An Introduction to Cognitive Behavioral Therapy (CBT)
Do you ever feel like you’re just winging it—getting things done but barely scraping by? Or maybe you feel like you’re always running on empty? If you’re living with attention deficit hyperactivity disorder (ADHD), these scenarios are all too real. But ADHD isn’t that straightforward. It exists on a spectrum, and not everyone experiences the same symptoms. So, the healing journey can feel like a slippery slope. However, cognitive behavioral therapy for ADHD offers a promising solution. By examining the connections between thoughts, emotions, and behaviors, cognitive therapy helps manage your symptoms, shifting you from survival mode to feeling in sync with who you are and what you want. Let’s explore how it can make a world of difference.
Cognitive behavioral therapy (CBT) teaches us how our thoughts, emotions, and beliefs shape our choices, actions and behaviors. For example, if you have adult ADHD and you’re preparing for a big presentation at work, you might think, “If I mess up, my colleagues won’t think I’m good enough.” The pressure overwhelms you, and anxiety sets in. Nervous about making mistakes, you put off practicing and putting in the effort. As the presentation date approaches, your stress intensifies, and you procrastinate even more. Finally, you rush through the presentation at the last minute and give a shaky performance. You scan your colleague’s facial expressions and automatically believe they think you’re incapable, reinforcing your fear and making it more difficult to give a presentation in the future. These negative thought patterns can impact all areas of life, from work to personal relationships, affecting your self-esteem and thus, ignoring your achievements and what makes you wonderful. But CBT therapy helps you identify and change these unhelpful thoughts. For instance, using the same example, you might break your tasks into manageable steps, reducing overwhelm and allowing for more thorough work. You may also realize despite the rushed work, you did many things well. Through various techniques and strategies, you can foster more realistic beliefs, improve your overall well-being, and tackle your ADHD symptoms effectively.
Common Symptoms of ADHD in Adults
Adult ADHD can be tricky to pin down because there’s not as much research. Even though it usually starts in childhood, the symptoms often stick around into adulthood but manifest differently. For instance, you might notice less hyperactivity but more trouble with focus as adult responsibilities pile up.
Nonetheless, here are a few core symptoms to observe:
- Carelessness and lack of attention to detail
- Starting new tasks before finishing old ones
- Poor organizational skills
- Difficulty focusing or prioritizing
- Frequently losing or misplacing things
- Forgetfulness
- Extreme impatience
- Restlessness and edginess
- Difficulty keeping quiet and speaking out of turn
- Interrupting others and blurting out responses
- Mood swings, irritability, and quick temper
- Inability to handle stress
- Poor time management
- Taking risks without regard for personal safety, like reckless driving
CBT for ADHD: How It Works, Examples & Effectiveness
After everything, you may have a few questions, such as “Why is cognitive behavioral therapy effective for ADHD? And how can CBT help with ADHD symptoms?”
Cognitive behavioral therapy treats adult ADHD by helping you develop organizational skills, build coping skills, set realistic goals, and create structured routines
Here are a few studies that support its effectiveness:
- A 2023 meta-analysis of 28 studies found that CBT significantly reduces core and emotional symptoms of ADHD in adults, leading to less depression and anxiety and boosting self-esteem and quality of life.
- A 2021 study provided cognitive behavioral therapy using a chatbot to 46 individuals aged 19–60 for four weeks. Participants showed major improvements, particularly in ADHD Hyperactive-Impulsive symptoms and overall ADHD symptoms.
- A 2020 meta-analysis reviewed non-medicine therapy for ADHD. It found approaches like cognitive-behavioral therapy significantly improved attention disorders, concentration, and working memory.
- A 2018 study tracked college students through a CBT program over two semesters. They experienced big gains in executive functioning and drops in anxiety and depression. These benefits lasted for 5 to 7 months after treatment, showing CBT’s long-term effectiveness for ADHD.
