Non-Pharmaceutical Psychological Interventions for Adult ADHD: A Comparative Literature Review

Abstract

Adult attention-deficit/hyperactivity disorder (ADHD) is estimated to affect 2.5–5% of adults globally. Although medication remains a first-line treatment, many individuals experience only partial benefit, unwanted side effects or discontinue use over time. This review examines current evidence on four major non-pharmacological interventions—cognitive-behavioural therapy (CBT), mindfulness-based approaches, psychoeducation, and cognitive training—and discusses their effectiveness and clinical relevance. Findings from randomized controlled trials and meta-analyses show consistent clinician-rated improvements across all four interventions. CBT shows the most consistent effects, leading to reductions in symptoms and improvements in daily functioning. Mindfulness-based interventions are particularly effective in enhancing attention and emotional regulation, while psychoeducation improves participants’ understanding of ADHD and their self-management skills. Cognitive training yields modest gains in cognitive performance, though its transfer to real-world functioning appeared limited. Top-down approaches such as CBT and psychoeducation, and bottom-up methods like mindfulness and cognitive training, represent complementary therapeutic pathways. Combining these evidence-based strategies within individualized, multimodal treatment plans may improve outcomes for adults with ADHD beyond what medication alone can achieve.