What is the effectiveness of dialectical behavior therapy for ADHD? 

Dialectical Behavior Therapy (DBT) was originally developed to help people with emotional instability and impulsive behaviour. In recent years, researchers and clinicians have begun exploring its use for ADHD, particularly when emotional dysregulation or relationship difficulties are a major concern. 

NHS and NICE perspective 

According to NICE guideline NG87, DBT is not currently a standard treatment for ADHD. NICE and NHS guidance prioritise medication, cognitive behavioural therapy (CBT), and parent training as the main interventions. 
However, DBT may occasionally be offered within NHS mental health services when individuals with ADHD also experience emotional instability, impulsivity, or co-occurring mood difficulties. 

How DBT supports ADHD-related challenges 

DBT’s four skill modules; mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness, address several ADHD-related difficulties: 

• Mindfulness helps reduce inattention and distractibility. 

• Emotion regulation builds awareness of mood swings and frustration triggers. 

• Distress tolerance helps manage impulsive reactions and stress overload. 

• Interpersonal effectiveness improves communication and reduces social conflict. 

A Frontiers in Psychiatry (2024) study found that DBT-informed skills training improved emotional regulation and interpersonal functioning in young adults with ADHD, particularly those prone to rejection sensitivity or frustration. 

Research evidence and outcomes 

A PubMed (2023) study showed that DBT protocols adapted for ADHD improved impulsivity control, emotional stability, and self-reported quality of life. A Lancet Psychiatry (2024) meta-analysis found DBT may be a useful adjunct to CBT for people with ADHD who also experience mood or emotional dysregulation, especially when medication alone isn’t sufficient. 

In practice, DBT is often adapted for ADHD with shorter sessions, visual aids, and executive function coaching to match attention span and working memory needs. Frontiers in Psychology (2023) reported that DBT-informed group programmes improved emotional self-monitoring and reduced conflict among university students with ADHD. 

Expert opinions and practical use 

The Royal College of Psychiatrists notes that while CBT remains the primary therapy for ADHD, elements of DBT, especially distress tolerance and mindfulness can enhance treatment for those struggling with intense emotions. 
The Mayo Clinic and Cleveland Clinic also highlight DBT as helpful for emotional control and impulse regulation, particularly when ADHD coexists with anxiety or personality traits. 

Takeaway 

DBT isn’t yet part of formal NHS ADHD care, but growing research supports its value for managing emotional dysregulation and impulsivity, areas that standard CBT may not fully address. For teens and adults with ADHD who feel easily overwhelmed, DBT’s structured, skills-based approach can offer new ways to pause, reflect, and respond with greater balance and control.