How CBT Can Support the Treatment of ADHD Symptoms
Through cognitive behavioral therapy, you learn various techniques and coping strategies to challenge negative thought patterns, reduce impulsivity, complete tasks, build new skills and improve focus and self-control. Here are a few skills you’ll learn in CBT:
1. Change Your Beliefs
As you find yourself in more situations where you feel unregulated and out of control, you might develop negative thoughts like:
♦ I can’t do anything right ♦ There’s no point in trying ♦ I’m not as smart as other people ♦ I’m a failure
You may also tend to:
♦ Polarize: Seeing situations in extreme black-and-white terms without considering the gray areas. For example, you might believe if a friend doesn’t immediately respond to your text, they must be upset with you.
♦ Catastrophize: Assuming the worst possible outcome will occur. For instance, thinking that if you make a mistake at work, you’ll definitely lose your job and ruin your career.
♦ Filter: Focusing exclusively on negative details while ignoring positive aspects of a situation: you receive many compliments on a project but dwell only on one critical comment.
Cognitive behavioral therapy for ADHD helps you turn these negative thoughts into positive ones. For example, “I’m better at other things, and no one is good at everything. And “My friend probably didn’t text me because she was busy”.
2. Break Tasks into Smaller Parts
Successive approximation, also known as shaping, is a technique used to help you gradually achieve a desired behavior or task by breaking it down into smaller, manageable steps.
Let’s say you struggle to complete tasks like a lengthy assignment due to difficulty focusing for extended periods.
Here’s how successive approximation could help:
- Identify the Task: The task is to complete a 10-page research paper for a college course.
- Break it Down: Break the task into smaller, achievable steps.
- Spend 5 minutes brainstorming ideas for the paper.
- Research and gather sources for 15 minutes.
- Outline the paper for 10 minutes.
- Write the introduction paragraph (approx. 15 minutes).
- Write the first body paragraph (approx. 20 minutes), and so on.
- Set Achievable Goals: Start with the first step and aim to complete each step within a manageable timeframe. Use a timer to stay on track and maintain focus.
- Slowly Increase: As you complete each step, slowly increase the difficulty or duration of the tasks. For example, increase the writing time for each paragraph or extend the research phase.
- Reward Progress: Celebrate completing each step as it builds towards the overall goal of finishing the paper. Rewards could include a short break, a favorite snack, or anything that makes you happy.
By breaking down the overwhelming task of writing a research paper into smaller, manageable steps and gradually increasing the complexity, this cognitive therapy technique helps you stay focused, improve time management, and achieve bigger goals. Triple win.
3. Self-Discovery with CBT for ADHD
Guided discovery involves guiding you to explore your beliefs, thoughts, and behaviors through questioning and exploration.
- For instance, if you feel inadequate as a parent due to your child’s behavior, your cbt therapist might inquire about the experiences or thoughts reinforcing this belief.
- By examining evidence, you can recall past successes in handling similar situations and identify effective strategies.
- Challenging assumptions involves setting realistic expectations and recognizing that perfection is unattainable.
- Broadening your perspective helps you understand how your beliefs impact stress levels and interactions with your child.
Through other cognitive therapy techniques and tools, such as setting goals and other coping skills, you gain valuable insights into the broader impacts of your beliefs, reducing stress and improving your ability to navigate ADHD-associated challenges.
4. Focused Work with CBT for ADHD
This technique helps you recognize and manage distractions more easily. For instance, if you’re an entrepreneur who struggles with focus due to incoming emails and notifications:
- Set a 30-minute timer for focused work.
- Note distractions by writing them down, but postpone checking them until your work period ends.
- Use the remaining time to make continued progress on your tasks.
- Review and address distractions during a brief break after the session.
- Reflect on what went went and what didn’t to refine your approach.
By following focused work, you maintain momentum in your day-to-day tasks and minimize the impact of interruptions and missed deadlines caused by ADHD-related distractibility.