Working Therapeutically With ADHD Clients

ADHD is increasingly recognised in adulthood, yet many therapists and mental health professionals still report feeling uncertain about how it presents in the therapy room and how best to support neurodivergent clients in compassionate, informed ways.

Often, ADHD is misunderstood as simply a difficulty with attention or organisation. But for many adults, the experience runs much deeper than that.

Many clients arrive in therapy carrying years of criticism, shame, overwhelm, and a persistent sense that something about them is "wrong" or "too much". Some have spent years masking their difficulties, while others have internalised messages that they are lazy, disorganised, dramatic, or failing at things that seem easy for everyone else.

When ADHD has gone undiagnosed for a long time, those experiences can significantly impact on identity, relationships, emotional wellbeing, and self-esteem.

ADHD Is More Than Attention

ADHD can affect far more than concentration.

Differences in executive functioning, emotional regulation, nervous system responses, and rejection sensitivity can all shape how someone experiences the world and relates to others.

Sometimes it isn't the situation itself that feels overwhelming, it's how quickly the nervous system reacts to it.

For some people with ADHD, rejection can feel like emotional acceleration. A small shift in tone, a delayed response, or a perceived misunderstanding can quickly trigger intense emotional responses before there has been time to process what is happening logically.

When these experiences are understood through a compassionate lens, shame often begins to soften. And when shame softens, regulation becomes more possible.

The Impact of Late Identification

Many adults with ADHD reach therapy long before they ever consider neurodivergence.

Instead, they may present with:

• Anxiety

• Burnout

• Low self-esteem

• Emotional overwhelm

• Relationship difficulties

• Chronic feelings of failure or inadequacy

For some, receiving an ADHD diagnosis later in life can bring both relief and grief. Relief that things finally make sense, and grief for the years spent misunderstanding themselves.

As therapists, understanding this context matters. It allows us to move away from pathologizing behaviours and towards curiosity, collaboration, and compassion.

ADHD Exists Within Relationships Too

ADHD doesn't only affect the individual, it often lives within the relationship dynamic too.

Many couples come to therapy not because love is missing, but because understanding has been lost beneath stress, frustration, hurt, and repeated miscommunication.

When ADHD is recognised and supported compassionately, relationships can begin to shift away from blame and towards teamwork, understanding, and more effective communication

Working in ADHD-Informed Ways

ADHD-informed practice isn't about having all the answers or becoming an expert overnight.

Often, it begins with slowing down, listening differently, recognising patterns that may previously have been overlooked, and understanding how shame, overwhelm, and nervous system dysregulation can shape a person's experience.

Small shifts in understanding within the therapy room can have a powerful impact on how safe, understood, and supported a client feels.

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Alongside my therapy, supervision, and ADHD assessment and coaching work, I also facilitate accredited CPD workshops for therapists and mental health professionals through The Listening Rooms.

One of the workshops we offer explores adult ADHD presentations, emotional regulation, rejection sensitivity, executive functioning, and practical ways of working more collaboratively and compassionately with neurodivergent clients.

If you'd like to explore the workshop further, you can find more information here:

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