Is There Any Real Benefit to Cognitive Behavioural Therapy in ADHD?

Have you, or someone you know, recently been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)? Receiving an ADHD diagnosis can be a confusing time - on the one hand your experiences are finally beginning to make sense; on the other, you now have a lot more questions to answer. The biggest among them being - so what now?

ADHD is a chronic condition. This means that ADHD is a condition that you will have to learn how to live with. However, there are various tips and tricks that can help you better manage your symptoms. 

The first line of treatment for ADHD is medication. At its root, ADHD is a neurodevelopmental disorder. Simply put, this means that ADHD has a biological basis and is caused by an imbalance in the chemicals in our brain (called neurotransmitters). Medication is thus required to regain a sense of chemical balance. 

So if ADHD is a balancing act between chemicals in my brain, why did my doctor recommend Cognitive Behavioural Therapy (CBT) as well?

That’s a good question. 

Yes, medication is an essential part of ADHD treatment. It helps reduce many of the symptoms associated with ADHD and can generally improve quality of life. But on its own it can only take you so far. 

Think of it as driving a car - you need to accelerate to keep moving;  but you also need to change gears, check your mirrors, and occasionally blast the horn to really optimise the process. Therapy for ADHD is a lot like the latter.  

Studies have found that a combination of medication and therapy is far more effective for managing symptoms of ADHD as compared to medication or therapy alone.

Okay, so how does CBT work? 

Let’s start with breaking down what CBT is.

Cognitive Behavioural Therapy is a psychotherapeutic intervention which focuses on the relationship between our thoughts, feelings, and behaviour.  The basic premise holds that how we think about a situation, will influence how we feel, and how we behave. 

Imagine you have a big exam coming up. You believe that the subject is difficult and that you are going to fail the exam (thought). This makes you anxious (feeling) which results in you deciding to watch some TV instead (behaviour). Now, since you haven’t studied, you might not do too well on the test, which will further (inaccurately) confirm your initial thought that the test was too difficult for you.

CBT works by helping clients identify and modify patterns in their thinking which might be affecting the way they view and interact with the world. It also equips them with relaxation and problem solving strategies to better cope with the ups and downs of life.

But, how does CBT benefit ADHD specifically?

Psychoeducation

A large goal of CBT for ADHD is arming you with appropriate  information. A CBT therapist will help you better understand what ADHD is and how it affects your day to day functioning. They will also outline the process of therapy. The aim is to know enough about your condition that it no longer feels alien or overwhelming.

Recognising and Restructuring Beliefs

CBT helps you recognise negative beliefs you may hold about yourself. For people with ADHD, a lifetime of missed deadlines, misinterpreting social cues, or forgetting important tasks, can lead to inherent negative beliefs about the self. You might think of yourself ‘as a failure’ or as ‘someone who can never get things right’. Not only does this take a toll on your self esteem, it can lead to pessimism, self criticism and loss of motivation. CBT can help you recognise the role such beliefs play in the way that you perceive the world and help you restructure them to be more adaptive for you.

Dealing with procrastination and distractions

Along with deep rooted thought work, CBT can also help you manage your day to day frustrations associated with ADHD -  procrastination, dealing with distractions, boredom. CBT therapists will work with you to create a system that works uniquely for you. This will include time management strategies, tactics to delay distractions, and ways to cope with negative emotions such as frustration or guilt. CBT will also help you: 

• Identify situations where such strategies might be useful

• Practise these strategies in session with your therapist

• Apply the strategies to real world situations 

Conclusion

ADHD can be a frustrating condition which takes a toll on all areas of your life. But, it is not without hope. With the right combination of medication and therapy you can learn to manage your symptoms and live a healthy, fulfilling life. CBT for ADHD can help you better understand your diagnosis, identify negative thoughts, and learn strategies to overcome the difficulties associated with ADHD.