Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that can affect behavior. Behavioral therapy can help manage ADHD symptoms by encouraging helpful changes and improving self-control and self-esteem.

Treatments for ADHD typically involve medication and psychotherapy. Behavioral therapy is a type of psychotherapy that can help a person with ADHD develop or enhance a wide range of skills in order to manage challenges related to behavior. It can also help parents and other caregivers develop constructive ways to respond to children with ADHD.

The effectiveness of therapy varies from person to person, and a doctor may also recommend medication to achieve the best results.

In this article, we describe what behavioral therapy is, how effective it is for ADHD, and which techniques different types of behavioral therapy employ.

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Behavioral therapy is an umbrella term for different forms of therapy focusing on a person’s behavior.

The aim is to help a person identify unhealthy or harmful behaviors and change these by adopting helpful behaviors instead. It is based on the idea that a person learns behavioral patterns and can therefore learn new ones, though learning and reinforcing these behaviors can take time.

Common forms of behavioral therapy can include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

Certain behaviors associated with ADHD can be disruptive and challenging. Medication can help control the core symptoms, while behavioral therapy aims to teach or enhance helpful coping skills and strategies.

Different forms of behavioral therapy may help a person:

  • stay focused for longer
  • organize thoughts and tasks
  • reduce procrastination
  • avoid hyperactivity when it is inappropriate
  • identify and correct impulsive actions

While research is often in early stages, there is growing evidence that behavioral therapy is an effective component of ADHD treatment.

The Centers for Disease Control and Prevention (CDC) note, for example, that parent training and behavioral training in young children who have ADHD can help with symptoms. This may require caregivers, teachers, and therapists to jointly establish rules and define positive behaviors.

A 2016 study, meanwhile, found that CBT is an effective treatment for adolescents with ADHD that has not responded well to medication. A similar 2018 study concluded that college students with ADHD benefit from CBT. The researchers reported that the participants experienced less severe symptoms and improved “executive functioning,” a broad set of skills that help people complete tasks, manage time, and control emotions and behavior.

Adults with ADHD may also respond well to CBT. A 2016 review, for example, found mounting evidence that CBT may help reduce the symptoms in adults.

In addition, adults with ADHD are more likely to experience anxiety and depression which CBT can address.

Learn more about ADHD and relationships here.

As the research cited above suggests, some form of behavioral therapy may benefit a person of any age with ADHD — and it may also help caregivers.

For example, the CDC reports that training in basic behavioral therapy may be useful for caregivers of children under 12 with ADHD. The training can teach parents and other caregivers to provide the structure and support that the child requires, while also teaching the child helpful behaviors.

The age at which a child is ready for their own therapist can vary, but the average age is about 8–10 years old. From this point into adulthood, a person may work directly with a therapist to meet their behavioral goals.

There are many forms of behavioral therapy, and the most effective one depends on factors specific to each person. Someone with ADHD might consider:

CBT

This focuses on a person’s thoughts and behaviors. It can enable a person to change negative thought patterns to positive ones by changing the way that they view challenges. It can help people with ADHD find more effective approaches to time management, organization, planning, and impulse control. CBT can also help a person find more useful ways to manage emotions and stress.

DBT

This helps people tolerate and regulate their emotions. The goal of DBT is to teach people techniques that help them understand their emotions, as well as applicable ways to manage emotions and change behavior. This can help prevent impulsive or self-destructive patterns of behavior.

Coaching

This is a practical intervention that specifically targets areas of difficulty for a person with ADHD — areas such as planning, time management, goal-setting, organization, and problem-solving. Coaches provide practical skills to teach people with ADHD how to overcome these challenges.

Neurofeedback

This involves measuring brain activity and attempting to alter it to reduce symptoms of ADHD. People with ADHD typically display less activity in areas of the brain associated with personality, behavior, and learning. Neurofeedback aims to change behavior by increasing activity in these areas of the brain.

Learn more about neurofeedback for ADHD.

While each method of behavioral therapy differs, they overlap in using operant and classical conditioning techniques.

Operant conditioning is based on reinforcement. It aims to teach and reward positive behaviors to make them more likely to occur. Classical conditioning is a learning process in which people associate two stimuli to bring about a certain effect. For example, associating a certain sound with sleep may help a person feel sleepy after hearing that sound.

After identifying a problematic behavior, a person and their therapist can develop a plan to address it and substitute a positive behavior. This could involve a reward for switching to the more helpful behavior and consequences for continuing with the problematic one.

A child with ADHD may benefit from a goal chart. Demonstrating positive behavior moves the child one step closer to a reward on the chart, while problematic behavior sets them back. Seeing their progress can give a child a sense of accomplishment as they work toward their goal.

Behavioral therapy for ADHD is not a quick solution; it takes time and discipline to see results.

Changing thoughts and patterns of behavior requires regular effort, and while it can help to set time limits for certain milestones, the pace of progress depends on factors specific to each person and how effective the treatment is for them.

By working closely with a therapist, people with ADHD may see improvements in symptoms and feel more in control of them. Even after seeing improvements, it is important to stay consistent with the reward and consequence system to avoid backsliding.

Doctors often recommend behavioral therapy for ADHD alongside other treatments, such as medication. Stimulant or nonstimulant drugs may address the neurological component of the disorder, such as by increasing the levels of important neurotransmitters in the brain.

Behavioral therapy can complement medication well, especially when medication alone is ineffective.

Behavioral therapy for ADHD involves identifying problematic behaviors and working to substitute positive ones. Research suggests that behavioral therapy is an effective way to manage symptoms of ADHD in children, teenagers, and adults.

A doctor may suggest that a person with ADHD also takes medication for the most effective results.