Exploring Therapy for Adults With ADHD: 11 Options & How They Work – ADDA

Around 30% of adults don’t respond well enough to standard drug treatment for ADHD.^[1]

This is where ADHD therapy comes into the picture as an alternative management option. Or an additional, evidence-backed treatment, even when medication is working as intended.

Studies have shown that a combination of drug and behavioral therapy for ADHD can lead to significant improvements in symptoms in adult ADHD.^[2]

These therapies enhance treatment by helping people build the structures, skills, and habits they need to thrive and succeed.

Through ADHD therapy, you can work on key areas, such as communication, focus, emotional regulation, and time management.

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Exploring Different Science-Backed Therapies for Adult ADHD

While medications are effective for many, adults with ADHD can also manage their symptoms through other methods, such as behavioral therapy, ADHD coaching, and support groups.

There are a few behavioral therapies for ADHD, including:

• Mindfulness-based cognitive therapy
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy
• Neurofeedback

You might be wondering what type of therapy best treats ADHD in adults. Well, it boils down to your personal preference and individual response to treatment.

While CBT has the most scientific evidence proving its efficacy, other therapies might work better for you. How well your treatment works also depends on your symptoms and their severity, as well as your therapist’s expertise and experience level.

The good news is you don’t have to stick to just one form of therapy. Some people find that combining two types of ADHD therapies helps them control their symptoms more effectively.

Let’s take a deeper look at how these different forms of therapy help manage ADHD.

Cognitive Behavioral Therapy (CBT) for ADHD

CBT is a goal-oriented, short-term psychotherapy that helps you pinpoint unhealthy thinking and behavioral patterns. Research has found that CBT can help adult ADHDers manage their symptoms and boost their self-esteem.^[3]

One example of an unhealthy thought pattern that CBT addresses is the all-or-nothing mindset. This way of thinking causes you to procrastinate or avoid tasks you think cannot be done “perfectly.” Other examples include comparing yourself to others, magnifying your mistakes, and downplaying your achievements.

Through CBT, you’ll learn how to dismantle these unhelpful beliefs and habits and replace them with new, beneficial ones.

Apart from changing how you perceive yourself and your capabilities, this adult ADHD therapy can also help you work on different skills and areas. They include the following:^[4]

• Relationships and friendships
• Organization and planning
• Focus and attention
• Problem-solving
• Procrastination

Your therapist will help you devise practical strategies to overcome your ADHD-related challenges. For instance, they may guide you in building a system, such as a calendar, task list, or finding an app to help you stay on track and complete your tasks on time.

Mindfulness-Based Therapy for ADHD

Mindfulness-based cognitive therapy (MBCT) is a treatment approach that combines both CBT and mindfulness meditation. Through this form of therapy, you’ll gain a deeper understanding of ADHD and its symptoms.

The CBT portion of this treatment helps you identify and modify problematic thought patterns.^[5]

You’ll also engage in mindfulness meditation under this program. Mindfulness meditation is a type of mental training thought to enhance the function of brain regions altered by ADHD.^[5]

Based on research studies, MCBT has been shown to improve the following areas:

• Attention and focus: Mindfulness trains a person to pay attention in a particular way. The aim is to purposefully focus on the present moment without judgemental thoughts. Because of this, mindfulness may help improve concentration in those with ADHD.^[6]
• Emotional reasoning: This ADHD treatment for adults teaches individuals to regulate how they experience and express emotions. For example, participants will learn to view emotional states as temporary, passing events – helping them control their emotions better.^[5]
• Impulse control: MBCT can sharpen a person’s self-awareness and emotional regulation, thus improving impulse control.
• Executive functioning: Mindfulness meditation training enhances executive function.^[4]This refers to the mental skills that allow you to plan, organize, focus, and juggle multiple tasks.
• Mental health: Research has found that MBCT can help reduce anxiety, depression, and stress.^[7]

Based on current evidence, MCBT can be offered in addition to medication or as an alternative management option for ADHDers who don’t respond well to drug treatment.

Dialectical Behavioral Therapy (DBT) for ADHD

DBT is a form of talk therapy that teaches a person to manage their emotions and behaviors. It is one means of treating ADHD at home and can be conducted in various ways, such as through group, individual, or phone sessions.

