CBT is a unique therapy that targets the dysfunctional thoughts and feelings that are preventing you from managing time, completing projects, and scheduling your life productively with ADHD.
Cognitive Behavioral Therapy (CBT) is an umbrella term for a group of interventions used to treat disorders like anxiety, PTSD, and ADHD. The way CBT is used to treat each condition varies, but all CBT focuses on cognitions — or thoughts — and behaviors in the here and now. It's a short-term, goal-oriented form of psychotherapy that aims to change negative thinking patterns with cognitive restructuring and change how patients feel about themselves, their abilities, and their futures. This ADHD therapy requires patients to get in touch with their thoughts and feelings and learn how to modify them when they’re dysfunctional.
A woman thinks positive thoughts because she knows negativity will kill her productivity.
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How Does CBT Work?
Cognitive behavioral therapy is based on the recognition that cognitions, or automatic thoughts, lead to emotional difficulties. Automatic thoughts are spontaneous interpretations of events. These impressions are susceptible to distortion, such as unfounded assumptions about yourself (or others), a situation, or the future. An unhealthy internal dialog could prevent an individual from working toward an aggressive goal, developing productive new habits, or generally taking calculated risks.
For adults with ADHD, the “cognitions” — or thoughts — addressed relate to the self-instructions used when beginning a task. This includes our thoughts on how to organize, prioritize, and plan. The behaviors addressed are physical skills and habits — for example, learning how to use a planner.
Man procrastinates by throwing a paper airplane in his office. CBT can improve procrastination.
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How Does CBT Change Behaviors?
“Oh that? I can do it later.” We're all guilty of procrastinating, but when we think this way consistently, we miss deadlines or create unnecessary stress. CBT trains the ADHD brain to instead think, “Let me look at what’s involved so I ensure I make the deadline.” Essentially, it replaces our dysfunctional thought patterns — which have gotten us into trouble before — with functional patterns to help get the job done.
According to J. Russell Ramsey, Ph.D., an effective CBT program will help adults with ADHD correct the following distorted thought processes and more:
All-or-nothing thinking —viewing everything as good or bad: If you don’t do something perfectly, you’ve failed.
Overgeneralization —seeing a single negative event as part of a pattern: For example, you always forget to pay your bills.
Mind reading — thinking you know what people think about you or something you’ve done — and it’s bad.
Fortune telling — forecasting that things will turn out badly.
Magnification and minimization — exaggerating the significance of minor problems while trivializing your accomplishments.
“Should” statements — focusing on how things should be, leading to severe self-criticism as well as feelings of resentment toward others.
Comparative thinking — measuring yourself against others and feeling inferior, even though the comparison may be unrealistic.
Man takes pills to treat his ADHD because medication works differently than CBT.
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Medication vs. CBT
CBT intervenes to lessen life impairments — procrastination, time management, and other common executive functioning difficulties — not to treat the core symptoms of inattention, hyperactivity, and impulsivity. Medication is best for basic attention functions like reducing distractibility or prolonging your attention span. In other words, medication can help you focus, but CBT tells you what to focus on.
The combination of medication and CBT is often the treatment of choice for dealing with the wide-ranging effects of ADHD. A 2024 meta-analysis published in the Journal of Attention Disordersfound that CBT plus medication is more effective than medication alone in improving adult ADHD symptoms and maintains an advantage for at least three months1
Woman having a conversation with her therapist about hypersensitivity.
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Does CBT Treat Comorbid Conditions?
CBT addresses ADHD symptoms and comorbidities, such as mood and anxiety disorders. The techniques used to treat each condition are different, so a therapist may decide to focus on one symptom or comorbidity individually before moving to the next one. Remember, none of these conditions will go away overnight. They all require the patient to practice, develop awareness, and challenge negative beliefs. Don’t get discouraged!
CBT teaches how to categorize tasks into urgent now and important (urgent later).
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How CBT Improves Executive Functions
CBT helps patients improve executive function skills. For example, CBT can help a patient learn how to prioritize tasks by using the Eisenhower Matrix, which is a simple, effective decision-making tool for determining which tasks deserve our immediate action, our long-term attention, our delegation skills, and our circular bins.
People hold hands to show compassion after being sensitive to criticism.
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CBT for RSD
Rejection sensitive dysphoria (RSD) is a common but misunderstood ADHD symptom. It is extreme emotional sensitivity and pain triggered by the perception that important people have rejected or criticized a person. For example, if your boss makes one negative comment about your work, you ignore everything else they said and immediately jump to “I messed up. I’m worthless.” In CBT, a therapist will examine the facts and determine if they support this conclusion. In most cases, they don’t — and over time, the patient will learn to respond to criticism in a more helpful and self-encouraging way.
There is little evidence that cognitive behavior therapy (CBT) is helpful for children with ADHD. However, children with ADHD may benefit from elements of CBT — like positive self-talk and learning coping strategies for emotional regulation.
A woman researches cognitive behavioral therapy techniques for adhd on her laptop.
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