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CBT for ADHD: How It Works, Examples & Effectiveness

Published: December 12, 2022 Updated: January 4, 2023
Published: 12/12/2022 Updated: 01/04/2023
Headshot of Sidney Deupree, MA, LPC, NCC
Written by:

Sidney Deupree

MA, LPC, NCC
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD
  • What Is CBT?Definition
  • How Can CBT Help With ADHD?How It Helps
  • Common CBT Techniques For ADHDTechniques
  • Is CBT Effective For Treating ADHD?Effectiveness
  • When Can I Expect to See Results From CBT?Results
  • CBT & Medication For ADHDMedication
  • Examples of CBT For ADHDExamples
  • At-home CBT Exercises For ADHDAt-Home CBT
  • How to Find a CBT TherapistFind a Therapist
  • Final Thoughts On CBT For ADHDConclusion
  • Additional ResourcesResources
  • CBT for ADHD InfographicsInfographics
Headshot of Sidney Deupree, MA, LPC, NCC
Written by:

Sidney Deupree

MA, LPC, NCC
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. For most, ADHD is diagnosed in childhood and lasts through adulthood. Those with ADHD may have trouble paying attention, be fidgety or unable to sit still, or be unable to control impulsive behaviors. Cognitive Behavioral Therapy can be an effective treatment to help control these behaviors.

CBT therapy works! Connect with a therapist that uses CBT to treat ADHD. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

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What Is CBT?

Cognitive behavioral therapy is a practical type of therapy that looks at the way our thoughts, emotions, and behaviors are shaped by both our own preconceived notions and our environment. The goal of CBT is to help the individual learn to recognize irrational thought patterns that lead to negative behavioral outcomes, and construct new, rational thought patterns in their place.

How Can CBT Help With ADHD?

When working with someone with attention-deficit/hyperactivity disorder (ADHD), treatment usually involves extensive behavior modification. Behavioral interventions, organizational skills, and social skills are all areas of focus, whether the client is a child or has adult ADHD. CBT treats many of the peripheral symptoms of ADHD, such as procrastination and time and task management.

A CBT session focuses on these areas of daily functioning and the therapist creates a plan for treatment for adult ADHD to address these concerns. Tasks can range from staying on top of financial responsibilities to encouraging endeavors that facilitate personal wellbeing, including sleep, exercise, and hobbies.3

CBT For Children With ADHD

Cognitive behavioral therapy is usually the first treatment option for children under age six. It allows the parents to develop skills and training to effectively help their child. With children, a great deal of behavior management training with the parents and even with the child’s school is often required, as well as individual behavior training with the child.3

Under the age of six, behavior management can be just as effective as medication without the worry of side effects associated with ADHD medications.

Common CBT Techniques For ADHD

Working with someone with ADHD requires a great deal of focus on behavior modification, though other aspects of cognitive behavioral therapy (CBT), such as relaxation and cognitive restructuring, can also be beneficial for treating ADHD symptoms and signs.

Here are more common techniques used for working with ADHD:

S.M.A.R.T. Goals

S.M.A.R.T. means the goals are:4

  • Specific: the client knows exactly what it is they want to accomplish. The goal is clearly defined
  • Measurable: the client will know if progress is being made and when they have achieved their goal
  • Attainable: the client has the skills and resources necessary to reach the goal.
  • Realistic: It is something the client will devote their time and energy into accomplishing.
  • Time specific: an appropriate amount of time is set for completing the goal

Example: In the scenario of a teenager who is often delayed while going to school due to forgetting important items, SMART goals can help this teenager stay more focused so they don’t forget important school items and can get to school on time:

  • The specific goal in this situation is getting to school on time
  • It is measurable by tracking the time when they get to school
  • It is attainable because the teenager will have learned ways to organize themselves, such as making a checklist of items or organizing them the night before
  • It is realistic assuming the teenager is motivated and committed to this goal
  • Time specificity could be 1-2 weeks for this particular example

Cognitive Restructuring

Cognitive restructuring is the process of breaking down negative thinking patterns by identifying irrational thoughts and replacing them with rational ones. Though this may not seem like an integral part of a treatment plan for ADHD, it often is for those with ADHD & depression, anxiety, or low self-esteem. Cognitive restructuring helps retrain them to see themselves and their environment in a more positive, productive way.

