CBT for ADHD: Taking Accountability and Building Better Systems

Main Points, No Filter

✅ ADHD is an explanation, not an excuse. Understanding your ADHD means recognizing its impact without taking the blame for everything.

✅ You need better systems, not better intentions. Knowing what to do isn't the same as being able to do it consistently.

✅ Medication is one tool, not the whole toolbox. Effective ADHD management may include medication, behavioral changes, environmental adjustments, and therapy.

✅ Work with your brain, not against it. CBT for ADHD helps build practical skills for managing time, tasks, and space.

✅ You're the main character, but you're not alone. Taking accountability gives you agency in your story. Group therapy offers the opportunity to learn from others while working toward your own goals.

I recently learned about the word sonder. Merriam-Webster defines it as “the realization and understanding that all other people have lives as complex as one's own”. Perhaps there is a little bit of sorrow that you can’t fully know a person. As a parent, there is a little bit of grief that our children are having these whole other experiences that are not attached to us.

“[sonder is] the idea that we all think of ourselves as the main character and everyone else is just extras. But in reality, we're all the main character, and you yourself are an extra in someone else's story. “

John Koenig wrote about this in a book called The Dictionary of Obscure Sorrows.  Check out his TEDx Talk below.

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As the video suggests, when you find a word that describes your sentiment exactly, you feel understood and connected to others. This sentiment comes up in therapy sessions a lot. When I work with couples, we strive for each person to be heard and understood. Even though I didn’t realize there was a word for it, we are looking to achieve sonder.

In a healthy relationship, your partner is not intentionally doing something to piss you off. The conflict is a consequence of an action that may have nothing to do with you.  Understand that you are the main character in your story, but not your partner’s story.

To be clear, that doesn’t mean you can’t be irritated with your partner. Instead of feeling attacked, use that irritation as a cue that something important needs to be addressed. Use the idea of sonder to invite curiosity into the conflict. Realize that neither of you are intentionally picking at each other’s old wounds. Both of you enter the relationship with your own shit, now what do we do with it?

My previous blogs have discussed how to navigate conflict and how ADHD impacts a relationship.  Part of navigating through conflict is coming up with sustainable solutions. This includes what you would like to see from your partner and what are you willing to do differently.  As Ari Tuckman says, “if you are part of the problem, you are part of the solution”.

ADHD and Relationships: Understanding Your Role in the Story

ADHD is often the scapegoat in relationships. Blaming relationship conflict on ADHD is an easy target, so why not eliminate those so you can get to the deeper stuff?

ADHD is an explanation, not an excuse

If you have a gluten sensitivity, you follow a gluten-free diet or suffer the consequences. You make lifestyle adjustments because of your sensitivity. Gluten works for some people and it doesn’t work for you. The solution is that your family will accommodate and go to a restaurant that has gluten free options and but it’s still okay if your family eats the rolls set on the table.

If you have ADHD your partner may understand that you struggle with working memory or emotional regulation. Understanding means your partner works not to take it personally. They work to step down so you can step up. Understanding does not mean your partner has to deal with the consequences and while you do nothing about it.  Remember that while your partner is an extra in your story, the conflict and resolution of the story are defined by how the main character and supporting actors interact.  

Managing ADHD requires better systems, not better intentions

ADHD is a disorder of self-regulation. The question isn’t about your intentions; we can assume you don’t mean to forget to pay the bills. The question is what do you want to do about it? You have options here:

1. You could do nothing.

You have made it this far in life. You can decide if you want things to be the same or be different. You might think that taking medication or making changes is a sign of weakness. You shouldn’t have to “cheat” your way through life. You should be able to just do things like everyone else. If other people have an issue with you, that’s their problem, not yours.

2. You can do something about it. 

We call this the “contemplation stage”.

You are aware:

·      there is a problem

·      that you play a role in the problem

·      that you play a role in the solution

Having ADHD doesn’t mean you are broken or need to be fixed. ADHD is a way to describe how your brain works.  Maybe it’s worth it to try to make some changes to work with your brain, not against it. This is where we start talking about systems.

Systems can include (but are not limited to) medication, changes to behavior, and changes to the environment.

Understanding ADHD Treatment Options

Medication for ADHD

The first line of defense for ADHD is often medication. There is a variety of medication options, both stimulant and non-stimulant. There are pills, liquids, and patches each are delivered and metabolized in different ways. ADDitude magazine describes the different types of medication in this article. 

While medication is a common approach to treatment of ADHD symptoms, it is not the only approach. More importantly, medication itself isn’t nearly as effective when it’s the only tool in your toolbox.

