How to use behavioural therapies for both ADHD and addiction

PostedNovember 25, 2025

UpdatedNovember 26, 2025

ByMy Patient Advice

Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Behavioural therapies are now recognised as a cornerstone of ADHD and addiction recovery. According to NICE guidance (NG87), NHS England, and the Royal College of Psychiatrists (CR235), combining behavioural therapy with medication helps people manage impulsivity, emotional instability, and substance cravings more effectively than either approach alone.

Key behavioural therapies for ADHD and addiction

Cognitive Behavioural Therapy (CBT)

CBT helps people recognise and change unhelpful thoughts and habits. A BMJ Open trial found that CBT significantly reduced cravings, impulsivity, and relapse in adults with ADHD and addiction, particularly when used alongside stimulant medication.

Dialectical Behaviour Therapy (DBT)

DBT adds mindfulness and emotion-regulation training, making it useful for people with ADHD who struggle with emotional reactivity. Meta-analyses show DBT reduces cravings and relapse rates by improving distress tolerance and coping skills.

Motivational Interviewing (MI)

MI enhances motivation for change, helping people set goals and commit to treatment. It is widely used across NHS addiction services as a first-line psychological approach for individuals with ADHD and substance use disorders.

Contingency Management

This approach uses structured rewards, such as vouchers or privileges to reinforce positive behaviours like attending sessions or maintaining abstinence. NHS pilots and Lancet Psychiatry studies report improved engagement and relapse prevention through these methods.

ADHD Coaching

Coaching focuses on structure, organisation, and accountability. It helps people develop routines and self-management skills that reduce the chaos often linked to both ADHD and relapse.

NICE and NHS recommendations

NICE and NHS England recommend a multi-modal approach, combining behavioural therapies with medication and environmental support. The NHS ADHD Taskforce (2025) calls for “joined-up psychological therapy and medication support,” include access to digital CBT, DBT, and group programmes within community and integrated care settings.

The Royal College of Psychiatrists (CR235) emphasises that regular therapy, ADHD coaching, and ongoing review are essential for maintaining progress and preventing relapse.

Real-world and service integration

Across the UK, NHS pilots now offer blended models of therapy, combining digital CBT, motivational interviewing, DBT skills groups, and coaching within shared-care frameworks. These integrated systems provide accessible, flexible support that matches the complex needs of people living with both ADHD and addiction.

Services such as Theara Change are also developing evidence-based behavioural and coaching programmes aligned with NICE standards to help adults strengthen daily structure, emotional regulation, and recovery stability.

Takeaway

Behavioural therapies, especially CBT, DBT, MI, and ADHD coaching, play a central role in managing both ADHD and addiction. According to NICE, NHS, and RCPsych evidence, these interventions help people gain control, reduce relapse risk, and build healthier, more structured lives.

Victoria Rowe, MSc

Author

Victoria Rowe is a health psychologist with a Master’s in Health Psychology and a BS in Applied Psychology. She has experience as a school psychologist, conducting behavioural assessments, developing individualized education plans (IEPs), and supporting children’s mental health. Dr. Rowe has contributed to peer-reviewed research on mental health, including studies on anxiety disorders and the impact of COVID-19 on healthcare systems. Skilled in SPSS, Minitab, and academic writing, she is committed to advancing psychological knowledge and promoting well-being through evidence-based practice.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.