Psychotherapy is essential in the treatment of ADHD for several reasons. First, it can decrease impulsivity by increasing the ability to label, stay with and let go of emotional reactions. Impulsivity can be tamed if you can put one step in between an impulse and an action. Impulsivity results when behavior becomes automatic. This means there is no thought process - there is simply an action that after the fact seems like a really bad idea. As an example, a person with ADHD may be driving home from work and without really thinking about it, drive into a bar and after the fact notice that he had promised to take his son to his soccer practice.
Another reason psychotherapy is essential is that the diagnosis of ADHD is unreliable. This means that depending on the process of evaluation, there is some chance that the diagnosis of ADHD is wrong. A person who has high levels of anxiety and or depression will have difficulty concentrating, difficulty following direction, difficulty following through and poor judgment. A very thorough evaluation lasting over time is usually required to sort out these difficult differential diagnoses. I treat many people that come to me with the diagnosis of ADHD and by the end of 12 sessions, it is clear that the distractibility and difficulty concentrating are primarily related to anxiety.
Psychotherapy can also target key symptoms such as procrastination. Clients can be asked to predict how difficult a certain task will be and then after they complete the task to record how painful it really was to follow through. Most people find that resistance is caused by a "boogey man." The dreaded and avoided tasks are often not as bad as they seem. As an example, you may find it took 15 minutes to complete some paperwork that you imagined would take hours and would be tormenting to complete.
Simple shifts can help overcome procrastination such as asking clients to shift their attention from how terrible they imagine the task to be to how good they will feel when it is behind them. This can increase motivation enough to overcome procrastination.
Psychotherapists can increase the level of functioning for children and adults who struggle with ADHD. This doesn't mean that it cures ADHD, but many people can have all the symptoms of ADHD but have successful careers and relationships. Psychotherapy can help you reach that state.
More Answers from Lara Honos-Webb, PhD