Behavior Modification

Behavior modification works by identifying and eliminating any unwanted behaviors and encouraging and developing new, appropriate behaviors. Behavior modification in children typically requires parental involvement in treatment. The parents and therapist work together to develop an action plan for behavior modification, which the parents then apply at home. Collaboration with teachers is also beneficial as children often have the same behavior issues at school.

Skills Training

Skills training addresses life skills that may be difficult for those with ADHD. These skills include:

  • Time management
  • Social skills
  • Organizational skills
  • Healthy lifestyle adjustments

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Is CBT Effective For Treating ADHD?

CBT has long been established as one of the leading therapeutic approaches utilized for treating many mental health conditions. It is also one of the top-researched types of therapy and is therefore a highly evidence-based treatment approach.5

Here are examples of the effectiveness of treating ADHD with CBT:

  • In a series of studies, there was found to be a significant improvement in those with ADHD who received a combination of CBT and medication as compared with those who only received medication. These findings were found true for children, adolescents, and adults with signs and symptoms of ADHD6,7
  • In a randomized control trial examining the efficacy of CBT on college students with ADHD, measured over two semesters, it was found that these college students had overall improved executive functioning and better use of disability accommodations9
  • In a randomized clinical trial for adults with ADHD and substance abuse disorder, it was found that after 15 sessions of CBT therapy, these adults had reduced symptoms of ADHD and substance utilization11
  • In a review of studies pertaining to ADHD treatment for children aged 6 to 12, followed longitudinally for 24 months, it was found that CBT in addition to medication was found to be the most effective in mitigating ADHD symptoms than medications alone, though medications did have improvements as well11
  • CBT has also been proven effective in treating ADHD along with the often co-occurring conditions, such as anxiety, depression, and conduct disorder5

When Can I Expect to See Results From CBT?

Seeing results from CBT treatment depends on the individual and the variability of their symptoms. The standard treatment model of CBT is 10 to 12 sessions with one session a week, each session lasting one hour. It can take time to see results depending on other mental health issues or past traumas. It’s important to go in with an open mind and do the homework your therapist sets up for you in order to see timely results.8

CBT & Medication For ADHD

Traditionally, talk therapy combined with medication is the gold standard for treatment of ADHD. Different modalities of CBT, such as mindfulness-based CBT and motivational CBT, can also have a greater impact than traditional CBT depending on co-occurring mental health disorders such as depression, anxiety, or PTSD. Overall, medications and CBT work well in treating ADHD, however the combination of the two is shown to be most effective.11

Examples of CBT For ADHD

Everyone’s experience with ADHD is unique to them, but CBT can help with a variety of ADHD issues. Whether it’s trouble focusing at work or school, a behavioral issue, or problems getting out the door in the morning, CBT can provide techniques that lead to lasting change.

Trouble With Being Late & Staying Motivated

Melissa is a 45-year-old business professional. She was fired from her previous job after she received multiple reprimands for showing up late and not meeting deadlines for her assignments. She says she has a difficult time motivating herself to do activities that she doesn’t enjoy and often forgets due dates for her assignments.

Melissa is starting a new job and has decided to see a therapist to help her understand why she is struggling with these issues. Her therapist diagnosed her with ADHD and together they developed a treatment plan including daily planning of assignments and appointments, time management strategies, and cognitive restructuring to help her work through her feelings of frustration and a sense of failure..

Trouble With Academic Performance

Todd is 16 and in high school. His mom describes him as lazy and unmotivated. She worries that he will not be able to get into college after he graduates due to his poor academic performance. Though Todd does well on tests, he struggles with homework and lengthy assignments. His teachers say he doesn’t follow along during lectures and interrupts other students while they are talking.

Todd’s mom takes him to see a psychiatrist who diagnoses him with ADHD. The psychiatrist prescribes Todd medication and refers him to a CBT therapist to work on his behavioral issues. In therapy, Todd learns how to set goals for himself and break those goals down into smaller, easy-to-accomplish steps.

