Psychotherapy in Adult Attention Deficit Hyperactivity Disorder

Implications for Treatment and Research

Alexandra Philipsen


Expert Rev Neurother. 2012;12(10):1217-1225. 

In This Article

Abstract and Introduction


Attention deficit hyperactivity disorder (ADHD) is a risk factor for co-occurring psychiatric disorders and negative psychosocial consequences in adulthood. Previous trials of psychotherapeutic programs for adult ADHD were based on cognitive behavioral psychotherapeutic approaches and showed significant effects. Targets of psychotherapeutic interventions include not only coping with the core symptoms and associated problems such as depression and anxiety, but also probable consequences such as low self-esteem. Improvements in ADHD symptomatology and associated symptoms have been reported after psychotherapeutic treatment. The support of other participants is strongly regarded as helpful by patients in group therapy. This manuscript provides an overview of psychotherapy approaches and results of studies evaluating programs developed to treat adults with ADHD. Finally, the specific requirements of psychotherapy for adult ADHD as well as further research questions will be discussed.


Adult attention deficit hyperactivity disorder (ADHD) is a serious mental disorder with high comorbidity rates for affective disorders, substance abuse, anxiety and personality disorders, lower educational status and higher risks for unemployment, divorce or imprisonment compared with the general population.[1] ADHD has an enormous impact on the lives of affected individuals and their families. The current treatment guidelines recommend multimodal therapy composed of stimulants as first-choice medication and disorder-specific psychotherapy.[2] Accordingly, the guidelines of the National Institute for Health and Clinical Excellence recommend drug treatment only as part of a comprehensive program including psychological and behavioral needs.[101]

If comorbid disorders such as severe depression and addiction are a primary concern, guidelines specify that these should be treated first, for example, with antidepressants and detoxification. Subsequent to the treatment of comorbidities, the extent of impairment through ADHD should be reassessed.[1,3,101]

In childhood ADHD, psychotherapeutic interventions with or without medication constitute an integral part of guideline-based treatment and can be adjusted to patients' individual requirements.[101] However, in contrast to psychopharmacological trials, few studies have addressed the effects of nonmedical treatment in adult ADHD.[4,5]