Can Cognitive-Behavioral Therapy Help College Students with ADHD?

What you need to know

• A new 12-session cognitive-behavioral therapy (CBT) program was developed specifically for college students with ADHD
• The program focused on improving time management, organization, planning, and academic skills
• Students who completed the program showed significant improvements in ADHD symptoms and executive functioning
• The therapy was well-received by students and shows promise as a treatment option for ADHD in college

The challenges of ADHD in college

Attention-deficit/hyperactivity disorder (ADHD) affects about 8% of college students and can significantly impact academic performance and quality of life. College presents unique challenges for students with ADHD, as it requires more independent self-management compared to high school. Without the structure and support previously provided by parents and teachers, many students with ADHD struggle with:

• Time management and meeting deadlines
• Organization and planning
• Staying focused during lectures and while studying
• Completing long-term projects
• Resisting distractions and procrastination

These difficulties often lead to lower grades, higher dropout rates, and increased anxiety and depression among college students with ADHD. While medication can help reduce core ADHD symptoms, many students need additional support to develop the executive functioning skills necessary to succeed in college.

A new therapy program for college students

To address this need, researchers developed and tested a new cognitive-behavioral therapy program specifically designed for college students with ADHD. The 12-week program aimed to teach students strategies to improve their:

• Time awareness and management
• Organization and planning skills
• Ability to break down large tasks
• Techniques for overcoming procrastination
• Academic skills like note-taking and writing papers
• Challenging negative thought patterns

The program was delivered in weekly 2-hour group sessions on a college campus. Eighteen students diagnosed with ADHD participated in the study.

Key components of the therapy

The CBT program incorporated several key elements:

Cognitive strategies: Students learned “rules” or mantras to guide their daily scheduling, prioritizing, planning, and self-activation. For example: “If I’m having trouble getting started, then the first step is too big.”

Behavioral techniques: The program utilized methods like:

• Breaking down complex tasks into smaller, manageable parts
• Using contingent self-reinforcement
• Practicing distraction control
• Visualizing long-term rewards to sustain motivation

Academic skills: Several sessions focused specifically on applying executive functioning strategies to academic tasks like reading textbooks, taking notes in lectures, and writing papers.

Addressing negative thoughts: Two sessions were devoted to identifying and challenging negative self-statements and beliefs that can undermine progress.

Weekly practice: Each session included a home exercise for students to practice applying the new strategies in their daily lives. Completing these exercises was strongly associated with overall benefit from the program.

Promising results

After completing the 12-week program, students showed significant improvements in several areas:

ADHD symptoms: Both clinician ratings and students’ self-reports indicated a reduction in inattentive ADHD symptoms. Seven of the 18 students no longer met the full diagnostic criteria for ADHD after treatment.

Executive functioning: Students improved on measures of time management, organization, concentration, and overall executive functioning. However, there was still room for improvement compared to students without ADHD.

Academic strategies: Scores increased on scales measuring time management, concentration, and motivation related to academics.

Student feedback: Participants rated the program components as helpful overall. They found the strategies for using a planner, breaking down tasks, and challenging negative thoughts to be especially useful.

There were no significant changes in grades (GPA) or symptoms of depression and anxiety. The researchers suggest more time may be needed for the new skills to translate into academic performance.

Conclusions

• The cognitive-behavioral therapy program was feasible to implement on a college campus and well-received by students with ADHD
• Students showed meaningful improvements in ADHD symptoms and executive functioning after completing the program
• The therapy shows promise as a treatment option for college students with ADHD, either alone or in combination with medication
• More research is needed to determine the long-term benefits and compare the therapy to other treatment approaches

While the results are encouraging, this was a small initial study without a control group. Larger controlled trials are needed to confirm the effectiveness of this CBT program for college students with ADHD. However, the therapy provides a promising new option to help students develop the executive functioning skills needed to manage ADHD and succeed in college.