The goal of DBT is to help a person build essential skills to cope with day-to-day activities and replace unhelpful behaviors with positive ones.

DBT focuses on the following four main components:^[8]

• Mindfulness: As discussed earlier, mindfulness helps an individual focus on the present moment in a calm and non-judgemental manner.
• Emotional regulation: This component can teach you how to express your emotions and change your response to various situations. You’ll learn to manage difficult feelings and be less vulnerable to negative emotions.
• Interpersonal effectiveness: In DBT, you’ll also find out how you can culture positive relationships, build proper boundaries, and end unhealthy friendships. You’ll work on your communication skills, listening skills, and self-respect.
• Distress tolerance: This form of training teaches you how to apply various self-soothing techniques when facing difficult situations. You’ll learn to develop healthy coping mechanisms to overcome tough times and challenges.

During therapy sessions, your therapist will teach you how to apply these skills to your daily life. They might also provide homework assignments that encourage you to practice them in your day-to-day life.

Based on research studies, DBT can reduce the severity of ADHD symptoms, depression, and feelings of hopelessness, as well as improve mindfulness. It may also enhance social skills, decrease impulsivity, and boost the overall quality of life of adults with ADHD.^[9]

Therefore, researchers concluded that this therapy might be helpful if you don’t respond well to drug treatment.^[9] 

Neurofeedback for ADHD

Neurofeedback is a type of brain training that involves measuring brain activity. It uses an electroencephalogram (EEG), a non-invasive test that measures your brain’s activity.

The measured activity is then translated into sounds or visual cues presented to you in real time. This feedback allows you to learn to control and modulate your brain activity to achieve specific goals through trial and error.^[10]

Neurofeedback therapy generally involves the following steps:

• You’re given a simple task, like reading, while having the device hooked up to you.
• The EEG measures your brain waves and activity.
• Feedback is provided in real-time.
• When you achieve optimal brain activity, the feedback provided may be as simple as a beep you hear or something more complex like moving a character in a video game.
• Whenever you get distracted or lose focus, the feedback changes. For instance, your character might stop moving in the game.

Some research has found that neurofeedback can be a promising treatment option for ADHD. In fact, one scientific analysis showed that neurofeedback might be as effective as stimulant medications in as little as 35 sessions.^[11]

Holistic Approaches to Complement Adult ADHD Therapy

Different non-medical approaches can address symptoms of ADHD along with co-occurring issues, such as depression, anxiety, interpersonal conflict, and low self-esteem.

If you’re looking for a holistic way to manage your symptoms of ADHD, you may consider asking your healthcare provider about the following options:

• Music therapy: Music therapy can be active, where you’ll play an instrument, or passive, which involves listening to music. Some research has found that active music therapy may help improve social skills and reduce aggression or impulsivity. Passive music therapy was found to enhance attention and academic skills.^[12]
• Pet therapy: Animal-assisted therapy typically involves a trained pet and an owner with a diagnosed condition, such as ADHD. A service dog, for instance, can help an ADHDer release excess energy and reduce anxiety or distress.
• Art therapy: This type of therapy can help ADHDers enhance their problem-solving skills and focus, as well as increase relaxation and reduce stress. During art therapy, you’ll work with a professional to create works of art that can help you express and work through your thoughts and emotions.
• Interpersonal therapy: Interpersonal therapy helps you process and resolve any issues or conflicts that might have developed between you and others due to ADHD-related behaviors. It can also help address personal issues, low self-esteem, and feelings of failure.^[13]
• Occupational therapy: This therapy guides ADHDers in building the skills needed to adapt well to their environment. It helps people identify barriers to success in their workplace, school, or home and find solutions to overcome them.
• ADHD coaching: An ADHD coach will collaborate with you to set up structures that bring you closer to your goals. They’ll teach you skills and strategies to improve your time management, organization, and focus.
• Support Groups: ADHD support groups offer a safe place for ADHDers to connect with people on the same journey. You’ll be able to exchange advice and gain support and a sense of belonging in a non-judgemental community.

The best management option for your ADHD depends on your symptoms, struggles, and goals.

For instance, someone who wants to build meaningful relationships and resolve conflict might benefit from interpersonal therapy. Meanwhile, a person who wishes to understand and regulate their emotions better might opt for art therapy.

