ADHD Therapy Overview: The 9 Best Treatments for Children and Adults
Studies confirm that children with ADHD achieve the greatest symptom control with a combination of ADD medication and behavioral therapy. Many adults, too, successfully use non-medical ADHD therapy in their treatment plans. Here, we explain the most popular therapies for ADHD: cognitive behavioral therapy, neurofeedback, play therapy, and more.
The research is clear: ADHD medication paired with behavioral therapy is the most effective treatment for attention deficit hyperactivity disorder (ADHD) in children — particularly those who also exhibit oppositional behavior. This finding comes from the National Institute of Mental Health1 and its landmark Multimodal Treatment Study of Children with ADHD, and is reinforced by the American Academy of Pediatrics (AAP). But the power of therapy for ADHD does not diminish with the age of the patient. Many children and adults use ADHD therapy to teach behavioral, social, and academic skills that may help manage ADHD symptoms throughout life.
Consult with a mental-health professional to help determine what type of ADHD therapy is best suited for you or your child, and use the overview below to understand the 9 most popular therapies for ADHD.
ADHD Therapy #1: Behavioral Therapy for Children
Behavioral therapy addresses problem behaviors common among children with ADHD by structuring time at home, establishing predictability and routines, and increasing positive attention. A good behavioral therapy plan begins with common-sense parenting, according to William Pelham, Jr., Ph.D., director of the Center for Children and Families at the State University of New York at Buffalo.
ADHD behavioral therapy plans should do the following:
- Reinforce good behavior with a reward system.
- Discourage negative behavior by ignoring it.
- Take away a privilege if the negative behavior is too serious to ignore.
- Remove common triggers of bad behavior.
Thomas E. Brown, Ph.D., author of A New Understanding of ADHD in Children and Adults, cautions that “The benefits a child receives from behavioral treatment are strongly influenced by the ability of the parent to consistently implement the program plan.” Fortunately, a variety of credible Parent Training Programs teach strategies to encourage positive behavior from a child and strengthen the parent-child relationship.
ADHD Therapy #2: Cognitive Behavioral Therapy for Adults
Cognitive behavioral therapy (CBT) is essentially brain training for ADHD. It is a short-term, goal-oriented form of psychotherapy that aims to change negative patterns of thinking and reframe the way a patient feels about herself and her symptoms of ADHD.
CBT does not treat the core symptoms of ADHD: inattention, hyperactivity, and impulsivity. Rather, it helps lessen the life impairments experienced by people with ADHD, such as procrastination and time management. There’s no evidence that CBT can replace drug therapy for ADHD, or even permit lower dosages, but research does suggest that it helps adults with ADHD more than do other forms of therapy. A 2010 study by Boston’s Massachusetts General Hospital found that a combination of drug therapy and CBT was more effective at controlling ADHD symptoms than was drug therapy alone.2
An effective CBT program will help adults with ADHD correct the following distorted thought processes and more:
- All-or-nothing thinking — viewing everything as entirely good or entirely bad: If you don’t do something perfectly, you’ve failed.
- Overgeneralization — seeing a single negative event as part of a pattern: For example, you always forget to pay your bills.
- Mind reading — thinking you know what people think about you or something you’ve done — and it’s bad.
- Fortune telling — forecasting that things will turn out badly.
- Magnification and minimization — exaggerating the significance of minor problems while trivializing your accomplishments.
- “Should” statements — focusing on how things should be, leading to severe self-criticism as well as feelings of resentment toward others.
- Comparative thinking — measuring yourself against others and feeling inferior, even though the comparison may be unrealistic.
ADHD Therapy #3: Dialectical Behavior Therapy for Adults
Dialectical Behavioral Therapy (DBT), like CBT, focuses on the social and emotional challenges associated with ADHD and other neuro-psychological disorders. Created by Marsha Linehan, Ph.D., ABPP, a professor of psychology at the University of Washington and founder of The Linehan Institute, DBT was initially designed to treat the harmful behaviors of patients diagnosed with borderline personality disorder (BPD).3 It is now one of the most successful treatments for improving emotional regulation skills. DBT is taught in a series of skill-based modules in weekly group sessions — each one focused on a particular skill. Individual therapists provide additional support to personalize the use of these skills in life situations.
ADHD Therapy #4: ADHD Coaching
ADHD coaches help children, teens, and adults with ADHD organize and take charge of their lives. More specifically, coaches can help their clients achieve emotional/intellectual growth, strong social skills, effective learning strategies, compelling career and business exploration, and thoughtful financial planning.