He applies this to his homework assignments and begins turning them in on time after he learns how to use a planner to keep track of assignments and due dates. He also learns social skills that help him have more productive interactions with peers and teachers.

Behavioral Problem & Inattention

Jay is 7 years old and starting 2nd grade. He was referred to the school counselor for behavioral issues. His teacher said she couldn’t keep Jay in his seat; he would constantly leave his desk and wander around the room. During a conference with his parents, the school counselor learned that Jay is having trouble at home as well.

His mom says she has to ask him multiple times to do simple tasks like picking up his toys or getting ready for bed. She says he becomes easily frustrated when making decisions and that leads to emotional outbursts. Jay’s school counselor completes testing and determines Jay has ADHD. She refers Jay to a CBT therapist who begins working with Jay and his parents.

Together they develop a detailed routine for Jay that begins from the time he wakes up to the time he goes to bed. They break down more complicated tasks like getting ready for bed into simple steps: Take a bath, put on pajamas, brush his teeth, comb his hair, read a story, then go to sleep. Having a routine helps Jay feel secure and more in control.

The therapist also works with Jay on impulse control and helps his parents implement effective rewards and consequences for his behaviors. The parents and therapist consult with his teacher and pass along the behavior strategies they’ve used with him that she can use with him in class.

At-home CBT Exercises For ADHD

There are many everyday changes you can make that help manage the symptoms of ADHD. If you’re concerned about your every-day wellbeing, working with a qualified therapist is always advised, but cognitive behavioral therapy techniques can be used in various settings outside of therapy in order to keep control over symptoms of ADHD.

Here are CBT techniques you can implement as part of your ADHD treatment plan:3

  • Create a routine: set a schedule each day from morning to night
  • Get organized and maintain organization daily: have designated spots for things like school supplies, shoes, and clothing
  • Manage distractions: learn what background noises impede attention and what may help, such as movement or music
  • Take breaks: try to break down long or complicated tasks into shorter, more manageable ones
  • Set goals and reward accordingly: make sure goals are achievable and rewards are congruent with the goal accomplished
  • Search for and create positive opportunities: those with ADHD may find certain situations stressful. Identifying ways in which you excel, whether work, school, or hobbies, can help create positive experiences
  • Maintain a healthy lifestyle: eating nutritious foods and getting regular physical exercise are an important part of overall health that can have a positive impact on managing ADHD symptoms

How to Find a CBT Therapist

Knowing how to choose a therapist can feel overwhelming. When contacting a provider, you can ask if they are familiar with cognitive behavioral therapy and how much clinical experience they have using CBT specifically for ADHD. An online directory is another great way to filter for CBT specialists that are available for in-person or online CBT sessions.

How Much Does CBT Cost?

CBT for ADHD can usually be covered by mental health insurance. Many children especially have coverage for ADHD treatment when it has been diagnosed by the child’s pediatric care team. However, there is still usually a copay for mental health services as well as a copay for medications, which can range from $10 and upwards of $100 depending on your insurance coverage.

Looking at “in-network” providers might be able to help with the out-of-pocket costs with copays and keep it as low as possible. Out-of-network providers or those who do not accept insurance may charge anywhere from $80 to $200 a session. Therapists and practices may offer sliding scale prices for sessions to ensure you are able to attend the full course of treatment.

Final Thoughts On CBT For ADHD

If your ADHD is holding you back in any way, CBT can provide helpful tools for changing your thought and behavior patterns. You don’t have to suffer alone—therapists with experience in ADHD can help you cope and live your best life with ADHD.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

BetterHelp Get support and guidance from a licensed therapist. BetterHelp has over 20,000 therapists who provide convenient and affordable online therapy. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Online-Therapy.com provides a weekly live video session, unlimited text messaging and self-guided activities like journaling. Starting at $64 per week, this is one of the most affordable options for CBT therapy. Try Online-Therapy

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You can search for therapists by specialty, experience, insurance, or price, and location. Find a therapist today.

