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Cognitive Behaviour Therapy for ADHD

Cognitive Behaviour Therapy or CBT was developed over 40 years ago and has empirical support in proving effective in treating depression and anxiety. More recently CBT has been shown to be an effective addition to medication in treating ADHD. Unlike regular supportive therapy, results come more quickly with CBT. Benefits accrue even after a dozen therapy sessions.

The focus of CBT is on the way momentary thoughts and long-lasting beliefs about ourselves and others control how we feel and behave. CBT is a tool for getting organized, keeping focused and becoming better at controlling anger and improving relationships with others by tackling the illogical thoughts and unfounded expectations that stop us from interacting the way we want.

CBT explores the “distorted thinking” that keep us from doing what we want. Some examples:

Over-generalizing. Making a broad conclusion based on a small misconception. This small faulty conclusion becomes the basis for looking at other situations which may have nothing to do with the situation which cased the initial misconception. For instance, “I’ll never be able to pass the physics exam, if I can’t remember what movie I saw last night.”

All or nothing thinking. (also known as black or white thinking). Interpreting a situation we experience without taking into account subtle (and sometimes not so subtle) distinctions. An example would be to believe that if we are not perfect, we are failures.

Mind Reading. In this unhelpful thought pattern, we decide that we know what undergirds someone’s behavior. A common example is if someone we know passes us by without saying hello, we assume that they don’t like us (instead of, for example, they were thinking about something else and were not aware of their surroundings).

Magnification. This refers to blowing things out of proportion (“making mountains out of molehills”). For instance, you believe that if you are five minutes late to meet a friend, you are a terrible person.

Once we recognize these unrealistic thoughts, we have more ability to replace them with more constructive thinking.,

CBT for ADHD introduces useful strategies to address three of the most common problems facing people with ADHD: time management, organization and planning. According to Dr. Mary Solanto, the ideal learning format for adults with ADHD is a group setting, where members provide mutual support and the sense that one is not alone. This structured group is lead by a therapist who directs the group through a discussion of ADHD related problems, and provides exercises to teach specific skills, for instance how to set up a schedule and keep track of time.

Empirical evidence points to the effectiveness of CBT for ADHD. The American Journal of Psychiatry (2010) published a study that compared the effectiveness of Solanto’s program to basic supportive therapy. Results indicated that participants in Solanto’s program reported better organization and attentiveness and showed measurable, marked improvement in executive functioning skills than participants in a basic therapy and a support group.

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