Key points
- In a 2010 JAMA trial of 86 adults already on medication, 12 sessions of CBT beat an attention-matched relaxation and education control, and responders kept their gains at 6 and 12 months.
- A Mount Sinai trial published in 2010 found that 12 weeks of group meta-cognitive therapy, a CBT-based approach to time management and planning, outperformed supportive therapy.
- A 2018 Cochrane review rated the evidence that CBT helps adults with ADHD in the short term as low quality.
- New York law includes psychotherapy in the licensed practice of psychology, clinical social work and mental health counseling.
- A telepractice provider serving a patient located in New York must hold a New York license or be otherwise authorized, according to the State Education Department.
Medication helps many adults with ADHD, but it does not teach anyone how to plan a week, start a dreaded task or recover after a missed deadline. That is the gap ADHD-focused therapy tries to fill. This article explains what CBT for adult ADHD involves, what the key trials found, which New York licenses can provide it and how to find a therapist, based on sources read in October 2026.
To be clear at the start: Dr. Shershow's practice does not provide therapy or CBT. The practice offers adult ADHD psychiatric evaluation, treatment planning, medication management when appropriate and ongoing follow-up. Many patients see a therapist separately, and the two kinds of care can run side by side.
What CBT for ADHD actually involves
Standard CBT is often built around anxious or depressive thinking. ADHD-adapted programs put more weight on skills. The best-known adult protocols were tested in Boston and New York:
- The Safren protocol (Massachusetts General Hospital). Twelve individual sessions for adults who still had significant symptoms despite medication. In the 2010 trial, core modules covered psychoeducation with organizing and planning (calendars, task lists, problem-solving), reducing distractibility and cognitive restructuring, with optional sessions on procrastination or involving a partner.
- Meta-cognitive therapy (Mount Sinai, New York). A 12-week group program that, in its authors' words, uses cognitive-behavioral principles to impart skills in time management, organization and planning, and targets thoughts that undermine self-management.
Both involve homework between sessions. Expect to practice a planner or task system, not only to talk about the week.
What the trials found
| Study | Who took part | Compared with | Main result |
|---|---|---|---|
| Safren et al., Behaviour Research and Therapy, 2005 | 31 adults stable on ADHD medication with continuing symptoms | Medication alone | Lower independent-rated ADHD symptoms with CBT; 56% responders versus 13% |
| Safren et al., JAMA, 2010 | 86 medication-treated adults with persistent symptoms | Relaxation with educational support (same number of sessions) | Better assessor-rated symptoms with CBT; responders 67% versus 33% on the ADHD rating scale; gains maintained at 6 and 12 months |
| Solanto et al., American Journal of Psychiatry, 2010 (Mount Sinai) | 88 adults, with and without medication | Supportive group psychotherapy | Greater improvement in inattention on self, collateral and blinded evaluator ratings |
| Lopez et al., Cochrane review, 2018 | 14 trials, 700 adults | Various | CBT may help in the short term; evidence rated low quality |
| Ostinelli et al., Lancet Psychiatry, 2025 | 113 trials of drugs, therapies and neurostimulation | Placebo or control | CBT reduced symptoms on clinician ratings but not on patients' own ratings |
The fair summary: CBT adapted for ADHD has real trial support, the trials are small, and the strongest evidence is for CBT added to medication in adults who still struggle. The larger reviews are more cautious than any single trial. A longer look at the research is in does ADHD treatment work in adults. The 2024 American Family Physician review of adult ADHD lists CBT among the recommended non-drug therapies.
Who can provide therapy in New York
Several licensed professions include psychotherapy in their legal scope of practice. Titles matter, because "therapist" and "coach" are not licenses.
| License | What New York law includes | Notes |
|---|---|---|
| Psychologist | Diagnosis and treatment of mental, emotional, cognitive and behavioral disorders, including psychotherapy and psychological testing (Education Law 7601-a) | Cannot prescribe in New York |
| Licensed clinical social worker (LCSW) | Diagnosis of mental, emotional and behavioral disorders, and short-term and long-term psychotherapy (Education Law 7701) | A licensed master social worker (LMSW) provides clinical services only under supervision in approved settings |
| Licensed mental health counselor (LMHC) | Assessment and treatment through counseling and psychotherapy (Education Law 8402) | One of four licensed mental health practitioner professions, with marriage and family therapists, creative arts therapists and psychoanalysts |
| Psychiatrist or psychiatric nurse practitioner | Medical diagnosis and prescribing; some also provide therapy | Ask whether therapy is part of the service or separate |
Before booking, look the clinician up on the State Education Department's online license verification search, which shows license type, status and any discipline. The steps are in how to check a license and record in New York, and they work the same way for psychologists, social workers and counselors.
