You’re wide awake at 1am, phone in hand, scrolling through tabs on ADHD coaching, CBT for ADHD, “ADHD coaching vs therapy”, and “ADHD coach vs therapist”. You read a few hopeful headlines, a couple of success stories, and at least one horror story. Instead of feeling clearer, your brain is now doing that familiar ADHD thing: too many options, not enough clarity, and a quiet fear of choosing “wrong”.
This guide is here to help you work out whether to start with therapy, especially CBT for adult ADHD, or ADHD coaching or how the two can work together in real life. It will not tell you that there is only one right answer. Instead, it will walk you through the differences, the overlaps, and some practical next steps so you can choose what fits your situation rather than what shouts loudest in your feed.
Not sure if it is ADHD yet?
If you are still wondering whether what you are experiencing is really ADHD, getting a clear assessment can make choices about CBT for ADHD, medication and ADHD coaching much simpler.
ADHD Certify, focuses on ADHD assessments for adults and children, while TheraChange provides ongoing therapy support once you know what you are dealing with.
This kind of joined up “diagnosis and treatment pathway” is how many UK services now organise ADHD care so that you are not left to piece it all together alone.
Before you decide between an ADHD coach and CBT, it helps to understand what CBT for ADHD actually looks like in a session and how it is different from the kind of practical, accountability focused support you get in ADHD coaching vs therapy setups.
What CBT for ADHD Actually Looks Like (Not Just in Theory)
CBT for ADHD is a structured talking therapy that helps you understand and change the thoughts, emotions and behaviours that keep ADHD patterns going. A qualified therapist delivers ADHD CBT, usually in weekly sessions, and focuses on concrete problems like getting started, staying on track and handling intense emotions.
In practice, sessions feel quite practical.
You might work on CBT exercises for ADHD such as breaking a task into smaller steps, using a “5-minute start”, tracking unhelpful thoughts like “I always fail” or using simple “pause and plan” steps to handle anger or rejection sensitivity.
These CBT techniques for procrastination and emotional storms are there to give you repeatable tools, not lectures about motivation.
In the UK, an NIHR Evidence summary published in 2024 concluded that cognitive behavioural therapy improves core ADHD symptoms in adults and can also help with related problems like low self-esteem, anxiety and depression, especially when added to medication.
CBT exercises for ADHD highlights practical skills for time management, organisation and emotional regulation.
What ADHD Coaching Is (And How It Differs from Therapy)
ADHD coaching is a practical, future focused service that helps you turn “I know what I should do” into “I actually did it this week”.
An ADHD coach works with you on concrete goals, daily routines, time and task management and accountability, which is especially relevant for ADHD coaching UK where support is often funded privately or through schemes like Access to Work.
Compared with therapy, which explores why you feel or react the way you do, ADHD coaching is more “What are we setting up this week so you can show up and do it” and centres on strengths, experiments and real-life problem solving.
Expert opinion suggests that ADHD coaching can improve executive functioning and follow through, especially alongside therapy, but it does not yet have the same guideline level backing as CBT or other psychological treatments so it is best seen as a complement rather than a replacement.
CBT vs ADHD Coaching: Which Is Right for You Right Now?
Once you know what CBT vs ADHD coaching actually mean, the next step is to see where you fit.
CBT vs ADHD coaching at a glance
| Aspect | CBT for ADHD | ADHD coaching |
| What it is | Structured psychological treatment using ADHD CBT techniques to change thoughts, emotions and behaviours. | Practical, goal focused support that targets habits, systems and accountability for ADHD in daily life. |
| Best for | Emotional pain, shame, anxiety or depression plus ADHD symptoms, and long-standing patterns like procrastination and conflict. | Practical, goal focused support that targets habits, systems and accountability for ADHD in daily life. |
| Who delivers it | Regulated mental health professional trained in CBT, often within NHS or accredited private services. | Trained ADHD coach or coaching service, standards vary; not a regulated mental health role. |
| Typical format and length | Time limited programme such as 8 to 16 weekly sessions, sometimes with follow ups or groups. | Flexible ongoing sessions, often weekly or fortnightly, online or in person, tailored to goals. |
| Evidence and guidelines | Backed by multiple trials and reviews and recommended in UK and international guidelines as part of CBT for ADHD treatment. | Growing but smaller evidence base, mainly showing improvements in executive function and follow through; no NICE level endorsement yet. |
| How you usually pay | NHS referral in some areas or private self pay; sometimes covered by insurance or health plans. | Usually self funded or supported by schemes like Access to Work or employer wellbeing budgets, especially for ADHD coaching UK. |
At this point, it can help to pause and ask: “Do I need an ADHD coach or therapist right now?”
Mini Decision Tool: 4 Questions to Help You Choose This Week
Answer these quickly in your head:
- Are your main struggles big feelings (anxiety, low mood, shame, conflict) or follow‑through (deadlines, chaos, missed tasks)?
- Have you had any self-harm or suicidal thoughts, or serious problems with alcohol or drugs, in the last year? (Yes / No)
- Do you need someone who can treat mental health conditions, not just help with habits and routines? (Yes / No)
- Could you realistically handle weekly tasks like simple CBT exercises for ADHD or small action steps between sessions right now? (Yes / No)
Now use it as a rule of thumb:
- Mostly feelings, any yes on risk, and yes to needing a regulated professional → lean therapy / CBT for ADHD first.
- Mostly follow‑through, no on risk, and you feel able to act on weekly tasks → ADHD coaching could be your starting point.
- A mix of both → consider a step-by-step plan where you secure therapy first, then add ADHD coaching UK or workplace support once you have a basic safety net.
Disclaimer:
This mini check is not medical advice. It is a starting point to clarify your needs, but a GP or qualified therapist should help you make any final decision about CBT or ADHD coaching.
Finding your next step
If reading this has left you thinking “I probably need to work on the patterns underneath my ADHD, not just the surface habits,” starting with CBT based therapy is often a strong first move for long term change.
The right provider will not just offer sessions, but also help you decide whether therapy is truly what you need right now, and how it fits alongside options like ADHD coaching and medication in a realistic care pathway.
At TheraChange, therapy is framed as something you can grow through, not stay in forever. The focus is on teaching practical tools and CBT exercises for ADHD that you can use independently, so over time you rely less on weekly appointments and more on your own skills and supports.
If you’re unsure whether CBT for ADHD is right for you, a short, structured conversation about your symptoms, goals, and current support can help clarify the next step, whether that’s beginning therapy, exploring ADHD coaching, or a combination that matches where you are now.
