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Adult ADHD Therapy: Finding the Right Therapist

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WebMD Feature

For adults with ADHD, the standard treatment is medication. But experts say that ADHD therapy -- and other psychosocial treatments -- can play a key role alongside drugs.

“I think for many adults with ADHD, therapy is essential,” says David W. Goodman MD, assistant professor of psychiatry at the Johns Hopkins University School of Medicine.

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While ADHD medicines are effective, they may not be enough. To use a phrase popular among ADHD specialists, pills don’t build skills. Even with medication, a person may still be struggling with the residual effects of adult ADHD - the disorganized habits, the low self-esteem. Therapy can address some of these key issues.

“With the ADHD medication as a foundation, it’s the psychosocial treatments that can come in and finish the job,” says J. Russell Ramsay, PhD, co-director of the University of Pennsylvania’s Adult ADHD Treatment and Research Program.

So how does ADHD therapy differ from traditional therapy? And how do you find a therapist? WebMD turned to the experts to get the details.

Treating ADHD With Therapy

Therapy for ADHD tends to be pretty different from typical therapy. Ramsay says that traditional, open-ended talk therapies often don’t work for people with ADHD. Why?

Adults with ADHD often need very practical, concrete help. While delving into personal issues can still be important, it’s the symptoms of ADHD, such as disorganization and forgetfulness, that are really interfering with their lives. “What people with ADHD really need to focus on is improving their functioning at work, in school, and in their relationships,” says Ramsay.

Ramsay stresses that most people with ADHD already know what they should be doing. “A guy with ADHD knows that it’s a problem that he’s always late on his taxes,” Ramsay says. “And he knows the solution, too -- stop procrastinating.” What he lacks is the set of skills that will help him get organized. ADHD therapy is typically about learning those skills and finding ways to overcome the impediments that ADHD sets in your path.

Although there haven’t been many studies of psychosocial treatments for ADHD, results have been promising. For instance, one 2006 study showed that medication combined with therapy eased the symptoms of ADHD, improved functioning, and reduced symptoms of anxiety and depression. A 2004 study found that psychosocial treatments were especially beneficial in people who only had a partial response to medication.

So what could psychosocial ADHD treatments do for you? They could help you:

  • Get organized. Psychosocial treatments focus on various ways to reduce the chaos in your life. People with ADHD need visual and auditory cues to remember things, says Goodman. He gets his patients to use certain tools systematically - ranging from Post-It Notes to PDAs - to help them function better. A therapist might have very specific recommendations, right down to how you organize your closet and where you put your keys when you get home from work. That level of specificity can be a huge help with adult ADHD.
  • Change your habits. Psychosocial treatments help people identify specific problematic behaviors and change them. You might learn ways to manage yourself, like using rewards as an incentive to get specific tasks done. Play that game of computer solitaire after you answer your boss’s emails.
  • Understand your condition. A therapist can help you understand how adult ADHD has affected your life. Once people realize that many of their problems are due to a medical condition and not some personal failing, they start to feel much better about themselves.
  • Challenge negative beliefs. Over the years, people with ADHD tend to have accumulated a lot of self-doubt. They come to think that many tasks are beyond them and give up. Therapy can help them question these self-limiting beliefs and overcome them.
  • Improve social skills. People who have grown up with ADHD may lack some important social skills. They might have poor communication or a tendency to interrupt when someone else is talking. ADHD therapy can help people learn how to pick up on social cues and read people better.
  • Repair relationships. ADHD in adults doesn’t only affect the person with the diagnosis - it affects his or her spouse, children, and friends. Sometimes, ADHD therapy can include other family members. It can be a good way to get them to better understand your condition and teach them ways to help. Family members may also have a lot of built-up anger toward a loved one with undiagnosed ADHD. Therapy can help them see that your forgetfulness isn’t a sign of self-centeredness. Instead, it’s a symptom of a condition that you’re learning how to control.
  • Treat other conditions. The odds that a person with ADHD also has another psychiatric condition are about 40%, says Goodman. “Rates of depression and anxiety are strikingly high in adults with ADHD,” says McCracken. “Those conditions really need therapy.”
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