Skip to main content
SpringerLink
Log in

Cognitive Behavior Therapy for Adults with Attention-Deficit/Hyperactivity Disorder: A Review of Recent Randomized Controlled Trials

  • Attention-Deficit Disorder (R Bussing, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

To review the efficacy of cognitive behavioral therapy for adults with attention deficit hyperactivity disorder. Recent, controlled studies of the efficacy of Cognitive Behavior Therapy (CBT) treatment in adults with ADHD are reviewed. CBT is a feasible and acceptable treatment strategy in medicated adults with ADHD that leads to improvement in ADHD symptoms and co-morbid problems. CBT includes delivery of cognitive and/or emotional strategies to individuals or groups of 4 to 10 participants. The number of CBT sessions may vary from 6 to 14. Blinding may help reduce response bias. Coaching and homework may enhance motivation as well as help in generalizing strategies to patient’s daily lives. Outcomes studied include participants’ self-reports of symptoms and evaluator reports based on standardized measures of ADHD and its comorbidities. CBT is an effective treatment for adults with ADHD particularly when combined with medication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Kessler R, Lane M, Stang P, et al. The prevalence and workplace costs of adult attention deficit hyperactivity in a large manufacturing firm. Psychol Med. 2009;39:137–47.

    Article  PubMed  CAS  Google Scholar 

  2. Kessler R, Adler L, Ames M, et al. The prevalence and the effects of adult attention deficit hyperactivity disorder on work performance in a nationally representative sample of workers. J Occup Environ Med. 2005;47:565–72.

    Article  PubMed  Google Scholar 

  3. Safren SA. Cognitive behavioral approaches to ADHD treatment in adulthood. J Clin Psychol. 2006;67:46–50.

    Google Scholar 

  4. •• Safren SA, Sprich S, Mimiaga MJ, et al. Cognitive behavioral therapy vs relaxation with educational support for medication treated adults with ADHD and persistent symptoms: a randomized controlled trial. JAMA. 2010;304:875–80. The study detailed in this paper demonstrated that CBT, in contrast with relaxation exercises, led to significantly greater improvements in ADHD Rating Scale scores, and Clinical Global Impression Scale scores. These positive effects of CBT treatment were maintained at longer term (12 months)..

    Article  PubMed  CAS  Google Scholar 

  5. Knouse LE, Safren SA. Current status of cognitive behavioral therapy for adult attention deficit hyperactivity disorder. Psychiatr Clin North Am. 2010;33:497–509.

    Article  PubMed  Google Scholar 

  6. Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163:716–23.

    Article  PubMed  Google Scholar 

  7. Hirvikoski T, Waaler E, Alfredsson J, et al. Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial. Behav Res Ther. 2011;49:175–85.

    Article  PubMed  Google Scholar 

  8. •• Weiss M, Murray C, Wasdell M, et al. A randomized controlled trial of CBT for adults with and without medication. BMC Psychiatry. 2012;12:30. This is the most recent article on the subject that attempts to demonstrate the pertinent issue of how medication augments the outcome of CBT. This study proposes that CBT may be effective in individuals not on medication and that medication is not essential for increasing subject’s receptivity to CBT..

    Article  PubMed  Google Scholar 

  9. Newark PE, Stieglitz RD. Therapy relevant factors in adult ADHD from a cognitive behavioral perspective. Atten Defic Hyperact Disord. 2010;2:59–72.

    Article  PubMed  Google Scholar 

  10. Safren S, Otto M, Sprich S, et al. Cognitive behavior therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther. 2005;43:831–42.

    Article  PubMed  Google Scholar 

  11. •• Emilsson B, Gudjonsson G, Sigurdsson JF, et al. Cognitive behavior therapy in medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial. BMC Psychiatry. 2011;11:116. This recent study evaluated a newly developed CBT program and demonstrated that CBT is effective in improving ADHD symptoms in adults. Further, it showed that these gains from treatment could be maintained at follow-up at 3 months..

    Article  PubMed  Google Scholar 

  12. Bramham J, Young S, Bickerdike A, et al. Evaluation of group cognitive behavioral therapy for adults with ADHD. J Attention Disord. 2009;12:434–41.

    Article  Google Scholar 

  13. Virta M, Salakari A, Antila M, et al. Short cognitive behavioral therapy and cognitive training for adults with ADHD—a randomized controlled pilot study. Neuropsychiatr Dis Treat. 2010;6:443–53.

    Article  PubMed  Google Scholar 

  14. • Solanto MV, Marks DJ, Wasserstein J, et al. Efficacy of metacognitive therapy for adult ADHD. Am J Psychiatry. 2010;167:958–68. This paper demonstrates the efficacy of manualized CBT vs supportive therapy on 86 adults with ADHD. Improvements in the severity of ADHD were seen for meta-cognitive over supportive psychotherapy group..

    Article  PubMed  Google Scholar 

  15. Knouse LE, Cooper-Vince C, Sprich S, et al. Recent developments in the psychosocial treatment of adult ADHD. Expert Rev Neurother. 2009;8:1537–48.

    Article  Google Scholar 

  16. Hesslinger B, Philipsen A, Richter H. Psychotherapie der ADHS im Erwachsenenalter: Ein Arbeitsbuch Hogrefe Verlag. Göttingen, Germany: GmbH & Co. KG; 2004.

Download references

Disclosure

M. Mongia: none; L. Hechtman: board member and consultant for Shire, Purdue Pharma, Janssen-Ortho, and Eli Lilly and Company, and payment for lectures including service on speakers’ bureaus, payment for development of educational presentations, and travel/accommodations/meeting expenses reimbursed from Shire, Purdue Pharma, Janssen-Ortho, and Eli Lilly and Company.

Author information

Authors and Affiliations

  1. Division of Psychiatry, McGill University, Montreal Children’s Hospital, 4018 Ste-Catherine St. West, Montreal, Quebec, H3Z 1P2, Canada

    Monica Mongia

  2. Division of Child Psychiatry, McGill University, Montreal Children’s Hospital, 4018 Ste-Catherine St. West, Montreal, Quebec, H3Z 1P2, Canada

    Lily Hechtman

Authors
  1. Monica Mongia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lily Hechtman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lily Hechtman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mongia, M., Hechtman, L. Cognitive Behavior Therapy for Adults with Attention-Deficit/Hyperactivity Disorder: A Review of Recent Randomized Controlled Trials. Curr Psychiatry Rep 14, 561–567 (2012). https://doi.org/10.1007/s11920-012-0303-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-012-0303-x

Keywords

Search

Navigation