ADHD Cognitive Behavioural Therapy (CBT)

CBT (Cognitive Behavioural Therapy) specifically for ADHD

CBT stands for ‘cognitive behavioural therapy’ and it is a type of talking therapy. Adult ADHD CBT is very different to the typical Anxiety CBT that is common in the NHS and normally focusses on mild anxiety or depression. ADHD CBT is a behavioural course of counselling, that specifically deals with symptoms and executive function difficulties (like inattention and its impact on daily tasks), that people with ADHD struggle with. Ideally the therapist has experience/is aware of, adult ADHD. From our experience of meeting people at ADHD Support Groups [Link], many people have found ADHD CBT to be very helpful and much more effective than just medication on its own. ADHD CBT on the NHS, is typically 10 – 14 sessions rather than the 6 that are provided for standard Anxiety CBT.

 

How to access ADHD CBT on the NHS

 

It is helpful that the NICE Guideline for NHS England, does recommend that ADHD CBT should be available, at least on a group basis. However, the reality of the situation is that very few areas provide any service. Some areas may not provide CBT, but may have an ADHD nurse that provides a similar service. A good place to find out about services in your area is to go to a local peer support group.

If you think you would benefit from ADHD CBT, we would encourage you to request it. If the service is not available in your area, you can request an ‘out of area’ referral to the National ADHD Clinic at the Maudsley Hospital, London. An ‘out of area’ referral is a special referral that causes your local NHS to have a funding meeting that determines, on a case by case basis, whether a service for that patient will be funded. From our experience with peer support groups, most ‘out of area’ referrals are successful, or the local NHS makes special arrangements locally to provide that service to that patient. Therefore, once again we would urge you to request ADHD CBT, not only can it be very effective in terms of improving symptoms, but requesting the service also sends a message to the NHS that there is a demand for this service. For many people, when they have ADHD CBT, it is the first time they have spoken to any therapist who understands and acknowledges ADHD, and for many people this can be life changing.

 

-For the Brighton & Hove area, see at the bottom of the page for more details.

 

How to request an ‘out of area’ referral

If you are already diagnosed with ADHD, the place to start is to request ADHD CBT with your GP or psychiatrist. It might be that you are referred to the community mental health team and they may offer you a course of standard Anxiety / Depression CBT. Although, anxiety and depression can co-occur with ADHD, often it is unmanaged ADHD symptoms that are the cause for the Anxiety or Depression symptoms. Therefore, the most effective treatment would be to actually treat the cause – the ADHD symptoms. Many people have reported feeling worse after having CBT that did not focus on ADHD, or a therapist who did not have any understanding of ADHD. Therefore we would recommend that you refuse the treatment and make it clear that you would like ADHD specific CBT.

After making this request you may be refused treatment because a service for ADHD CBT is not available in your area. At this stage, once you have been refused treatment, go back to your GP or Psychiatrist and request an ‘out of area’ referral to the Maudsley Clinic. If your request, is not taken seriously, you can ask to see a different GP, or you can request this in writing with your GP. See below for the Maudsley Clinic details and quotes from the NICE Guideline that you can copy and print out.

 

ADHD NICE Guideline 72 Quotes about ADHD CBT

12.7.1.8

For adults with ADHD stabilised on medication but with persisting functional impairment associated with the disorder, or where there has been no response to drug treatment, a course of either group or individual CBT to address the person’s functional impairment should be considered. Group therapy is recommended as the first-line psychological treatment because it is the most cost effective.

 

12.7.1.9

For adults with ADHD, CBT may be considered when:

-the person has made an informed choice not to have drug treatment
drug treatment has proved to be only partially effective or ineffective or the person is intolerant to it
-people have difficulty accepting the diagnosis of ADHD and accepting and adhering to drug treatment
-symptoms are remitting and psychological treatment is considered
sufficient to target residual (mild to moderate) functional impairment.
p374

Attention Deficit Hyperactivity Disorder: Diagnosis and Management of Adhd in Children, Young People, and Adults. Leicester: British Psychological Society, 2009. Print.