How can therapy help with ADHD-related imposter syndrome?
Many adults with ADHD describe imposter-type feelings; a sense of being undeserving of success or fearing they will be “found out”. According to NHS guidance, long-term struggles with organisation, attention and emotional regulation can lead to anxiety and low self-esteem. These patterns make it harder to trust positive feedback, even when achievement is genuine.
Why therapy can be helpful
NHS Talking Therapies, including the HPFT low-self-esteem webinar, explain that adults with ADHD often discount praise and focus on mistakes. Therapy helps identify these automatic thoughts (“I only succeeded by luck”) and replace them with more balanced interpretations based on evidence.
The Royal College of Psychiatrists notes that adults with ADHD commonly underachieve relative to their ability, leading to long-standing self-doubt. CBT-based interventions can help unpack these beliefs and understand how past experiences shape current self-perceptions.
What therapy targets
CBT and related approaches used across NHS Talking Therapies and recommended in NICE NG87 focus on emotional regulation, problem-solving and negative thinking patterns. In the context of imposter feelings, this includes:
- Challenging self-critical thoughts
- Testing assumptions against real evidence
- Reframing perfectionistic rules (“I must work twice as hard”)
- Reducing avoidance of tasks or feedback
- Building confidence through gradual, supported successes
Therapy also helps with emotional regulation; a common difficulty in ADHD. Mindfulness and acceptance-based components, supported by emerging evidence, can reduce the intensity of shame, anxiety, and self-comparison that drive imposters’ feelings.
Strengths-based work and identity
A BMJ Open study highlights positive ADHD traits such as creativity, resilience and divergent thinking. Therapy can help individuals integrate these strengths into their self-identity, shifting away from a deficit-only narrative.
Many adults with ADHD have internalised years of stigma or misunderstood feedback. Therapy provides space to challenge these narratives, especially for people diagnosed later in life, who often believe their achievements came from luck or frantic last-minute effort rather than skill.
Practical tools and combined approaches
Skills-focused interventions; such as organisation coaching or time-management training can complement therapy by improving daily functioning. Better follow-through and fewer last-minute crises can increase self-efficacy and make achievements feel more credible.
Medication can also support therapy. As noted in NICE guidance, stimulant and non-stimulant treatments improve attention and emotional regulation. When symptoms are better managed, people often experience fewer setbacks and are more able to engage in therapeutic work around confidence.
Workplace adjustments recommended in ACAS neurodiversity guidance — such as clear expectations, regular check-ins and quieter spaces — can further reinforce consistent performance, helping individuals trust their abilities.
Private services such as ADHD Certify also provide structured diagnostic and medication-review pathways that follow UK clinical standards.
Takeaway
Therapy helps with ADHD-related imposter syndrome by addressing both the emotional patterns (self-criticism, anxiety, perfectionism) and the practical challenges (organisation, consistency) that erode self-confidence. Evidence from NHS and NICE shows that CBT-based approaches, strengths-based reframing, skills support and when appropriate medication can all help individuals recognise their achievements as real, earned and sustainable.