A professionally trained ADHD coach can realistically assist his or her ADHD clients in building skills like:
- Time, task, and space management
- Motivation and follow-through
- Developing systems for success
- Healthy communications and relationships
- Strategic planning and perspective
- Making conscious & wise choices
- A simplified and more orderly life
- Achieving a balanced, healthy lifestyle
One of the best ways to find an ADHD coach is through the ADHD Coaches Organization (ACO). This worldwide professional membership organization offers resources for coaches and those who seek them alike.
ADHD Therapy #5: Brain Training or Neurofeedback
Neurofeedback uses brain exercises to reduce impulsivity and increase attentiveness in children and adults with ADHD. By training the brain to emit brain-wave patterns associated with focus, as opposed to those associated with day-dreaming, neurofeedback helps to rein in ADHD symptoms like impulsivity, distractibility, and acting out.
Typically, neurofeedback patients wear an electrode-lined cap while performing a complex cognitive task, such as reading aloud. A computer reads the brain activity then maps the areas of the brain where there is too much or too little brain-wave activity – the theoretical sources of the patient’s ADHD symptoms.
Critics argue that neurofeedback has not been rigorously studied in any large, double-blind studies and that, though some patients report improvements in attention, it has little effect on other problems associated with ADHD.
ADHD Therapy #6: Play Therapy
Play therapy is used to help children with ADHD connect, learn, provide reassurance, calm anxiety, and improve self-esteem. Play is an indirect way for therapists to recast children’s perceptions, cognitions, and behaviors. As Carol Brady, Ph.D., a child psychologist practicing in Houston, says: “Children communicate metaphorically through play. As a therapeutic tool, it’s like giving a sugary pill instead of a bitter one.” Playing with a young child is essential for her to feel connected, secure, and attached.
ADHD Therapy #7: Music Therapy
For patients with ADHD, music therapy bolsters attention and focus, reduces hyperactivity, and strengthens social skills in three ways:
- Music Provides Structure. Music is rhythm, rhythm is structure, and structure is soothing to an ADHD brain struggling to regulate itself to stay on a linear path.
- Music Fires Up Synapses. Research shows that pleasurable music increases dopamine levels in the brain. This neurotransmitter — responsible for regulating attention, working memory, and motivation — is in low supply in ADHD brains.
- Music is Social. “Think of an orchestra,” says Tomaino, a 30-year veteran in music therapy. “If one instrument is missing, you can’t play the piece. All ‘voices’ are necessary.”
ADHD Therapy #8: Art Therapy
Art therapy helps children and adults with ADHD and other neuropsychological disorders who communicate their thoughts more easily through visual images and art making than they do with written or spoken words. Art therapy can be especially effective for active, busy children with ADHD, as it keeps their hands moving and triggers an acute mental and emotional focus not always achieved in talk therapy.
Children with ADHD use art therapy because the processes of drawing, painting, and sculpting can help address emotional problems, develop interpersonal skills, manage behavior, reduce stress, and increase self-awareness. Through art therapy, children with ADHD can build mental flexibility, problem-solving skills, and communication skills as they explain what they made to a parent or friend. Art also allows for organic moments of positive social interactions, like sharing materials, making compliments, or even making suggestions.
ADHD Therapy #9: Equine Therapy
Equine Assisted Psychotherapy (EAP) is an experiential ADHD therapy in which clients interact with horses — with the guidance of a specially trained mental-health professional and an equine specialist — instead of talking about their problems.
Natural Lifemanship is one model of EAP that is effective for treating ADHD. It is a trauma-informed approach based on neuroscience and the role of healthy, connected relationships. Clients learn to regulate their body energy and pick up on non-verbal cues to build a relationship with a horse. The horse provides immediate feedback to the client’s actions as other humans can’t or won’t do.
1 Arnold LE, Abikoff HB, Cantwell DP, et al. “National Institute of Mental Health Collaborative Multimodal Treatment Study of Children With ADHD (the MTA): Design Challenges and Choices.” Arch Gen Psychiatry (Sep. 1997) https://jamanetwork.com/journals/jamapsychiatry/article-abstract/497921
2 “Cognitive behavior therapy improves symptom control in adult ADHD.” Massachussets General Hospital (Aug. 2010) https://www.massgeneral.org/News/pressrelease.aspx?id=1273
3 Marsha Linehan, Ph.D., ABPP. University of Washington Center for Behavioral Technology. https://depts.washington.edu/uwbrtc/our-team/marsha-linehan/
4 ‘The ADDA Guiding Principles for Coaching Individuals with Attention Deficit Disorder.” The ADDA Subcommittee on AD/HD Coaching. (Nov. 2002) http://www.nancyratey.com/adhdcoaching/adda-coachingprinciples
Updated on January 31, 2020