm and changing behaviors for the better.
CBT is a structured, goal-oriented process that can be used in individual or group therapy settings to address a variety of psychological challenges. For individuals with ADHD, CBT sessions tend to focus on the types of challenges and scenarios that they have already encountered or are likely to encounter in daily life as a result of their symptoms.
Here are the primary components of CBT that a therapist will often support a client in working through:
- Identifying cognitive distortions. The first step in CBT usually involves becoming aware of negative and unrealistic thought patterns. Therapists may use many tools to help clients identify these thoughts and understand their impact on emotions and behavior, such as mindfulness techniques.
- Cognitive restructuring. Once negative thought patterns are recognized, the next step is challenging and restructuring them. Clients learn to evaluate the evidence supporting or contradicting their thoughts. They can then explore alternative, more balanced perspectives and replace irrational or harmful thoughts with more realistic and constructive ones.
- Reshaping behavioral patterns. CBT also emphasizes the role of behavior in influencing emotions. Clients work on changing specific behavioral patterns that may contribute to their distress. CBT providers also help clients set realistic goals and develop action plans to modify behaviors that may reinforce negative thought patterns.
- Preventing relapse. CBT teaches individuals to anticipate potential setbacks. Clients may learn to recognize signs of relapse and develop coping strategies to maintain progress and prevent a return to negative thought patterns and behaviors.
How CBT can help people manage ADHD
Cognitive behavioral therapy for ADHD often focuses on addressing the practical challenges that the individual faces as well as the impact this form of neurodivergence can have on one’s mood, self-confidence, and stress levels. People engaged in the CBT process are often assigned “homework” in between sessions that involve implementing the skills they’ve learned in therapy to cope with difficulties, monitor thoughts and behaviors, or engage in activities that promote positive emotions. Regular practice can help reinforce those skills and turn them into consistent habits.
CBT can help people with ADHD in several areas, including the following.
Psychoeducation
CBT for ADHD often begins with psychoeducation about the nature of ADHD, its impact on behavior, and how cognitive behavioral strategies can be applied to manage symptoms to help individuals better understand the condition. ADHD psychoeducation may also include addressing the potential toll that ADHD can take on one’s emotional health and learning about common comorbid conditions that often accompany ADHD.
Time management skills
The challenges that some people with ADHD face in relation to time management can create acute stress and anxiety. To mitigate this, therapists may work with individuals to learn techniques to manage their time and prioritize and organize tasks effectively. For example, they might teach their clients practical tips like creating a specific, structured plan for mornings or other times when focus and punctuality are particularly important. They may also help them implement systems or tools like timers, calendars, or specialized planners.
Goal setting
CBT for ADHD often involves setting specific, achievable goals, which begins with defining an individual’s strengths and figuring out how to leverage them. For example, if someone is especially creatively inclined, they might apply that creativity to develop an action plan for achieving a task.
CBT providers often work with individuals to help them find their strengths through self-reflection and tools like self-assessment inventories. Then, the CBT therapist will work with them to break down the larger goals into specific, measurable, achievable, relevant, and time-bound steps, which can help individuals with ADHD focus on particular behaviors or tasks they want to address to make them more achievable.
Organizational skills
Crafting personalized organizational strategies can benefit people with ADHD in managing their daily activities. In addition to using planners and organizers, one may develop methods to keep their space organized, such as using “toss,” “donate,” and “keep” containers when cleaning up. Staying on top of the clutter in the home or at work can cut down on distractions and overwhelm, too.
Problem-solving skills
Problem-solving skills may also be developed in CBT to help address challenges that may arise in daily life. These may include sharpening the ability to identify problems, generate potential solutions, and implement and evaluate those solutions. For example, people with ADHD often have difficulty making life decisions due to overthinking or lack of focus. In cases like these, it might be helpful to establish the most essential factor in the decision, such as price or time frame, and focus on that when making the choice.
Behavioral activation
This part of CBT may involve encouraging individuals to engage in positive, rewarding activities that can counteract the low mood or motivation sometimes associated with ADHD. For instance, the therapist might ask the client to write down daily activities they’ve completed between sessions along with the mood associated with each activity. The client and therapist can then discuss those activities in detail to explore any obstacles they may have encountered and to find ways to associate pleasure or enjoyment with unpleasant tasks.
Boosting self-esteem and confidence
Adults with ADHD may face challenges related to poor self-image, self-critical thoughts, or feelings of frustration at perceived failure. The cognitive restructuring techniques featured in CBT may help them replace such thoughts with more positive, self-supportive ones. One example of a technique that may be suggested by a CBT provider is keeping a success journal and recording at least one thing they accomplished each day. Celebrating minor victories may help increase the sense of accomplishment and confidence.
Mindfulness and relaxation techniques
CBT frequently incorporates mindfulness and relaxation techniques to help clients manage stress, cultivate better self-awareness, and reduce the impact of negative thoughts. For those with ADHD, it often has the added benefit of strengthening one’s ability to focus and control attention.
Healthy lifestyle habits
A CBT provider can help clients find ways to incorporate healthy habits—such as regular exercise, adequate sleep, and balanced nutrition—into their daily lives, as these tend to have a positive effect on individual health and well-being in general. However, research indicates they might be particularly important for people with ADHD when it comes to managing their core symptoms. One 2020 study suggests that exercise in particular may help alleviate ADHD symptoms, including reducing impulsivity and hyperactivity, improving attention, and enhancing executive functioning.
Seeking therapy for ADHD
In addition to other treatment options, research indicates that CBT stands as a promising and constructive approach for individuals navigating the challenges of ADHD. By addressing cognitive patterns, modifying behavior, and fostering practical coping mechanisms, CBT techniques can empower individuals with ADHD to better manage their symptoms and enhance their overall well-being.
If you’re struggling to cope with how adult ADHD affects your daily life and overall well-being, CBT may be a beneficial option for you to consider. With the rise of teletherapy through online platforms like BetterHelp, it’s easier than ever to find a trained CBT therapist familiar with treating individuals with ADHD. You can also attend appointments from the comfort of your home on a schedule that accommodates your needs via video, phone, or in-app messaging. Plus, research suggests that online therapy can be as effective as in-person therapy for treating a broad range of conditions, including ADHD, depression, and anxiety.
Takeaway
Reaching out for ADHD treatment is often the first step toward managing symptoms. Cognitive behavioral therapy is a popular treatment method that may help individuals improve self-esteem, time-management skills, organizational abilities, and more.
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