ADHD in adults is often misunderstood as simply being distracted or forgetful—but it runs much deeper than that. For many, it feels like a constant storm of emotional overwhelm, missed deadlines, and persistent self-doubt. While medication and behavioral strategies are commonly used in treatment, Acceptance and Commitment Therapy offers a compelling, evidence-based approach that addresses the emotional and cognitive complexities of adult ADHD.
ACT Strategies for Adult ADHD: Building Attention, Resilience, and Execution led by Dr. Jillian Graves, equips social workers, therapists, counselors, and psychologists with the tools to help clients manage ADHD in a more values-driven, compassionate way. Through ACT, clinicians can support adults in reconnecting with what truly matters, regulating emotional impulses, and taking committed action—even in the face of daily challenges.
Learn how the six core processes of ACT can be tailored to meet the unique struggles adults with ADHD experience, particularly when anxiety and depression are also present.
ADHD in Adulthood: More Than a Focus Problem
ADHD in adults never quite appears simply as hyperactive behavior. Rather, it may take the form of inner turmoil such as emotional reactivity, difficulty initiating tasks, trouble staying focused, and an ongoing feeling of being behind or "failing at life." Dysfunction at the heart of ADHD can generate distress in almost every domain, including work and relationships, as well as pose implications for self-esteem and health.
Making it worse, most adults with ADHD may also have comorbid conditions such as depression and anxiety. This can make them seem avoidant, overly perfectionistic, or lacking motivation when in fact they are stuck in cycles of shame, self-criticism, and emotional fatigue. Standard care for ADHD management doesn't quite cut it in these situations, as clients become incapable of initiative and action.
The Six Core Processes of ACT and How They Help ADHD Clients
ACT is founded on six interrelated processes intended to develop psychological flexibility- the quality of being able to remain present, open, and engaged with life even in the face of challenging thoughts, feelings, or urges. Below are the ways in which each process specifically benefits adult ADHD clients:
- Cognitive Defusion: Many adults with ADHD struggle with unhelpful thoughts like “I’m lazy,” “I’ll never get it together,” or “Why bother trying?” ACT helps clients recognize these as mental events, not facts, reducing their power over them.
Clinical Example: Use effective exercises to help clients observe their thoughts without self-judgment. Encourage them to repeat a negative thought in a silly voice to build distance and reduce believability.
- Acceptance: ACT invites clients to let feelings like frustration, boredom, or distraction arise naturally without attempting to eradicate or control them. This decreases emotional energy wasted in trying to combat reality and enables clients to focus on what matters most now, even when it is discomforting.
- Present-Moment Awareness: Adults with ADHD tend to "time travel" between past regrets and anxieties about the future. ACT directs them to be anchored in the present, which promotes mindfulness and engagement in present-day tasks.
Clinical Example: Learn a brief "5 senses" grounding exercise to prepare for an upcoming session or task to increase awareness and soothe over activated nervous systems.
- Self-as-Context
Clients come to view themselves as something other than being reduced to their diagnosis or symptoms. This process establishes a strong sense of self not defined by the ADHD label.
ACT Tool: Lead clients to look at things they've experienced or achieved in spite of their condition, as this can reinforce identity outside the ADHD label.
- Values: Values act as a compass for ACT. For ADHD clients who consistently feel "off track," values give clarity as to what is most important, thus motivating them to continue sustained effort over time.
- Committed Action: The behavioral component of ACT comes into play here. Clients define various small and feasible steps to behave that are aligned with their core values, even if they have to face inner resistance.
For instance, the broader goal of creating a résumé starts with the step “open a Google Doc”. The underlying idea is to reward progress, not perfection.
Working with Comorbid Anxiety and Depression
Comorbid clients with ADHD often have trouble with both depression and anxiety, which further complicates action and infuses them with shame. Below are four tips for modifying ACT techniques in such situations:
- Normalize Internal Struggles: Reinforce painful feelings and thoughts as not indicators of failure but part of being human. Employ metaphors such as "Passengers on the Bus" to describe moving forward painfully.
- Pace Progress Gently: Depressed clients might have little energy, while anxious clients might dread failure. Present committed action in terms of experiments instead of "must-dos" can mitigate pressure.
- Strengthen the Observer Self: Assist clients in the practice of observing their mind without being overwhelmed by it. This increases resilience and decreases the tendency to obsess over certain thoughts.
- Process Over Outcome: Emphasize value-driven action, not merely outcomes. This creates self-compassion and maintains motivation in the long term.
Why ACT Appeals to ADHD Clients
Most treatments try to get rid of the symptoms, but ACT flips that around. Its focus is on living in a meaningful way, despite the symptoms. This is particularly effective with ADHD clients who've learned they need to be "fixed" to do well in life.
By accepting the present moment, what is happening within them, and what they care about, ADHD clients can develop resilience, attention, and emotional regulation. This comes not through trying to change, but through becoming more adaptive towards change.
Advance Your Clinical Learning
If you work with adult clients with ADHD, particularly those also experiencing anxiety or depression, Core Wellness' ACT Strategies for Adult ADHD course is a must-have resource for professional counsellors and psychologists.
Instructed by Dr. Jillian Graves, a mental health practitioner with extensive experience in the fields of Dysregulation Trauma who specializes in ACT and other interventions. This interactive and actionable course provides:
- An overview of the six ACT core processes with adaptations specific to ADHD
- This course is full of clinical application, featuring experiential exercises, case studies, and tools to incorporate into your practice immediately.
- Methods to adapt ACT techniques to foster psychological flexibility and lower avoidance in comorbid clients.
Final Thoughts
Adult life with ADHD is not chaos, failure, or emotional overload. Through ACT, clients can learn to accept their inner experiences and take actions that matter toward a life that is consistent with who they are.
With the appropriate clinical tools, you can walk them gradually through distraction, manage emotions, and behave in accordance with their values.
Core Wellness is committed to empowering therapists with evidence-based training through both live and on-demand courses. By adding ACT skills to your clinical toolbox, you can assist your ADHD clients through implementation based on acceptance and values and thus bring meaningful change in their lives.
