Cognitive Behavioral Treatment for ADHD

Cognitive behavioral therapy, a form of therapy that focuses on thought rather than emotion, has been used for over 40 years to treat phobias, anxiety and depression. In the last decade, cognitive behavioral therapists have begun applying their methods to treat both attention deficit and attention deficit/hyperactivity disorder (ADD and ADHD).

ADHD

• ADHD is a neurobehavioral developmental disorder, first named in the '70s. The American Psychiatric Association defines it as a "persistent pattern of inattention or hyperactivity." Three to 5 percent of children in America display symptoms of ADHD, and approximately 40 percent of ADHD children continue to manifest the disorder into adulthood. Twice as many boys as girls are diagnosed with ADHD.

Diagnosis and Treatment

• According to the National Institute of Neurological Disorders and Stroke, warning signs of ADHD include fidgeting, talking too much, leaving work unfinished, and being unable to listen to instructions and pay attention to details. ADHD is usually treated with stimulants such as Ritalin, Adderall or Dexedrine, drugs that decrease hyperactivity and increase attention span. However, doctors recommend other methods of treatment in conjunction with medication: children with ADHD are often placed in specialized classrooms, tutored apart from school, and now, treated with cognitive behavioral therapy (CBT).

CBT and ADHD

• The symptoms of ADHD are often serious impediments to the patient's life. As a result, people diagnosed with the disorder can develop negative self-esteem and anxiety, thus compounding their original symptoms. Cognitive behavioral therapy helps patients control their negative patterns of thinking and understand that their way of seeing themselves influences the way they interact with the world. The goal of CBT is to show the patient that these thought patterns are changeable, and then to change them.

Specific Distortions

• People with ADHD often fall into specific ways of thinking about themselves. All-or-nothing thinking (where if something isn't perfect, it seems like a failure) is common, as is overgeneralization, where individuals see specific setbacks as part of an unchangeable pattern. This can cause social paranoia, where patients think that they are always viewed badly by others, and predictive thought, where patients expect failure before all events. Other ADHD thought distortions include a fixation on how things should be, rather than how they are or could be; comparative thinking, where the patient constantly measures himself against others; and over-personalization, or putting too much responsibility on oneself.

Efficacy

• Although cognitive behavioral therapy cannot be used as a substitute for medicine, a 2005 Boston study showed that CBT, when used in conjunction with medication, is significantly more effective treatment than medicine alone. In general, CBT is a fast-acting method of psychotherapy; therapists and patients usually report measurable positive results after 12 to 15 one-hour sessions. For those looking to find a cognitive behavioral therapist for treating ADHD, it is important to find a specialist with prior training in the treatment of ADHD, as many cognitive therapists have not had experience with this relatively new area of treatment.