What Does Cognitive Behavioral Therapy for ADHD Look Like? Here’s What You Need to Know

Cognitive Behavioral Therapy (CBT), in its simplest form, is therapy that helps you change your patterns of thinking and behaviors. But this is obviously a very broad definition. Each CBT therapist might have a vastly different approach. 

Having a broad definition of a single type of therapy can be great, because different people need different approaches. But it can also be confusing – how do you know exactly what you’re going to get and whether it will help you?

And if you have ADHD, you need a CBT therapist who understands ADHD brains.

CBT works best for ADHD when it’s focused on problem-solving. In order for ADHD brains to get something out of therapy, finding helpful solutions is key. So let’s break down how CBT and ADHD work together, and what you can expect when working with an ADHD expert. 

ADHD and CBT: Thought Patterns, Strategies, and Problem-Solving

People often assume that therapy will make them deal with the “emotional issues” behind a certain behavior. 

While this can sometimes be true, this approach typically isn’t helpful for people with ADHD. If you have ADHD, you probably won’t find much solace in things like journaling or deep breathing. Don’t get me wrong, these things can be helpful in relieving general stress. But they aren’t going to help you manage the issues at the core of ADHD. What will help is learning to deal with specific thoughts and habits that lead to unwanted behaviors.

Cognitive behavioral therapy for ADHD helps you come up with specific strategies to deal with issues you’re having in the here and now. This includes strategies to help you manage the tasks and challenges in your life that feel overwhelming. It also includes cognitive reframes to help you think about your challenges in a different light.

What Does Cognitive Behavioral Therapy for ADHD Look Like?

Many people with ADHD experience a lot of negative self-talk because of damaging societal stigmas. Growing up, you probably were told you are lazy or spacey. Your partner or friends might get frustrated at you for not listening to them. You might procrastinate at work and feel behind all the time. You might actively mask all your challenges to be more like everyone else around you. But you still struggle – and you probably beat yourself up for it.

As the famous saying goes, “We are our own worst enemy.” Your self-talk probably reflects the messages you’ve heard about yourself your whole life. But the things you tell yourself or believe about yourself aren’t necessarily true. 

One of the pillars of CBT is to help you gain clarity on what specifically in your life needs to change – and then set goals to work on those things.

This framework typically involves getting clear on what’s actually happening inside your head. A CBT and ADHD therapist will help you understand your emotional state about your issue. They’ll help you understand the cognitive distortions that are likely impacting your thoughts, beliefs, and behaviors. And then they’ll help you tackle those cognitive distortions so you can reframe your thoughts to be more helpful and accurate. 

The common cognitive distortions are:

• All-or-nothing thinking. Also known as black-and-white thinking, you see things in good vs bad and success vs failure. 
• Overgeneralization. You see one setback or failure as an indication that your whole life is a setback or failure. This may also be considered “catastrophizing.”
• Emotional reasoning. You assume things must be true based on how strongly you feel them. For example, “I feel stupid, so it must be true.”
• Comparative thinking. You compare yourself to others and see yourself in a more flawed light.
• “Should” statements. You criticize yourself using “should” and “shouldn’t” phrases a lot. 
• Magnification or minimization. You tend to put too much – or too little – importance and significance on certain circumstances or behaviors. 
• Mind reading. You assume people think badly of you, even when there’s no real evidence of this.
• Fortune telling. You make scary, negative, or otherwise inaccurate predictions about the future.
• Labeling. You label yourself based on something that happened. For example, if you are late on a deadline, you label yourself “stupid” and “a failure.”
• Personalization. You blame yourself for things that weren’t solely your fault, or you forego accountability entirely and blame others for things you are responsible for. 
• Discounting the positive. You ignore the positives of yourself or a situation, focusing instead on the negatives. You don’t think your own positive attributes really count. 

Understanding these cognitive distortions is key to changing thoughts and behaviors that don’t serve you. Unless you acknowledge the patterns of thinking that keep you stuck, you won’t be able to change your behaviors. 

So, for example, say you tend to let work projects pile up. Maybe the things you procrastinate on the most are boring or tedious, so you never start them. But then you might end up feeling overwhelmed, guilty, and anxious. You might always be rushing to finish deadlines on time, or turning projects in late. This can make your boss angry – and stress you out. 

You and your therapist can work together to figure out what exactly is going on here. You might be labeling yourself every time you procrastinate, calling yourself lazy and incompetent. Or maybe you compare yourself to your perception of your coworkers, wishing you could be more like them.

Once you understand the “why” behind your patterns of thinking and beliefs, you and your therapist can set about changing them by implementing specific strategies to help you.

In this phase of therapy, I help my clients break their issue down into manageable steps. In this example, we would figure out how to implement tools and strategies to get started on projects earlier. We would help you face the difficult emotions, like shame or guilt or overwhelm, that prevent you from completing a task in the first place. We would give you coping strategies to deal with difficult emotions and setbacks. And we would explore strategies that would help you. 

Everybody needs a little trial and error to find strategies that work for them. Some people might want to try the development and regular use of a watch, calendar, or to-do system with notifications or alarms. Others might need to focus on things that increase their self-care, like how to get better sleep or more exercise. 

Sessions might focus on how to implement problem-solving skills in your everyday life. They might look like figuring out how to be better organized, or how to procrastinate less. The sessions are designed to help you with whatever you feel is challenging for you. Whatever sessions may look like, they are built around finding solutions and solving the problems in your life. 

A CBT and ADHD Therapist Can Help You Cope With Your Challenges

If you want help coping with your ADHD, consider working with an ADHD and CBT therapist – like me. 

Together, we’ll look at the current thoughts and beliefs that rule your behaviors, find solutions to problems that plague you, and solve pressing issues in your life. 

You’ll learn how to understand your patterns of thinking, face difficult emotions, and find ways to feel more organized and on track. 

I’m ready if you are. Reach out today to get started.