Telehealth across state lines
The State Education Department's telepractice guidance for psychology says a practitioner serving a patient in New York "must hold a New York license, or be otherwise authorized to practice." If you live in New Jersey and see a New York therapist, or the reverse, ask which state's license covers the session you are taking from where you sit. The same location question shapes medical care, as explained in living in New Jersey, getting ADHD care in New York.
How to find an ADHD-informed therapist
- Use a professional directory. The Association for Behavioral and Cognitive Therapies, a professional organization, offers a "Find a CBT Therapist" directory of clinicians. Listing is not a guarantee of ADHD experience, so ask.
- Check academic programs. Some New York academic medical centers list CBT for adult ADHD among their services. Those are described in adult ADHD care in New York City.
- Ask your insurer for a list. New York-regulated plans must offer a first outpatient mental health appointment within 10 business days, and if they cannot find an in-network provider, must approve an out-of-network referral at in-network cost. New York's protections do not apply to self-funded employer plans. Details are in can't find an in-network psychiatrist.
- Ask your prescriber. A psychiatrist who knows your history can say what therapy should target.
Questions to ask a therapist
- How many adults with ADHD have you treated, and which approach do you use?
- Is the work structured, with skills practice and homework, or open-ended?
- How many sessions do you expect before we review progress?
- Will you coordinate with my prescriber if I sign a release?
- What is your license, and is it a New York license?
What to bring to the first session
- A short list of the two or three situations that go wrong most often, such as starting reports, paying bills or getting out the door on time.
- Your diagnosis paperwork or evaluation summary, if you have one, and a list of current medications.
- Your calendar or task system, even if it is barely used. Skills work starts from what you already have.
- Your plan's mental health benefit details, including copays and any limits on visits.
Therapy and medication together
Most of the trial evidence for CBT comes from adults who were already on medication and still had symptoms, which is why the two are often combined. A psychiatric evaluation helps sort out whether ADHD, anxiety, depression, a sleep problem or several of these are driving the difficulty, which in turn shapes what therapy should focus on. Dr. Shershow's evaluation covers those other explanations and ends with what it found and the treatment options that fit. The adult ADHD treatment page explains how care is organized, and practical non-drug supports such as ADHD coaching are compared separately.
Questions
Does Dr. Shershow provide CBT or therapy?
No. The practice provides adult ADHD psychiatric evaluation, treatment planning, medication management when appropriate and follow-up. Patients who want therapy see a separate licensed clinician.
Is CBT effective for adult ADHD without medication?
Some trials included adults not on medication, such as the Mount Sinai meta-cognitive therapy study. The strongest results, though, come from adults who were already taking medication and still had symptoms, and a 2018 Cochrane review rated the overall evidence as low quality.
How many sessions does ADHD-focused CBT take?
The tested programs ran about 12 sessions: 12 individual sessions in the 2010 Safren trial and 12 weekly group sessions in the Mount Sinai trial. Real-world courses vary, so ask the therapist what to expect.
Can a licensed mental health counselor treat ADHD in New York?
New York law defines mental health counseling to include assessment and treatment through counseling and psychotherapy. Counselors cannot prescribe, so medication would come from a physician or nurse practitioner.
Does insurance cover therapy for ADHD in New York?
Many plans cover outpatient mental health care, and New York-regulated plans must meet a 10-business-day standard for first outpatient appointments. The Department of Financial Services says New York protections do not apply to self-funded employer plans, so check your plan type and benefits.
Sources
- Safren et al., JAMA: CBT vs relaxation with educational support for medication-treated adults with ADHD (August 2010)
- Safren et al., Behaviour Research and Therapy: CBT for ADHD in medication-treated adults with continued symptoms (2005)
- Solanto et al., American Journal of Psychiatry: Efficacy of meta-cognitive therapy for adult ADHD (August 2010)
- Lopez et al., Cochrane Database of Systematic Reviews: Cognitive-behavioural interventions for ADHD in adults (March 2018)
- Ostinelli et al., Lancet Psychiatry: Comparative efficacy and acceptability of interventions for ADHD in adults (January 2025)
- American Family Physician: Attention-Deficit/Hyperactivity Disorder in Adults (August 2024)
- NYS Senate: Education Law section 7601-a, definition of the practice of psychology
- NYS Senate: Education Law section 7701, definitions of social work practice
- NYS Senate: Education Law section 8402, mental health counseling
- NYSED Office of the Professions: Mental health practitioners
- NYSED Office of the Professions: Psychology telepractice
- NYSED Office of the Professions: Online license verification
- Association for Behavioral and Cognitive Therapies: Get help (Find a CBT Therapist)
- NYS Department of Financial Services: Behavioral health insurance rights
