ADHD and Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is commonly used in the treatment of children, adolescents and adults with ADHD. A type of psychotherapy, CBT helps an individual to identify self-defeating behaviors. CBT techniques are designed to undermine these behaviors through intervention and the introduction of more positive approaches.¹

CBT has been shown to be effective at reducing the symptoms of ADHD in both children and adults. In children, CBT can motivate a child to calm down enough to cope with school and other challenges. In adults, CBT can help an individual to better meet their goals through thinking and self-management skills.²

Read more details about Cognitive-Behavioral Therapy (CBT).

In the 1971 article “Training Impulsive Children to Talk to Themselves: A Means of Developing Self-Control,” Dr. Donald Meichenbaum showed how CBT could be used to teach self-control in children who struggled with impulsivity. In some of Dr. Meichenbaum’s original studies, the technique—commonly known as “stop, look and listen”—proved effective on ADHD. CBT has also proved effective in helping preschoolers to stay on task in the classroom.³

CBT has also shown to be effective for improving children behavior in the classroom. Preschooler’s on-task behavior improved after just two hours of CBT, according to a 1976 study. In addition, their improvements ended up lasting up to two months.⁴

While further research was unable to support these finding, Dr. Phillip Kendall and Lauren Braswell concluded in their 1985 book Cognitive-Behavioral Therapy for Impulsive Children that CBT, when accompanied by behavioral contingencies, was effective in reducing impulsivity.⁵

Unlike medication treatment, CBT takes time. Depending on the circumstances, CBT can take anywhere from 12 weeks to nine months to complete. Techniques vary, particularly between children and adults. For children, CBT generally consists of a system of rewards and praises. When a child behaves well, he or she is rewarded with praise, small treats or privileges such as the right to stay up past bedtime. In adults, CBT generally takes the form of skills training, setting priorities, problem solving and managing stressful situations.⁶

In Beyond Ritalin, Stephen W. Garber and Marianne Daniels Garber describe two general CBT techniques for promoting self-control in individuals of all ages. Under the broad category of self-monitoring, the authors describe a process for solving problems, including the following six steps: 1. Define the problem 2. List possible solutions 3. Focus attention on the problem 4. Choose a solution 5. Try the chosen solution 6. Self-reinforce and/or self-correct.⁷

Find a mental health professional that specializes in CBT. For a list of certified CBT therapists, go to the Association of Behavioral and Cognitive Therapies website at http://abct.org/public/. CBT for ADHD is also offered at the Institute for Attention Deficit Hyperactivity and Behavior Disorders at New York University’s Child Study Center and the Duke Child and Family Study Center in North Carolina.

While there are no serious side effects stemming from Cognitive Behavioral Therapy, CBT is not for everyone and another type of treatment may work better for different individuals. CBT is also not a quick fix. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for you. This will take an investment of time and money on the individual’s part. Moreover, if you are feeling low energy, depressed, or anxious, it can be difficult to concentrate and get motivated and CBT relies on the individual engaging with the process, trying new strategies, and completing “homework” in between sessions. You need to have a certain degree of motivation to benefit from CBT. Lastly, to overcome anxiety or any other psychological disturbance, you need to confront it. This may lead you to feel more anxious for a short time.² However, if you are able to tolerate this, you may benefit from CBT and ultimately feel some relief from your symptoms. A good therapist will pace your sessions. You decide what you do together, so you stay in control and take on what you feel comfortable with.

1. Thomas E. Brown, Ph.D., Attention Deficit Disorder: The Unfocused Mind in Children and Adults, (New Haven and London: Yale University Press, 2005): 284.

2. Nancy Shute, “Cognitive Behavioral Therapy Can Help With ADHD,” U.S. News and World Report Health, August 24, 2010, http://health.usnews.com/health-news/blogs/on-parenting/2010/08/24/cognitive-behavioral-therapy-can-help-with-adhd.

3. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, Beyond Ritalin (New York: Villard Books, 1996): 146.

4. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, Beyond Ritalin (New York: Villard Books, 1996): 147.

5. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, Beyond Ritalin (New York: Villard Books, 1996): 147.

6. Stephen W. Garber, Ph.D., Marianne Daniels Garber Ph.D., and Robyn Freedman Spizman, *Beyond Ritalin *(New York: Villard Books, 1996): 148–149.

7. Nancy Shute, “Cognitive Behavioral Therapy Can Help With ADHD,” U.S. News and World Report Health, August 24, 2010, http://health.usnews.com/health-news/blogs/on-parenting/2010/08/24/cognitive-behavioral-therapy-can-help-with-adhd.