Leveraging the Power of Therapy to Manage ADHD

Medications are effective for a large group of people. However, they may not improve all symptoms of adult ADHD. Plus, they affect different people in different ways.

Because of this, the best treatment approach is to combine medication, therapy, and other management options, such as counseling and coaching. This enables you to create a holistic treatment plan that addresses all ADHD-related challenges in your career, academics, or relationships.

Remember that seeking therapy, coaching, or counseling isn’t a sign of weakness. Quite the opposite, acknowledging and tackling your struggles head-on is a brave step in the right direction.

With the skills, structures, and strategies you build through therapy, you’ll be in the best position to achieve your biggest goals and ambitions.

Check out ADDA+ for more expert-driven resources that will help you thrive as an adult with ADHD. You can also visit our virtual support groups, where you can seek advice and encouragement from those who have walked in your shoes.

References

[1] Basiri, N., & Hadianfard, H. (2023). Adult ADHD Treatment Based on Combination of Dialectical Behavior Therapy (DBT) and Transcranial Direct Current Stimulation (tDCS) as Measured by Subjective and Objective Scales. Journal of attention disorders, 27(1), 57–66. https://doi.org/10.1177/10870547221118527

[2] Knouse, L. E., & Safren, S. A. (2010). Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. The Psychiatric Clinics of North America, 33(3), 497–509. https://doi.org/10.1016/j.psc.2010.04.001

[3] Antshel, K. M., Hargrave, T. M., Simonescu, M., Kaul, P., Hendricks, K., & Faraone, S. V. (2011). Advances in understanding and treating ADHD. BMC medicine, 9, 72. https://doi.org/10.1186/1741-7015-9-72

[4] Sprich, S. E., Knouse, L. E., Cooper-Vince, C., Burbridge, J., & Safren, S. A. (2012). Description and Demonstration of CBT for ADHD in Adults. Cognitive and behavioral practice, 17(1), 10.1016/j.cbpra.2009.09.002. https://doi.org/10.1016/j.cbpra.2009.09.002

[5] Bachmann, K., Lam, A. P., & Philipsen, A. (2016). Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective. Frontiers in psychiatry, 7, 117. https://doi.org/10.3389/fpsyt.2016.00117

[6] Janssen, L., Kan, C. C., Carpentier, P. J., Sizoo, B., Hepark, S., Grutters, J., Donders, R., Buitelaar, J. K., & Speckens, A. E. M. (2015). Mindfulness based cognitive therapy versus treatment as usual in adults with attention deficit hyperactivity disorder (ADHD). BMC Psychiatry, 15(1). https://doi.org/10.1186/s12888-015-0591-x

[7] Aadil, M., Cosme, R. M., & Chernaik, J. (2017). Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults: A Literature Review. Cureus, 9(5). https://doi.org/10.7759/cureus.1269

[8] Linehan, M. M., & Wilks, C. R. (2015). The Course and Evolution of Dialectical Behavior Therapy. American Journal of Psychotherapy, 69(2), 97–110. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97

[9] Cole, P., Weibel, S., Nicastro, R., Hasler, R., Dayer, A., Aubry, J. M., Prada, P., & Perroud, N. (2016). CBT/DBT skills training for adults with attention deficit hyperactivity disorder (ADHD). Psychiatria Danubina, 28(Suppl-1), 103–107.

[10] McGough, J. J. (2022). Neurofeedback for ADHD: Time to Call It Quits? American Journal of Psychiatry, 179(12), 888–889. https://doi.org/10.1176/appi.ajp.20220861

[11] Enriquez-Geppert, S., Smit, D., Pimenta, M. G., & Arns, M. (2019). Neurofeedback as a Treatment Intervention in ADHD: Current Evidence and Practice. Current psychiatry reports, 21(6), 46. https://doi.org/10.1007/s11920-019-1021-4

[12] Martin-Moratinos, M., Bella-Fernández, M., & Blasco-Fontecilla, H. (2023). Effects of Music on Attention-Deficit/Hyperactivity Disorder (ADHD) and Potential Application in Serious Video Games: Systematic Review. Journal of medical Internet research, 25, e37742. https://doi.org/10.2196/37742

[13] Gentile, J. P., & Atiq, R. (2006). Psychotherapy for the patient with adult ADHD. Psychiatry (Edgmont (Pa. : Township)), 3(8), 31–35.