ArticleFrontiers in psychiatry2026
Strategies to enhance engagement in CBT for adult ADHD: an innovation tournament with stakeholders.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Adults with ADHD report challenges engaging in cognitive-behavioral therapy (CBT). This study investigates practices that might be applied to improve intervention fit and therapeutic engagement of CBT for adults with ADHD. Method: We conducted an Innovation Tournament (IT) and member checking with participants ( Results: A range of engagement barriers were identified, chief among them practitioner low understanding of ADHD (44.4%) and lack of attention to relevant impairments (33.3%). The highest rated focal areas for CBT were task management, organization, planning, and prioritization, emotion regulation strategies, responding to negative/maladaptive thoughts, anti-procrastination and self-motivation strategies, and long-term goal setting. Top recommendations for engagement strategies include ensuring high therapist knowledge of ADHD and 17 elements consistent with Motivational Interviewing. Some practices commonly found in CBTs for ADHD were rated as unpopular with stakeholders, most notably providing weekly ratings of ADHD symptoms as progress monitoring. Some practices rated as important to adults with ADHD were rated as not feasible to practitioners-most notably reducing shame and nurturing confidence. Implementation barriers identified were primarily related to low practitioner knowledge and skills, but also sometimes systemic constraints on practice. Conclusions: Implementation of recommended practices noted in this study should be tested empirically to understand the extent to which they increase engagement and effectiveness over standard practice.
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