Why medication alone may not be enough for ADHD

Medication availability and access

While availability is better now than before, sometimes the pharmacy just doesn’t have the medication in stock. The FDA has a portal for you to submit this information.  There are additional points of friction with accessing the medication when it is available, including limits with how soon you can get the prescription filled and the quantity that you can receive. Stimulant medication is not available via delivery, so you must pick it up from the pharmacy, which is not always convenient.

Remembering to take ADHD medication

If you have managed to get the medication and get it home, there is still the struggle taking the medication. Depending on how your body processes medication you may take more than one dose.

What ADHD medication doesn’t address

Research suggests that “drugs improve ADHD symptoms in about 70% of adults and 70–80% of children” (Advokat, 2013). The problem is that adults report inconsistent or discontinuation of the medication. The research goes on to say that “while … results show that stimulants are effective in reducing symptoms of ADHD in adults, uncertainties remain as to their efficacy on other key aspects of the clinical picture” (Biederman et al., 2011, p. 509).

How hormonal changes affect ADHD symptoms

I wrote previously about the change of ADHD symptoms that go along with changes in hormones. Because dopamine and estrogen fluctuate together, ADHD symptoms tend to fluctuate as well.

Non-medication treatments for ADHD

I often compare treatment for diabetes to treatment for ADHD. If you have diabetes, one prong of the approach is medication like insulin. But taking insulin isn’t enough. There are behavioral changes, like checking blood sugar and diet changes, in addition to medication, to effectively manage diabetes.

We have access to so much information that it can be overwhelming. How can a person who struggles with self-regulation filter through all the information to know where to start? You don’t have to do this alone. In fact, I don’t recommend it. There are experts who have done the research, taken the classes, and are trained to support you and your family as you embark on this journey. Just like finding the right medication, there will be a little trial an error with figuring out what works for you.

ADHD Coaching

Coaching for ADHD can address a specific goal or point of friction. Coaches offer actionable items that are in line with your goals. You get a different perspective and explore various ways to approach a problem.

Coaches come from various educational backgrounds and are not licensed by the state. This means the consumer has more options to find a coach that is the right fit. This also means that coaching is not a regulated profession like counseling.

If you feel like coaching might be a good fit for you, consider a coach that has been credentialed by the International Coaching Federation (ICF). There is even an ADHD-specific training within the ICF framework.

ADHD Support Groups

CHADD is an organization with local chapters. There are free resources for professionals, teachers, and parents. You can find support groups online and in person. CHADD also hosts an international conference. It is a collection of resources for professionals and the public.

Therapy for adult ADHD

Therapy for ADHD is counseling provided by a licensed professional. Look for a therapist for ADHD that has additional training in working with the diagnosis. You will see additional credentials like ADHD – CCSP (certified clinical service provider). Look for “neuroaffirming” or “neurodivergent” in the service descriptions.  

How can therapy help adults with ADHD?

Under the umbrella of therapy, there are different options that may be a good fit. You don’t need to have a diagnosis of ADHD in hand to participate in therapy. Therapy can help you understand the diagnosis if you suspect you have ADHD or have a family member with ADHD.

Individual therapy for ADHD

Individual therapy with a therapist who is an expert in ADHD will help you navigate your struggles while keeping in mind the unique perspective that comes with neurodivergence. The therapist may encourage you to focus more on self-regulation and self-compassion. You can read more about my approach to therapy here.

Couple therapy when one or both partners have ADHD

Couple therapy when one or both partners have ADHD navigates the “usual” couple conflicts that have been amplified by ADHD. We work to implement solutions that minimize the impact of ADHD on the relationship while ensuring the partner with ADHD doesn’t take the fall for everything.  You can read more about couple therapy here.

What is Cognitive Behavioral Therapy (CBT) for ADHD?

Cognitive Behavioral Therapy (CBT) is a theoretical perspective that guides clinicians in their work with clients. This approach involves change in behaviors (such as getting a better sleep routine) and change in thought (being okay with the fact that you need 8 hours of sleep to function). This approach can be structured or unstructured and offered in group or individual formats.

CBT for ADHD Group Therapy: The Therapy: No Filter Approach

Mary Solanto has created a group therapy format for clinicians. We have adapted the lessons to our no-nonsense approach to therapy.  

What skills will you learn in CBT for ADHD?

🎯 Self-Management techniques: breaking down large tasks into smaller ones (and completing those tasks)

🎯 Time Management Skills: scheduling, flow charting, time estimation, figuring out how to get out of the door ON TIME.

🎯 Space Management Techniques: systems for sorting, user friendly positioning of materials

I won’t sugar coat it. This is a commitment. The weekly sessions are two hours long and there is homework in between sessions to review the material and practice what you learned. Each session builds on skills learned in the previous session.  It’s a lot and it’s worth it.

