Cognitive behavioral therapy for ADHD

The nature of cognitive-behavioral therapy (CBT) and how it can be used to help individuals with ADHD has sparked a lot of curiosity, but there's also a lot of misunderstanding. Cognitive-behavioral therapy (CBT) is a type of mental health treatment that focuses on the "here and now" thoughts and behaviors. This differs from typical psychoanalytic or psychodynamic treatment, which entails recapturing and reprocessing childhood events that may have led to contemporary emotional issues. CBT differs from past therapies in that its aims and procedures are defined explicitly and can thus be measured for each individual.

CBT's Beginnings and Early Applications

CBT evolved from a fusion of cognitive therapy (created by Aaron Beck in the 1960s and popularized by Albert Ellis) and behavior therapy (established by B.F. Skinner, Joseph Volpe, and others). We all have automatic thoughts, according to Beck and Ellis, that occur in response to an event, situation, or other stimuli. These thoughts or cognitions may be beneficial, resulting in happy feelings and successful coping, or they may be harmful, resulting in depression or anxiety, as well as maladaptive behavior. Irrational ideas or cognitive distortions are often the source of unpleasant thoughts. Here are several examples:

Perfectionism is fueled by all-or-nothing thinking.

Negative occurrences or outcomes are given special focus (and overlooking positive outcomes)

catastrophizing is the belief that something will be a disaster if it happens or does not happen.

Personalization is the act of considering oneself as the primary cause of a terrible external incident for which one is not accountable.

Therapy aids in the identification of these irrational beliefs by challenging and eventually negating them through discussion and home exercises, which usually include keeping thinking logs.

Cognitive therapy has evolved through time to treat depression and a variety of anxiety disorders, including generalized anxiety disorder, social anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder. In treatment, both negative behaviors and negative ideas are addressed (hence the term cognitive-behavioral therapy). Within the session and at home, exercises often entail progressive, systematic exposure to arousing events, as well as the development and practice of skills to better control those situations, as well as confronting any unreasonable automatic ideas that may arise.

What role does CBT play for adults with ADHD?

Adults with ADHD can benefit from CBT in two ways. First, in recent years, CBT programs for adults with ADHD have been designed expressly for them. Some of these programs are designed to assist people in improving their executive functions, which are required to effectively manage time, organize, and plan in the short and long term. Others concentrate on emotional self-control, impulse control, and stress management.

Furthermore, it is widely known that individuals with ADHD are more prone than adults in the general population to suffer from anxiety and depressive disorders. In a big nationwide survey, it was discovered that 51% of persons with ADHD had co-morbid anxiety and 32% had co-morbid depression. Treatments for these diseases that include CBT may thus be beneficial to many adults with ADHD, even if they are not expressly designed to address the symptoms and impairments associated with ADHD.

Executive dysfunction programs are classified as cognitive-behavioral therapy because they teach more adaptive cognitions about how to plan, organize, and prioritize tasks, as well as more successful behavioral skills. The self-instruction to "break down hard or unpleasant tasks into manageable portions" is an example of adaptive cognition. Using a planner on a regular basis and creating a file system are two examples of behavioral skills. Positive thoughts and actions reinforce one another; as a person gets more adept at managing time, he or she develops more positive self-beliefs and cognitions, which help to produce and maintain more adaptive behaviors.

In the treatment of adults with ADHD, how does CBT compare to medication?

Numerous studies have demonstrated that stimulant and non-stimulant medications are beneficial in treating ADHD in adults. CBT has been shown in studies to be beneficial whether or not a person is being treated with medication. Although no direct comparisons of CBT and medication have yet been made, clinical experience suggests that they have different effects: While medication can help with the fundamental symptoms of distractibility, short attention span, and impulsivity, CBT is more successful at improving executive self-management habits and skills, as well as emotional and interpersonal self-control.