Expert Commentary

Cognitive Behavior Therapy Can Minimize Negative Thoughts in Adult ADHD

J. Russell Ramsay, PhD

Associate Professor of Clinical Psychology in Psychiatry
Co-Director, PENN Adult ADHD Treatment and Research Program
Perelman School of Medicine of University of Pennsylvania
Philadelphia, Pennsylvania

Cognitive behavior therapy and associated coping strategies allow the adult ADHD patient to address the emotional components of the disorder, which are often overlooked. For instance, if a patient has had prior difficulty with a task or assignment, they will continue to view those activities negatively and with some degree of emotional aversion. Through cognitive behavior therapy, clinicians can effectively focus on detrimental thought patterns and motivate patients to tolerate discomfort and sufficiently perform tasks enough to see progress. This intervention can help limit the negative thinking that is an integral component of the conceptualizations associated with the disorder.

Emotional aversions to tasks may also arise because adult ADHD patients typically spend more net time on a given task than their peers. Despite this, their efforts will frequently yield fewer positive results. Some patients will react with self-criticism and avoid taking the necessary steps to complete the task.

Patients should be encouraged to feel comfortable requesting help and making reasonable accommodations for themselves. Some patients, however, may rely too heavily on others, such as clinicians or family members, and may be prone to underutilizing their own skills. These individuals must learn to effectively balance their utilization of self-maintained coping mechanisms with their requests for professional and familial help.



  1. Cognitive Behavioral Therapy. National Alliance on Mental Illness Web site. Accessed June 17, 2011.
  2. Safren SA, Perlman CA, Sprich S, Otto MW. Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program Therapist Guide (Treatments That Work). New York, NY: Oxford University Press; 2005.
  3. Solanto MV. Cognitive-Behavioral Therapy for Adult ADHD: Targeting Executive Dysfunction. New York, NY: Guilford Press; 2011.
  4. Weiss M, Hechtman LT, Weiss G. ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment. Baltimore, MD: JHU Press; 1999.


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