Cognitive behavioral therapy (CBT) may help people with attention deficit hyperactivity disorder (ADHD) develop skills such as time management, emotional self-regulation, and impulse control.

CBT is a type of psychotherapy that gives people tools and strategies to change unhelpful feelings, thoughts, and behaviors.

Someone with ADHD may receive CBT alongside ADHD medications or as an alternative to them. People may receive one-to-one or group CBT and may opt to have their therapy sessions in person or online.

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ADHD symptoms can present asTrusted Source mostly inattentive, mostly hyperactive-impulsive, or a combination of the two. As such, people with ADHD may experience different symptoms and benefit from different CBT exercises.

The charity Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) outlines the following five broad strategies that CBT practitioners and ADHD coaches may use to help those with ADHD.

Breaking down tasks

A CBT practitioner may teach someone to break up large tasks into smaller, more manageable sub-tasks.

This may be particularly helpful for people with ADHD who have difficulty with organization and planning. It may also help reduce overwhelming feelings and anxiety and help minimize distractions.

Setting realistic expectations

Some people with ADHD may have unrealistic expectations about the amount they can achieve within a specific timeframe.

They may start to feel overwhelmed, which could cause them to lose focus and become distracted. This may result in the person achieving very little of what they set out to achieve.

To set realistic expectations, people can try:

  • making a list of tasks
  • ordering the tasks in order of priority
  • setting a timeframe for each task
  • using a timer to stick to an established timeframe

Doing tasks immediately

Some people with ADHD feel overwhelmed by everyday tasks to the point that they delay these errands indefinitely. A CBT practitioner may encourage someone to take prompt action to avoid procrastination and feelings of anxiety.

The therapist may encourage someone to take a hands-on approach. They may ask someone to bring a list of small, achievable tasks to the session, such as sending an email or scheduling a doctor’s appointment.

The therapist may then give the person the tools and strategies to fulfill the task during the therapy session.

Checking in with the therapist

A CBT practitioner may encourage their clients to book a check-in session between their regular sessions to help the client prepare for a bigger task, such as a university or job application.

These sessions may assist someone with their planning and organization and also help relieve feelings of overwhelmingness and anxiety.

Using physical tools

A CBT practitioner may encourage their client to use tools, such as checklists and calendars, to help them with planning and organization.

The therapist may also encourage people to keep journals of their thoughts to gain insights into their thought patterns and behaviors. Setting aside some time to reflect on these thoughts may help reduce impulsive behaviors.

Psychotherapy treatments for ADHD aim to helpTrusted Source people with the condition manage their symptoms. However, since ADHD presents in different types, the specific goals of CBT will be personal to the individual undergoing therapy.

As a 2018 review explains, practitioners achieve this by teaching various practical techniques and addressing the thoughts and behaviors behind potentially harmful or challenging elements of ADHD.

They may also help someone manage challenging emotions, such as anxiety or depression, and improve their self-esteem.

A 2023 meta-analysisTrusted Source of 28 studies suggests that CBT can effectively reduce core and emotional ADHD symptoms in adults. CBT also led to an increase in quality of life and self-esteem.

Research in a 2018 review of 14 studies suggests that CBT in combination with medication was more effective at reducing ADHD core symptoms in adults compared to using medication alone.

The review’s authors suggest CBT may also be effective at short-term reductions in anger, anxiety, and depression. However, they note that their evidence is low quality and that further long-term studies are necessary.

A 2017 study investigated the effectiveness of group CBT for children and adolescents with ADHD. One group received 20 sessions of group CBT alongside the medication methylphenidate (Ritalin), while the other received Ritalin only.

The groups did not differ in terms of cognitive and behavioral outcome measures. However, the CBT and medication group showed improvements in the following:

  • empathy
  • assertiveness
  • self-control

The study authors concluded that a mixed treatment approach combining group CBT and ADHD medication may help improve certain ADHD symptoms in children and adolescents.

“CBT principles can be very helpful for ADHD symptoms. CBT can help with cognitive distortions or what some refer to as stinking thinking. These cognitive distortions are irrational thoughts that can have negative effects on mental health. A person with ADHD may have the cognitive distortion of all-or-nothing thinking and think that if they aren’t perfect in what they are doing, they are a failure. It is easy to see how this type of thought can negatively affect your mood, anxiety, and overall self-esteem. CBT can help you reevaluate that thought and replace it with a more realistic, helpful thought. In time, the goal is for you to change the way you think about successes and misses.

CBT can also help people with behavioral interventions. For example, the skills used in CBT can help people with ADHD get comfortable and in a routine of working on tasks before the deadline is approaching to avoid the anxiety that comes with procrastination, or it can help people learn how to break seemingly overwhelming tasks into smaller, more manageable ones.”

— Nicole Washington, DO, MPH

The Association for Behavioral and Cognitive Therapies provides an online directory where people can search for a licensed CBT therapist in their state. The directory also allows individuals to search for a CBT therapist specializing in ADHD.

Alternatively, a doctor may be able to refer someone to a licensed CBT practitioner who specializes in treating ADHD.

The cost of CBT may differ according to various factors, including:

  • the state the person lives in
  • the CBT practitioner’s skills and qualifications
  • the length of the CBT treatment

Cognitive behavioral therapy (CBT) is a type of psychotherapy that provides a person with the tools and strategies they need to change unhelpful feelings, thoughts, and behaviors.

Attention deficit hyperactivity disorder (ADHD) symptoms can vary, so people with the condition may benefit from different CBT strategies and exercise. Broadly, some exercises that may help include breaking down tasks, setting realistic expectations, and keeping a thought journal.

People can use an online directory to find a local CBT practitioner who specializes in ADHD. Alternatively, a person can make an appointment with their doctor, who can refer them to a suitable CBT practitioner.