How can cognitive behaviour therapy help with ADHD-related imposter syndrome? 

Many adults with ADHD experience deep-rooted self-doubt; feeling like a “fraud”, minimising achievements or worrying they are not “really” capable. Although research hasn’t yet examined ADHD-specific imposter syndrome directly, there is strong evidence that adults with ADHD frequently struggle with low self-esteem, shame and negative self-evaluation. A 2024 systematic review found consistently lower self-esteem in adults with ADHD, with self-esteem closely linked to depression, suicidality, and social anxiety (systematic review). 

This matters because imposter feelings are often fuelled by the same patterns: harsh self-criticism, masking, perfectionism and misinterpreting difficulties as personal failure rather than part of ADHD. 

Why CBT is recommended for adults with ADHD 

According to NICE NG87, adults with ADHD who choose non-pharmacological treatment should be offered a structured psychological intervention focused on ADHD, which may include CBT elements such as problem-solving, skills training and coping-strategy development (NICE NG87). NICE also advises considering CBT when medication improves core symptoms but emotional or functional difficulties persist, underscoring CBT’s role in supporting confidence, mood and self-evaluation. 

Recent NHS-based research shows that adults see CBT as a way to explore “patterns in behaviour, thinking and thought content”, although generic CBT needs adaptation for ADHD to address executive-function challenges and emotional dysregulation effectively (mixed-methods CBT study). 

How CBT helps with imposter-like thoughts in ADHD 

Even though imposter syndrome itself hasn’t been studied directly in ADHD, CBT mechanisms are well-established and map closely onto the patterns that drive imposter feelings: 

• Identifying self-critical patterns. CBT helps people notice automatic thoughts such as “I don’t deserve this job” or “I’m only succeeding by accident”. These patterns are common in ADHD, where shame and masking are widely reported in qualitative studies (qualitative synthesis). 

• Challenging unhelpful beliefs. Through cognitive restructuring, individuals examine evidence for and against “fraud” beliefs and begin developing a more balanced view of their abilities. 

• Behavioural experiments. CBT often involves gently testing predictions (for example, “If I ask for help, they’ll realise I’m useless”). Evidence from broader CBT literature shows this can reduce fear-driven avoidance and recalibrate self-beliefs. 

• Building practical skills. ADHD-adapted CBT includes concrete strategies for time management, organisation and emotional regulation. As functioning improves, confidence often grows; a mechanism supported by work-focused and metacognitive interventions showing better performance and perceived competence (Work-MAP intervention). 

• Improving self-awareness. ADHD research shows discrepancies between perceived and actual performance in some cognitive tasks, suggesting that metacognitive support helps people evaluate themselves more realistically (metacognition study). 

Related approaches that support identity and confidence 

CBT isn’t the only therapeutic model shown to help with self-evaluation in ADHD: 

• ACT-based programmes: such as the UK “Understanding and Managing Adult ADHD” webinar improve psychological flexibility and self-acceptance, with participants reporting a kinder, more accurate understanding of their ADHD patterns (UMAAP programme). 

• Coaching with CBT elements: qualitative studies show that reflective, strengths-based coaching helps later-diagnosed adults reframe past experiences, challenge internalised blame and build a more stable, positive self-concept. 

Some individuals access these interventions through NHS pathways; others through regulated private routes such as ADHD Certify, which provides ADHD assessments for adults and children in the UK.  

Takeaway 

CBT cannot eliminate ADHD, but it can meaningfully reduce the patterns that feed imposter feelings. By helping individuals understand their ADHD, challenge self-critical beliefs, develop practical strategies and build a more compassionate self-story, CBT supports both confidence and day-to-day functioning. This article is for general information only for personalised advice, speak to a GP or qualified mental health professional.