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Key points
- A seasoned therapist takes in the whole person: what’s happening psychologically, relationally, and environmentally.
- Find someone who understands ADHD and executive functioning challenges and works collaboratively to solve daily issues effectively.
- Effective therapy will use a variety of evidence-based modalities to create appropriate interventions to address mental health issues.
Recently, I received an email from a 22-year-old queer woman recently diagnosed with ADHD and depression.
They said,
I am trying to find someone to speak with. I need help understanding my ADHD. I'm also feeling sad every day.
What should I be looking for in a therapist? I want to find someone that can explain to me what is going on in my brain and how I can feel happier. I don't know where to begin.
When you are struggling with ADHD and a co-existing mental health issue, it's so important to engage in a thorough process to find the best therapeutic match for you. You'll benefit from learning how to manage your executive functioning challenges and improve your mood simultaneously.
The first important step towards finding a therapist is acknowledging that you need more support to manage work, school, or daily life events.
You may notice more times of sadness, anxiety, or frustration. Or you may receive feedback from school or work that you aren’t performing up to par. Perhaps you struggle with making and maintaining friendships or feeling overwhelmed.
Maybe it’s hard to make desired changes in your life, you are using drugs or alcohol to cope with issues, or you feel lonely, disconnected, and bad about yourself. Finding someone to talk to who knows about ADHD, understands executive functioning struggles, empathizes with your situation, and works with you to find solutions can make things easier on all fronts.
You want to choose a therapist who doesn’t judge you or make you feel abnormal but rather expresses empathy, listens to what you say, pays attention to nonverbal messages, and offers a variety of useful interventions (cognitive-behavioral therapy, internal family systems, positive psychology, psychodynamic psychotherapy, mindfulness, etc.) to improve daily functioning.
Look for someone who also can explain how your brain works and why self-regulation, disorganization, focus, and initiation are common challenges when you live with an ADHD brain.
Therapy for older teens and adults with ADHD generally includes assessing, diagnosing, and treating ADHD and, specifically, the mental health conditions that travel with it. Whether it’s anxiety, depression, eating disorders, bipolar disorder, trauma, oppositional defiant disorder, self-harming behaviors, or substance abuse, a well-trained therapist will differentiate between these issues and use a variety of evidence-based modalities to create appropriate interventions.
In addition, therapists are licensed by the state after years of training and internships and are legally bound to adhere to 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 wide lens that includes environmental, family, and couples' issues and will examine connections between feelings, thoughts, behavior, and bodily health.
A seasoned therapist takes in the whole person: what’s happening psychologically, relationally, and in their environment. Instead of asking, “What’s wrong with this person? Or what’s wrong with you,” they wonder about what’s happened in your life that has brought you here, what’s going on in your present-day experiences, and how can we work together to create a future that fits you and supports your authenticity.
Although a crisis can be one type of motivator for wanting a therapist, some people seek therapy to pursue well-being and more satisfying relationships.
Either way, when working with an older teen or an adult with ADHD, the therapist has to do an intricate dance. They must move artfully between examining feelings, thoughts, and behavior while creating interventions with the client that aim at daily living issues that perpetuate the problems they came in for.
For healing and change to occur, there must be a practical aspect to the work that improves executive functioning challenges, builds self-esteem, improves resilience, and lowers stress. In addition, sometimes, there can be a family component to the therapy if that seems appropriate. It's important for any practitioner to get a sense of what this piece of the work would look like.
To find a therapist who best fits your needs requires a thorough vetting process. Be prepared to interview a few people before finding the one who clicks.
Follow these tips to help you along the way:
1. Reflect on what you are looking for: Forget about being shy. You are shopping for a service. Decide in advance how many people you are willing to try out.
- Do you want someone quieter and more introverted or more dynamic and actively engaged?
- Male or female?
- Older or younger?
- LGBTQIA friendly?
- Informed about autism, learning disabilities, trauma, and cross-cultural issues?
Be precise about what you want and do some research in advance.
2. Do your homework: Get referrals from your physician, friends, or colleagues before talking with your insurance company. Make sure whoever you see takes your insurance, and your insurance company has approved you to meet with a few different people.
You may want to be able to interview one or two people before making a decision.
3. Conduct a little phone assessment before agreeing to meet: Ask questions such as:
- “What type of training have you received about ADHD?”
- “How many clients with ADHD have you worked with, and how would you describe your work?”
- “Do you think you are an active participant who speaks freely or more of a listener who speaks occasionally?”
- “Do you coordinate with other professionals that might be involved?” “When and how do you elicit feedback?”
- You want to get a sense of what therapy would be like with them. Do they use the past to help you master troubling issues in the present?
- What types of interventions will they use to assist you and/or your child in applying and practicing what we discuss in session?
4. Inquire about collaborating with coaches: Therapy can dovetail nicely with coaching. For example, you may be working on social anxiety and making friends in therapy and then get help from a coach for strategies to complete homework or work projects more efficiently.
Some therapists incorporate coaching practices into their work with clients by focusing on action-oriented techniques and forward-thinking goals.
They may apply classic cognitive-behavioral tools such as making lists, trial-and-error experiments, or giving an assignment for the family to do in between sessions.
Coaches, however, are not supposed to use "therapeutic" tools, techniques, or interventions to treat a mental health diagnosis without being a licensed therapist. When they work with the same client, it’s best if the therapist and the coach coordinate what they’re doing and clarify goals to keep boundaries clean and monitor progress.
5. Give the therapist a chance: The first few therapy sessions are for getting to know each other and seeing if you are a good fit. Be prepared to share information about yourself and ask them any questions you may have about them and their work.
Make sure you are clear about therapy logistics, including the provider’s cancellation policy and financial arrangements. If things seem especially awkward and your gut tells you to continue looking, follow your instincts.
Otherwise, if the session goes well with a natural flow of conversation, solid listening, pertinent questions, and a positive connection, return for a second session and embark on the therapeutic process.
To find a therapist near you, visit the Psychology Today Therapy Directory.