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For Further Reading

  • ADHD Statistics and Resources
  • Best Books About ADHD
  • ADHD Podcasts
  • ADHD Youtube Channels
  • Mental Health America
  • REBT vs. CBT: Understanding the Differences

CBT for ADHD Infographics

Common CBT Techniques for ADHD How Can CBT Help with ADHD? CBT and Medication for ADHD

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • What is ADHD (2020), Center for Disease Control and Prevention Website. Retrieved from: https://www.cdc.gov/ncbddd/adhd/facts.html

  • Randall C. Wyatt, PhD and Erika L. Seid, MA. Cognitive Behavioral Therapy with Donald Meichenbaum, PHD. Retrieved from: https://www.academia.edu/32251626/Instrctr_Manual_CBM.pdf

  • Treatment of ADHD (2020), Center for Disease Control and Prevention Website. Retrieved from: https://www.cdc.gov/ncbddd/adhd/treatment.html

  • SAMHSA Native Connections. “Setting Goals and Developing Specific, Measurable, Achievable, Relevant, and Time-bound Objectives” (PDF). Substance Abuse and Mental Health Services Administration.

  • Dianne Grande. Cognitive Behavioral Therapy: How it works & what to expect (2020). Choosing Therapy. Retrieved from: https://www.choosingtherapy.com/cognitive-behavioral-therapy/

  • Sprich, S. E., Burbridge, J., Lerner, J. A., & Safren, S. A. (2015). Cognitive-Behavioral Therapy for ADHD in Adolescents: Clinical Considerations and a Case Series. Cognitive and behavioral practice, 22(2), 116–126. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/27616874/

  • Corbisiero, S., Bitto, H., Newark, P., Abt-Mörstedt, B., Elsässer, M., Buchli-Kammermann, J., Künne, S., Nyberg, E., Hofecker-Fallahpour, M., & Stieglitz, R. D. (2018). A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)-A Randomized Controlled Trial. Frontiers in psychiatry, 9, 571. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/30505283/

  • Osborne, D., Meyer, D., Moulding, R., Kyrios, M., Bailey, E., & Nedeljkovic, M. (2019). Cost-effectiveness of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder. Internet interventions, 18, 100277.

  • Anastopoulos, A. D., Langberg, J. M., Eddy, L. D., Silvia, P. J., & Labban, J. D. (2021). A randomized controlled trial examining CBT for college students with ADHD. Journal of Consulting and Clinical Psychology, 89(1), 21.

  • van Emmerik-van Oortmerssen, K., Vedel, E., Kramer, F. J., Blankers, M., Dekker, J. J., van den Brink, W., & Schoevers, R. A. (2019). Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: results of a randomized clinical trial. Drug and alcohol dependence, 197, 28-36.

  • Kemper, A. R., Maslow, G. R., Hill, S., Namdari, B., LaPointe, N. M. A., Goode, A. P., … & Sanders, G. D. (2018). Attention deficit hyperactivity disorder: Diagnosis and treatment in children and adolescents.

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: October 7, 2020
    Original Author: Sidney Deupree, MA, LPC, NCC
    Original Reviewer: Benjamin Troy, MD

  • Updated: November 22, 2021
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for Readability; Added the sections, “When Can I Expect to See Results From CBT?,” “CBT & Medication for ADHD,” and “How Much Does CBT Cost?.” Revised and added examples to “Common CBT Techniques for ADHD;” Added new research to “Is CBT Effective for Treating ADHD?” New content reviewed by Dena Westphalen, PharmD.

  • Updated: December 12, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

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Reviewed by:

Benjamin Troy

MD
  • What Is CBT?Definition
  • How Can CBT Help With ADHD?How It Helps
  • Common CBT Techniques For ADHDTechniques
  • Is CBT Effective For Treating ADHD?Effectiveness
  • When Can I Expect to See Results From CBT?Results
  • CBT & Medication For ADHDMedication
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  • At-home CBT Exercises For ADHDAt-Home CBT
  • How to Find a CBT TherapistFind a Therapist
  • Final Thoughts On CBT For ADHDConclusion
  • Additional ResourcesResources
  • CBT for ADHD InfographicsInfographics
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