Cognitive Behavioural Therapy (CBT)
At Possibilities, clinicians offer Cognitive Behavioural Therapy, also known as CBT. We’re asked many questions about CBT. Here are the most common questions and our answers.
With Cognitive Behavioural Therapy (CBT) you’ll challenge the thoughts, feelings, and habits that keep you stuck. Once you’ve completed a course of CBT, you’ll THINK differently, DO differently, and FEEL a whole lot better about who you are and what you can accomplish!
Cognitive Behavioural Therapy (CBT) is a widely used model of psychotherapy delivered by professionals in various disciplines in the field of mental health. It is also one of the most researched models in psychotherapy with abundant scientific evidence to support its effectiveness in a range of disorders like anxiety and depression. A central idea in CBT is that thoughts, feelings and behaviours are all connected. This idea isn’t a weak assumption; it’s a finding strongly supported by science. Our thoughts affect how we feel—and they also affect the actions we take!
Yes! A recent study published in 2020 examined the effectiveness of CBT for adults with ADHD. This study was actually a meta-analysis, so the researchers reviewed many studies where CBT was offered to adults to see if ADHD symptoms were reduced. Data collected across the studies showed that CBT is effective and can help to reduce the symptoms of ADHD in adults.
Yes! At the core of CBT is changing thoughts to change moods. So CBT is a therapy that is used often to alleviate symptoms of anxiety and depression with strong scientific support for its effectiveness. Depression and anxiety often occur with ADHD, so when CBT is used to help improve functioning in ADHD, feelings of worry and sadness can also decrease as mood improves.
Yes. In ADD and ADHD there are core symptoms like inattention and impulsivity, with far-reaching effects that make daily living, working, and being attentive in relationships really hard. With so many symptoms affecting so much, the gold standard in ADHD treatment is typically a combination of treatments. So you might combine CBT with medication treatment and with accommodations at school or work. Medication can help boost focus by making naturally occurring neurochemicals in the brain, like dopamine, more available to sustain focus across the day. Accommodations at work or school, like extra time to complete tasks and a quiet place to work, can support focus and persistence further. Psychotherapy like CBT can help you learn new strategies and new ways of thinking, so your thoughts and esteem support work completion rather than sabotage them. Individuals with ADHD can certainly use CBT as a single treatment, or they combine it with others to support focus and persistence even further!
Thoughts, feelings, and actions are connected and influence each other. This is a core principle in CBT. What you think influences what you feel, and what you do. You can be consciously aware of your thoughts—this is another core principle of CBT—and changing your thoughts can help you change your feelings, and the actions that follow.
Change happens in the thoughts-feelings-action sequence because humans crave consistency. When our thoughts don’t match our feelings or actions, we feel discomfort—or what psychologists call cognitive dissonance. If there is a mismatch in the sequence, our mind and body make adjustments. So if your thoughts tell you, “I’ll never get that dream job,” you’ll likely feel defeated and you probably won’t apply. There is nothing positive about this sequence, but at least the elements are consistent!. In CBT, when you challenge your thoughts and change them, feelings and emotions also change—again, to reduce the discomfort that comes from mismatches and to create internal consistency. Change your thought to, “I might get this dream job,” and you’ll probably feel hopeful, apply, and even prepare for the interview!
Unhelpful and inaccurate thoughts are targeted for change in CBT. All of us have thoughts that are distorted, inaccurate and unhelpful. Some of us have more of these thoughts than others. If you’ve struggled with ADHD your whole life—not finishing tasks, not getting the dream job, not following conversations—then your mind is probably filled with unhelpful and unflattering thoughts about who you are and what you can accomplish. If you think you can’t do what’s important, then you’ll feel miserable, and you won’t even try. Changing thoughts that are extreme and unfair to thoughts that are more balanced and accurate can give you hope and help you get started on goals worth pursuing. In CBT, the therapist will help you identify distorted and unhealthy thoughts that are holding you back.
In CBT, you don’t stop when you learn to spot distorted and unhelpful thoughts. That’s just the beginning! Next you learn to challenge those thoughts by thinking of evidence that supports or refutes what you are thinking. If you constructed a deck with your finest DIY skills, then you can’t think to yourself, “I never finish anything!” When evidence topples your distorted thoughts, then you can change them. “Some tasks I finish and others are much harder to get done,” is a more accurate and fair way of thinking. Armed with this new thought, you won’t be so hard on yourself—and you can begin thinking of strategies to help make tough tasks easier.
Yes. We know from science that thoughts, feelings, and actions are all connected—and they can influence each other in multiple directions. So actions you take first can then influence feelings and your thoughts about yourself. When CBT is applied to ADHD, therapy focuses on thoughts, but also on actions. Clinicians work with clients to discourage avoidance and procrastination and encourage getting tasks done. So behavioural skills training is an important part of CBT when applied to ADHD. Being aware of emotions—and helping to calm your body’s reactions—is also critical for meaningful change, and a part of CBT, so helpful thoughts and actions can gain more momentum in the thoughts, feelings and actions trio. At Possibilities, CBT is a core component in our ADHD Coaching program for kids, teens, and adults where thoughts and feelings are explored and specific behavioural plans for getting work done are developed.
Researchers know that CBT can help reduce ADHD symptoms, making difficulties less challenging on a day-to-day basis. But more research needs to be done to determine what elements of the treatment help bring about these improvements. Researchers have proposed several factors for CBT’s effectiveness in ADHD, like 1) improved self-esteem that comes from identifying, challenging and changing negative thoughts, 2) new understanding about the brain science behind ADHD that helps reframe past challenges, 3) knowing that actions, rather than procrastination, will leverage better outcomes and create more positive moods and thoughts, and 4) developing systematic behavioural plans that help get tasks done. Overall, it seems the broad range of cognitions, emotions, and behaviours that CBT targets makes it an effective treatment for ADHD.
Yes! We see clients across Ontario through secure video sessions. Our health professionals who offer CBT are licensed in the province of Ontario. You must be physically present in the province of Ontario for all therapy sessions
CBT can be an effective treatment for teens and adults. CBT programs can be adapted for younger children. Children as young as 8 years of age can benefit from this approach, but finding the best fit and approach can vary across our younger clients—which is true for teens and adults, too!
CBT at Possibilities is provided by non-medical health professionals such as psychologists. As such, these services are not covered by OHIP. Your private insurance plan may cover services offered by psychologists, social workers, or registered psychotherapists.
Yes! You do not need a referral to start CBT with one of psychologists, social workers or registered psychotherapists.
Please fill out our Child and Adolescent Intake Form for children and teens, or our Adult Intake Form for adults. Once this form is received, our Care Coordinator will review your needs, match you to an appropriate clinician, and get back to you with booking options. For any questions, email us at firstname.lastname@example.org or call 1-833-482-5558 to speak to one of our Clinical Coordinators.
Cited Research: Young, Z., Moghaddam, N. , & Tickle, A. (2020). The efficacy of Cognitive Behavioral Therapy for adults with ADHD: A systematic review and meta-analysis of randomized controlled trials. Journal of Attention Disorders, 24(6), 875-888.