ADHD and the search for therapy? | Psychology Today Canada

Recently, I received an email from a 22-year-old queer woman recently diagnosed with ADHD and depression.

They said,

I’m trying to find someone to talk to. I need help understanding my ADHD. I also feel sad every day.

What should I look for in a therapist? I want to find someone who can explain to me what is going on in my brain and how I can feel happier. I do not know where to start.

When you’re struggling with ADHD and a co-existing mental health issue, it’s so important to engage in a thorough process to find the best therapy fit for you. You will benefit from learning to manage your executive functioning challenges and improve your mood simultaneously.

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The first important step in finding a therapist is to recognize that you need more support to manage work, school, or daily life events.

You may notice more moments of sadness, anxiety, or frustration. Or you may receive feedback from school or work that you are not performing up to par. Maybe you find it hard to form and maintain friendships or feel overwhelmed.

Maybe it’s hard to make the changes you want in your life, you use drugs or alcohol to cope with problems, or you feel lonely, disconnected, and bad about yourself. Finding someone to talk to who knows about ADHD, understands the challenges of executive functioning, understands your situation, and works with you to find solutions can make things easier on all fronts.

You want to choose a therapist who does not judge you or make you feel abnormal but rather expresses empathy, listens to what you say, pays attention to non-verbal messages and offers a variety of helpful interventions (cognitive behavioral, internal family systems, positive psychology, psychodynamic psychotherapy, mindfulness, etc.) to improve daily functioning.

Look for someone who can also explain how your brain works and why self-regulation, disorganization, focus, and initiation are common challenges when living with an ADHD brain.

Therapy for older adolescents and adults with ADHD generally includes assessment, diagnosis, and treatment of ADHD and, in particular, accompanying mental health issues. Whether it’s anxiety, depression, eating disorders, bipolar disorder, trauma, oppositional defiant disorder, self-harming behaviors or substance abuse, a well-trained therapist will make the difference between these issues and will use a variety of evidence-based modalities to create appropriate interventions. .

Additionally, therapists are state-licensed after years of training and internships and are legally bound to follow state ethical and practice regulations. They consider race, gender, sexual preference, socioeconomic status, and religious issues that affect identity development, lived experience, and emotional and behavioral management. They look at a person with a broad focus that includes environmental, family, and relationship issues and will examine the connections between feelings, thoughts, behavior, and physical health.

An experienced therapist takes into account the person as a whole: what is happening psychologically, relationally and in their environment. Instead of asking, “What’s wrong with this person?” Or what is wrong with you”, they wonder what happened in your life that brought you here, what is happening in your current experiences and how can we work together to create a future that works for you and that supports your authenticity.


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Although a crisis can be a type of motivation for wanting a therapist, some people seek therapy to seek well-being and more satisfying relationships.

Either way, when working with an older teen or adult with ADHD, the therapist needs to do a complex dance. They must move shrewdly between examining feelings, thoughts, and behavior while creating interventions with the client that target everyday life issues that perpetuate the issues for which they came.

For healing and change to occur, there must be a practical aspect to the job that improves executive functioning challenges, builds self-esteem, improves resilience, and reduces stress. Also, sometimes there may be a family component to the therapy if that seems appropriate. It is important for any practitioner to have an idea of ​​what this part of the job would look like.

Finding a therapist that best suits your needs requires a thorough vetting process. Be prepared to interview a few people before you find the one that clicks.

Follow these tips to help you through the process:

1. Think about what you are looking for: Forget being shy. You are shopping for a service. Decide in advance how many people you are willing to try.

  • Do you want someone more calm and introverted or more dynamic and actively engaged?
  • Masculine or feminine?
  • Older or younger?
  • LGBTQIA friendly?
  • Knowledgeable about autism, learning disabilities, trauma and cross-cultural issues?

Be specific about what you want and do your research beforehand.

2. Do your homework: Get recommendations from your doctor, friends or colleagues before talking to your insurance company. Make sure the person you are seeing has your insurance and that your insurance company has cleared you to meet a few different people.

You may want to be able to interview one or two people before making a decision.

3. Do a short telephone assessment before accepting an appointment: Ask questions such as:

  • “What kind of training have you received on ADHD? »
  • “How many ADHD clients have you worked with and how would you describe your work? »
  • “Do you think you are an active participant who speaks freely or rather a listener who speaks occasionally? »
  • “Do you coordinate with other professionals who may be involved?” “When and how do you get feedback? »
  • You want to get an idea of ​​what therapy with them would be like. Do they use the past to help you deal with troubling issues in the present?
  • What types of interventions will they use to help you and/or your child apply and practice what we discuss in the session?

4. Find out about working with coaches: Therapy can go well with coaching. For example, you can work on social anxiety and make friends in therapy, then get help from a coach to find strategies to complete homework or work projects more efficiently.

Some therapists incorporate coaching practices into their work with clients, focusing on action-oriented techniques and forward-thinking goals.

They can apply classic cognitive-behavioral tools such as to-do lists, trial-and-error experiments, or give the family a task to do between sessions.

Coaches, however, are not expected to use “therapeutic” tools, techniques, or interventions to address a mental health diagnosis without being a licensed therapist. When working with the same client, it is best for the therapist and coach to coordinate what they are doing and clarify goals to keep boundaries clean and track progress.


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5. Give the therapist a chance: The first therapy sessions are for getting to know each other and seeing if you are a good candidate. Be prepared to share information about yourself and ask them any questions you may have about them and their work.

Be sure to be clear about the logistics of the therapy, including the provider’s cancellation policy and financial arrangements. If things seem particularly awkward and your gut is telling you to keep looking, follow your gut.

Otherwise, if the session is going well with a natural flow of conversation, solid listening, relevant questions and a positive connection, come back for a second session and embark on the therapeutic process.

To find a therapist near you, visit Psychology Today’s Directory of Therapies.

About Margie Peters

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