Cognitive Behavioral Therapy for ADHD: Techniques and Options

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If you’re looking for a different treatment for ADHD, you might want to try cognitive behavioral therapy (CBT).

Treatment for Attention Deficit Hyperactivity Disorder (ADHD) aims to reduce the impact the symptoms can have on your daily life.

Medications can help reduce your symptoms, and therapy can teach strategies to help you understand and cope with your symptoms.

But what type of therapy is best for ADHD? Cognitive-behavioral therapy (CBT) may be an option.

Cognitive-behavioral therapy (CBT) is psychotherapy that teaches you to identify thoughts that are working against you and turn them into helpful thoughts.

CBT is based on the idea that your thoughts affect your emotions, which can affect your behavior.

Slipping into a negative thought and behavior pattern is easy. CBT helps you identify these patterns and change them.

For example, you might have a big school assignment or a work project with a deadline, and you’re worried that you won’t be able to finish it on time.

Negative reason

  • Thought. “I can never finish this by the due date.”
  • Feeling. You become overwhelmed.
  • Behviour. You practice avoidance behaviors such as procrastination, and you end up missing the deadline and feeling bad about your performance.

You might reflect on that experience and think your problem was just procrastination. Your CBT therapist can help you identify the initial thought that led to your delays and modify it to create a positive pattern.

Positive trend

  • Thought. “It’s a lot of work, but if I start now and break it down into small pieces, it will be easier. And I can finish on time.
  • Feeling. You feel hopeful.
  • Behviour. You start working, notice your progress as you complete small sections, and keep going. You finish on time and are satisfied with your performance.

ADHD is more than impulsiveness and distraction. As you come across situations in which you feel unregulated and out of control, you can develop negative thought patterns.

Examples include:

  • “I’m not good at that kind of stuff.”
  • “There’s no point in trying.”
  • “I’m not as smart as the others.”
  • “I lose everything.”
  • “I will never be able to pull myself together.”
  • “Everything is too difficult.”

Cognitive-behavioral therapy for ADHD helps you reframe such thoughts and turn them into positive, proactive alternatives.

For example:

  • negative thought pattern: “I’m not good at that kind of stuff.”
  • positive thought pattern: “I’m better at other things, and nobody’s good at everything.”

Several CBT techniques can help you make positive changes in your life. A mental health professional can help you decide which ones to try and where to start.

Successive approximation

If you have problems with the execution of tasks, the successive approximation can help you. This technique involves working your way up to the task you find difficult by taking smaller, easier steps.

Your therapist can help you set small goals and choose a starting point. If you encounter a trigger, you can use exposure therapy to overcome it.

Exposure therapy

This strategy can be used to help manage different types of anxiety. The basic principle of this therapy is that if you face your fears enough, eventually they will become more manageable.

There are different types of exposure, such as imaginary life and real life.

Interoceptive exposure allows you to experience the physical sensations of anxiety so that they affect you less as you get used to them.

Some exposure therapies can be performed using virtual reality, such as targeting fear of heights.

Guided discovery

In Guided Discovery, your therapist becomes familiar with your perspectives and then helps you expand your thinking by challenging your beliefs. It gives you new perspectives that you may not have considered.

You might think you have a bad memory. The truth may be that you don’t retain information that doesn’t seem relevant or interesting, but your memory is good in other cases.

Guided discovery can help you make that distinction, motivating you to try memory-enhancing strategies for information that doesn’t interest you.

Cognitive restructuring

This technique allows you to challenge negative self-talk and reframe it as more constructive and positive.

For example:

  • negative interior monologue: “I don’t even know why I bother. I won’t anyway.
  • positive self-talk: “I’ve struggled to get things done in the past, but I’m learning new tricks to stay organized and on task. So I’m confident I’ll improve in that area.

Distractibility delay

This technique helps you become more aware of the distractions that interfere with your productivity and gives you strategies for dealing with them.

One strategy is to use a timer to see how long you can stay focused before your mind wanders. Once you know how much time you have, you can use that to plan your rolling approximation exercise.

If you can concentrate for 10 minutes, you might want to make sure each step of the task is no longer than 10 minutes.

The Distractibility Delay also teaches you to write down your distractions rather than dealing with them. If you’re in the middle of a 10-minute task, try to take note of the distraction, then deal with it once your 10-minute task time is up.

Studies support the use of CBT to help treat ADHD symptoms.

A 2018 review found that medication and CBT improved functioning and reduced depression and anxiety in people with ADHD more than medication alone.

The researchers found a similar result in a study 2016 featuring teenagers. CBT therapy has added benefits to drug therapy in adolescents who still had ADHD symptoms while taking medication.

The benefits of CBT appear to persist after the therapy sessions end, as demonstrated in a 2018 study of college students. Although their grades did not change much, CBT therapy resulted in:

  • reduces ADHD symptoms
  • improved executive functioning
  • decrease in symptoms of depression and anxiety
  • increased credit hours attempted and earned

The benefits persisted for 5-7 months after the CBT therapy sessions ended.

Cognitive-behavioral therapy is an effective treatment for many people with ADHD.

This type of therapy allows you to examine your thought patterns and restructure them in more useful ways. There are several ADHD symptoms that you can manage using this approach.

CBT with medication has been shown to produce better results than medication alone. The useful effects of CBT can continue for months after the treatment sessions have ended.

If you’re interested in trying CBT and don’t yet have a therapist, consider asking a medical professional to refer you to a qualified mental health professional.

If you’re not sure where to start, you can check out Psych Central’s hub for mental health support.

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