Can therapy reduce shame in ADHD adults

PostedNovember 3, 2025

UpdatedNovember 5, 2025

ByMy Patient Advice

Author: Harriet Winslow, BSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Shame is one of the most common yet least discussed emotional struggles among adults with ADHD. It often arises from years of perceived underachievement, rejection, and self-criticism. According to NICE guidance (NG87) and the NHS, emotional wellbeing and self-esteem should be key priorities in adult ADHD treatment, alongside medical and behavioural support. Recent studies suggest that targeted therapies including Cognitive Behavioural Therapy (CBT), Compassion-Focused Therapy (CFT), and Schema Therapy can meaningfully reduce shame, improve emotional regulation, and rebuild confidence for adults living with ADHD.

Understanding shame in adults with ADHD

Adults with ADHD often experience shame because of emotional dysregulation, rejection sensitivity, and perfectionism. These traits make it difficult to manage strong emotions or recover from criticism. Research published in the APA Monitor and Psychology Today highlights that repeated experiences of feeling “too much” or “not enough” can create long-term self-blame and withdrawal. Over time, shame becomes internalised, affecting relationships, work performance, and self-worth.

How therapy helps reduce shame

Therapeutic interventions play a vital role in breaking this cycle. Cognitive Behavioural Therapy (CBT) helps individuals identify and challenge self-critical thoughts while developing balanced, realistic self-appraisals. NICE-compliant ADHD care often includes CBT to support self-esteem and emotional regulation.

Compassion-Focused Therapy (CFT), developed to address self-criticism, teaches self-kindness and acceptance. Reviews from PubMed show that CFT can significantly reduce both external and internal shame, while improving mood and self-compassion. Schema Therapy also shows promise in modifying long-held beliefs of defectiveness or failure, helping adults with ADHD reframe their self-perception.

Mindfulness-based and trauma-informed approaches are increasingly used to help individuals tolerate difficult emotions and reduce self-stigma. Services like Theara Change in the UK are developing behavioural and emotional coaching models that incorporate compassion-based and mindfulness strategies to support adults managing ADHD-related shame.

Integrating therapy into ADHD care

Across NHS and private services, therapy is now recognised as a key element of adult ADHD support. Psychoeducation and therapy together help individuals understand their emotional patterns, externalise self-blame, and adopt healthier coping mechanisms. NICE guidance recommends combining medication, CBT, and compassion-based interventions for comprehensive emotional and functional improvement.

Key takeaway

Shame in adults with ADHD is deeply rooted but highly treatable. Evidence from NICE, PubMed, and Psychology Today confirms that therapies like CBT, CFT, and Schema Therapy can help individuals replace self-criticism with compassion, improve emotional regulation, and build lasting resilience.

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

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.