Fifteen minutes on the phone decides whether the next three months of therapy are the treatment that was tested or an expensive conversation. Most people spend those minutes describing their problem. Spend them asking questions instead.
**The short answer: the therapy with evidence for adult ADHD is structured, skills-based cognitive behavioural therapy with homework, around twelve to sixteen sessions, that works alongside medication. Six questions tell you whether a therapist runs it. Print this, make the call with it in front of you, score it, and stop calling when someone scores five or six.**¹ ²
Write down what you want before you dial
One sentence each. You will be asked, and the honest version saves a session.
- The three things that go wrong most weeks: ________________________ · ________________________ · ________________________
- Medication status: ☐ taking ☐ not taking ☐ deciding — prescriber: ________________________
- What "better" would look like in twelve weeks, in observable terms: ________________________
- Must-haves: ☐ evenings ☐ telehealth ☐ in person ☐ takes my plan ☐ sliding scale ☐ other: ________
Ask the six questions
Read them as written. Tick the column the answer lands in.
| # | Ask | Usable answer (1 point) | Stop answer (0 points) | ☐ |
|---|---|---|---|---|
| 1 | "Do you do CBT built for adult ADHD, and roughly how many adults with ADHD have you treated that way?" | Yes, a number, and a mention of structured modules or a manual | "I work with all kinds of issues" | ☐ 1 ☐ 0 |
| 2 | "What happens between sessions?" | Assigned practice that they review next time | "Whatever feels right for you" | ☐ 1 ☐ 0 |
| 3 | "How many sessions, and how will we know it is working?" | A range near twelve to sixteen; a repeated symptom or functioning measure | "It depends how deep we go" | ☐ 1 ☐ 0 |
| 4 | "Will you look at my actual calendar and task list?" | Yes, in session; one system for everything | "That's more of a coaching thing" | ☐ 1 ☐ 0 |
| 5 | "How do you work with my prescriber, and do you prescribe?" | Coordination with my consent; a clear no on prescribing | Any promise about medication | ☐ 1 ☐ 0 |
| 6 | "Which licence do you hold, and what is the number?" | Licence type and number, said plainly | Hesitation, or a coaching certificate as the only credential | ☐ 1 ☐ 0 |
Total: ______ / 6
The evidence behind the questions: across 32 studies, CBT for adult ADHD produced large pre-to-post effects (g = 1.00 on symptoms) and medium effects against controls; longer treatment was not better; format did not change the result.¹ In the randomized trial of medicated adults with persistent symptoms, twelve structured sessions doubled the response rate against relaxation with educational support, and gains held at a year.² Questions 1 to 4 test for that structure. Questions 5 and 6 test for scope.
Ask the two questions that are about you
Not scored; written down.
- "What would you want to know about me before the first session?" — ________________________
- "What is the total cost for a twelve-session course at your rate, and what happens to the rate if I use insurance?" — ________________________ (what a superbill is →)
Verify before you book
- Licence number from question 6, checked on the state's own lookup, not the therapist's website: ☐ done — how to verify a California licence →
- Licence type is one that can provide psychotherapy in California (psychologist, LMFT, LCSW, LPCC, or a registered associate under supervision): ☐ yes — what an associate is →
- "ADHD coach" is the only credential offered: ☐ if yes, this is coaching, not therapy — coach, therapist, evaluator or prescriber →
Score and decide
- 5–6 points, licence verified: book. Ask for the first two sessions to include the systems review.
- 3–4 points: ask one follow-up: "Would you be willing to run a structured twelve-session course with homework?" A yes with specifics moves them to 5. A hedge does not.
- 0–2 points: thank them and call the next name. This is not a judgment of the therapist; it is a mismatch between what you need and what they do.
Calls made: ______ · Highest score: ______ · Booked with: ________________________ · First session: ____ / ____
What happens next
Bring Step 1 to the first session and ask that the systems review happen in the first two. If, by session four, there has been no homework and no look at your calendar, say so in the room; the treatment with evidence has both, and a therapist who runs it will not be offended. What the sessions should contain, and what does not count →
Ready to make the calls? Filter therapists by approach, evening availability and payment route → · What happens on a consult call, in general →
Sources
- Knouse LE, Teller J, Brooks MA, "Meta-analysis of cognitive-behavioral treatments for adult ADHD," Journal of Consulting and Clinical Psychology 85(7), 2017 — doi.org.
- Safren SA, Sprich S, Mimiaga MJ, et al., "Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial," JAMA 304(8), 2010 — doi.org.
Paid for by participating therapists. Inclusion is computed from availability data — never purchased. No ads, no data sold.