This month I am going to talk to you about a therapy we implement in adults with ADHD, and which gives positive results together with medication. I had written about the basic characteristics of cognitive behavior therapy in previous months. The aim of Cognitive Behavior Therapy is to help individuals to become aware of their existing cognitive characteristics and belief structures, and to change them. It focuses on how people’s thoughts influence their emotions and behavior.
With CBT, persons create alternative thoughts and develop new perspectives that will provide new behavioral and ideational experiences. ADHD does not arise from negative thought. ADHD is the result of a complicated combination of genetic and neurobiological factors. Especially if ADHD has not been diagnosed until adulthood, it has powerful impact on the belief system that they have developed about themselves, the world and the future, known as the cognitive triad. Cognitive Therapy works on this belief system that negatively impacts individuals’ self-confidence.
ADHD diagnosis is related to our interpersonal, academic and vocational problems that affect the life spaces where we gain our sense of existence and competition. Recent research has shown that adults with ADHD have encountered more hardships and negative experiences in childhood compared to those without. It is not surprising that these negative experiences adversely impact a person’s concept of self and his/her qualifications. Cognitive Behavior Therapy is especially effective in dealing with these issues.
CBT is not the power of positive thought; it is the power of balanced thought. It helps us to find a balance between accepting the thoughts that cannot be changed, and being flexible in making changes and to define all possibilities in determining what can be changed.
If the aim of the therapy is not clear, neither will the results. In CBT, a discussion is carried out with the applicant and a joint agreement reached on the subject of what is expected to be achieved by participating in the therapy. While determining the aims of the therapy, examining specific problem the patients encounter in daily life, determining the effects of ADHD, and seeking new strategies for dealing with it, are major parts of the therapy.
Another feature of CBT for adult ADHD is that it is more structured in comparison to other therapy models. However, the degree of structuring changes from individual to individual.
The biggest problems that adults with ADHD have are, inability to finish what has been started, putting off tasks, difficulty in organizing, inability to establish priorities for what needs to be done, problem solving and decision making, time management, etc. The aim of the therapy is to enable the individual to achieve new skills in coping, and to gain new experiences in the fields of life they previously had problems with. The aim is to improve functionality and enable the person to gain new experiences that will revise the belief system of the individual.
The development and implementation of new coping skills is important in CBT from the perspective of adult ADHD. Many factors of daily life, such as time management, being organized and focusing, have become associated with pessimistic thoughts. The negative thoughts of the applicant, such as “I can’t do this,” or, “This won’t work for me,” are taken in hand in CBT and worked on.
My clinical observations support the views that behavioral methods, together with medication, are effective in changing established wrong habits in the treatment of ADHD, which is a lifelong condition and which creates problems with life in adulthood.
