CBT for ADHD

A version of Cognitive behavioural therapy (CBT) A structured, practical form of talking therapy. It's built on a simple idea: what you think affects how you feel, and both affect what you do. More in the jargon decoder (CBT) adapted for attention deficit hyperactivity disorder (ADHD) can help adults with ADHD, and is a recommended treatment in Australia’s ADHD guideline (Australian ADHD Professionals Association, 2022). It differs from the CBT usually offered for anxiety or low mood by focusing directly on day-to-day organisation and self-management. Here’s what it involves, how it works alongside medication, what the evidence says, and how to find it in Australia. ADHD in adults covers what ADHD looks like in adults and how it’s assessed.

How it differs from the usual CBT

Standard cognitive behavioural therapy works on the principle that what you think affects how you feel, and both affect what you do. CBT adapted for ADHD is practical. It usually works on organising and planning, setting priorities, breaking big tasks into smaller steps, setting up a calendar and task list you actually use, and handling distractions. It also works on the thoughts that get in the way when you’re stressed (Safren and colleagues, 2010).

Australia’s ADHD guideline describes what CBT for ADHD usually includes (Australian ADHD Professionals Association, 2022):

learning about ADHD and how it affects day-to-day life
changing your surroundings to make them more predictable and structured
practical ways to reduce ADHD’s impact on day-to-day life
working on unhelpful patterns of thinking.

What it’s like

In the trials, courses of CBT for ADHD were often about twelve sessions (Safren and colleagues, 2010; Solanto and colleagues, 2010). The therapy can be one to one or in group therapy, depending on what services are available and what you prefer (Australian ADHD Professionals Association, 2022).

Practice between sessions is part of most CBT. If keeping track of it is hard, raise that early, because it’s the kind of difficulty CBT adapted for ADHD is designed to work on.

Who it tends to suit

Practical help. You’d like strategies for managing time, organising and planning.
Already on medication. You’re taking ADHD medication and still finding day-to-day things hard.
Working in a group. You’d rather learn and practise skills alongside other people.

If you’ve had CBT before and it didn’t help

In a small UK study, 46 adults with ADHD described CBT they’d had, mostly the usual kind rather than a version adapted for ADHD (William and colleagues, 2024). Most found it unhelpful or overwhelming, and some found it harmful to their wellbeing. Nearly half didn’t finish the course. Some described learning a technique in the session and then not remembering it when it was needed, and falling behind on practice between sessions. The people in it chose to take part, and they described their experience rather than measured results, so it’s hard to say how common this is.

If CBT didn’t help before, it’s worth knowing whether it was a version adapted for ADHD, and it’s worth telling a new therapist what kept getting in the way.

What the evidence says

Australia’s ADHD guideline recommends offering therapy based on CBT to adults with ADHD (Australian ADHD Professionals Association, 2022). It recommends CBT firmly, but still notes that the research behind it is limited.

A review of 14 trials found CBT may help with the core difficulties of ADHD compared with sessions of general support, or with waiting for treatment (Lopez and colleagues, 2018). The reviewers rated the evidence low quality, mostly because the trials were small and measured things in different ways.

One trial included 86 adults who were already taking ADHD medication and still struggling. They had twelve individual sessions of either CBT adapted for ADHD or relaxation training with support (Safren and colleagues, 2010). The CBT group improved more, and the difference was still there a year later.

In another trial, 88 adults took part in a twelve-week group (Solanto and colleagues, 2010). The group focused on managing time, organising and planning, and on the discouraged or anxious thoughts that make those things harder. It helped with attention difficulties more than a support group that didn’t teach those strategies. The trial included people who were taking ADHD medication and people who weren’t.

CBT and medication

Australia’s guideline suggests using medication and non-medication approaches together (Australian ADHD Professionals Association, 2022).

The largest recent comparison of treatments for adults with ADHD pulled together 113 trials, with nearly 15,000 people (Ostinelli and colleagues, 2025). Two groups of ADHD medications were the only treatments that clearly reduced the core difficulties — attention, restlessness and impulsivity — both in people’s own ratings and in clinicians’ ratings. CBT also helped when clinicians rated the change. In people’s own ratings, the difference wasn’t clear. Most of the trials lasted around three months, so much less is known about how things go over longer periods, for medication or for therapy.

For people already taking medication, adding CBT helped with day-to-day functioning and with anxiety and low mood, compared with medication alone (Lopez and colleagues, 2018).

If you can’t take medication or would rather not, less is known about CBT on its own. In a trial of 88 adults, everyone had twelve group CBT sessions, plus some individual support (Cherkasova and colleagues, 2020). Of these, 42 were also taking ADHD medication and 46 weren’t. Straight after the course, the people also taking medication had improved more, with ADHD difficulties, with organising, and with how they felt about themselves. Over the next six months the gap narrowed. The people doing CBT without medication kept improving, and the people doing both held on to what they’d gained. Nobody in the trial went without treatment for comparison, and everyone rating people’s progress knew who was taking medication, so it can’t show how much of the change came from the CBT itself.

Decisions about medication are ones to make with your doctor. Therapy and medication covers what’s known about the two together.

Getting it in Australia

It’s worth asking any therapist whether and how they adapt CBT for ADHD. Questions you might ask when you contact a therapist:

How do you adapt CBT for adults with ADHD?
How much of your work is with adults with ADHD?
What happens if completing tasks or practice between sessions becomes difficult?
Do you offer individual sessions, group sessions, or both?

Paying for it

Full fee. Seeing a practitioner privately has no session limit. That includes a Counsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder or Psychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder , whom Medicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder doesn’t cover.
Workplace programs and community services. These usually offer a set number of sessions.
headspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder . headspace offers free or low-cost support for people aged 12 to 25.
Groups. A group usually costs less per session.
A Mental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder . CBT is one of the approaches Medicare can Rebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder under a Mental Health Treatment Plan from your GP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder , and your GP assesses whether a plan suits you. A plan gives a rebate on up to ten individual sessions a calendar year, and a separate ten group sessions. Ten sessions a calendar year is a funding limit, not a judgement about how much therapy anyone needs.

For a young person, the place to start is a GP, who can refer to someone who works with young people.

Free and low-cost options covers other ways to keep costs down. However good the method, how well you and your therapist work together matters a great deal. Why who you see matters more than what they do explains why.

If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

If you’re still working out whether you want therapy at all, what therapy actually is covers the basics. Would I benefit from therapy? helps you work out whether therapy is worth a try.