What to expect from the 13-week ADHD group therapy program

Our first group will start in January 2027.  The group will meet weekly through April 2027.  Here is a breakdown of what you get:

✅ Weekly video therapy sessions with a group of 6 – 8 people

✅ Follow up emails with notes from the session and tasks to work on before the next session

✅ Mid-week email check ins

CBT for ADHD x Therapy: No Filter Fee Schedule

The mission and vision of Therapy: No Filter is based on agency and access, for the provider and the consumer.  This means that the clinician does not bill the insurance company for the services provided. This also means that the consumer has access to quality care delivered by an expert at a rate they can afford in a format that is as frictionless as possible.

Group Therapy Rates

The fee for a weekly two-hour session is $60. You will be provided with documentation (superbill) that will allow you to submit claims to your insurance company for out-of-network reimbursement. Reimbursement rates vary by insurance, on average clients are reimbursed $21 - $48 per session.

Optional Add-On Session

Additional sessions are available if you need to work through something on your own. Additional 30-minute sessions are available for $90.

Individual CBT for ADHD

If group therapy doesn’t work for you. I get it. We can work one on one. The rate for CBT for ADHD individual sessions in $200 per hour. You will get the same information and materials as the group with the ability to customize the approaches and have more flexibility for meeting times.  

Getting Started with CBT for ADHD x Therapy: No Filter

If you are ready to make the commitment, let’s talk about the next steps.

Step 1: Scheduled a CBT for ADHD consultation

Use this link to schedule a consult. We will use this time to:  

✅ discuss details of the group including expectations and etiquette

✅ discuss ADHD diagnosis and symptoms (including a brief self-report scale)

✅ troubleshoot any technology issues so you are all set to start in January

After this consult, we will decide if the group is right for you. Group therapy isn’t a good fit for everyone and that’s okay. My motto is “the right way to do things is the way they get done”.

Step 2: Sign Up for CBT for ADHD therapy

If you decide that is a good option for you, sign up for the group. Payment for the first session is due at sign up. This holds your spot and provides accountability. You will receive paperwork to complete prior to the first session including the financial agreement.

Step 3: Prepare for your 13-week commitment

Whether you’ve decided on individual, group, or the hybrid format, this is a 13-week commitment. Guard this time on your schedule. For the January group, this means you will see the group every week through mid- April. Think of it like a season long commitment to a sports team.

Step 4: Show up and participate

Decide to show up for the sessions. If you are doing the group, this isn’t listening with your camera off while cooking dinner. This is setting yourself up in a private space, with your camera on, and ready to contribute. There is something cool about the group dynamic and how it evolves over time. You will walk away with more than you think.

Agency in Writing Your ADHD Story

Let’s bring this back to sonder.

We are the main character of our own stories. You incorporate your unique experiences, struggles, and perspectives into your story. We have an internal monologue that no one else hears and experiences that others can never fully understand. This is true for you, your partner, your parents, your children, and your dog.

ADHD is part of your story. It is an explanation for some of the ways that you interact with the world. Remember, ADHD isn’t the main character; you are. You can decide how your story unfolds.

Taking accountability for how ADHD shows up in your life doesn’t mean you are taking blame and admitting that you are broken. Therapy for ADHD will help you recognize what you have control over and what you do not. It will also help you figure out what you are willing to do about it.

One of the cool things about group therapy is that we get a glimpse of the story of other main characters. We may see a little bit of ourselves in another person. Just knowing that you are not alone in your struggles helps push you to achieve your goals. You will benefit from the group, and the group will benefit from you. You don’t have to figure out your own story alone.

Ready to build better systems for your ADHD?

If you've made it this far, maybe you're ready to move from understanding your ADHD to doing something about it.

CBT for ADHD x Therapy: No Filter starts in January 2027.

For 13 weeks, we'll work on building systems for managing time, tasks, and space. We'll practice the skills, troubleshoot what isn't working, and figure out how to make the tools work for your brain and your life.

This isn't about becoming someone who doesn't have ADHD. It's about having more agency in how you manage it.

And I'm not going to sugarcoat it. Showing up for two hours every week, doing the work between sessions, and trying something different takes commitment.

But you don't have to do it alone.

Your next step? Schedule a free consult.

We'll talk about your ADHD symptoms, what you hope to get out of the group, and whether this format is a good fit for you.

The right way to do things is the way they get done.

You get to decide what happens next.

References:

Advokat C, Scheithauer M. Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Front Neurosci. 2013 May 29;7:82. doi: 10.3389/fnins.2013.00082. PMID: 23754970; PMCID: PMC3666055.