"I can't seem to finish a project. Even if the majority of the work is done, I just can't get myself to finish. And starting things, even little things like doing the laundry, is really hard for me. My husband and boss constantly get mad at me for not doing things that I've agreed to do. But honestly, it isn't intentional. I just don't remember. Half the time I can't even remember where I put my car keys or cell phone!"

Attention-Deficit/Hyperactivity Disorder is an executive functioning problem originating in the prefrontal cortex of the brain. Executive functioning involves such processes as organizing; planning; sustaining attention for extended periods; paying attention to details; completing complex, multi-step tasks; controlling ones behavior during social interactions; and to some degree, regulating emotions.

The three subtypes of ADHD are Predominantly Inattentive, Predominantly Hyperactive/Impulsive, and Combined. Individuals who have the Predominantly Inattentive subtype struggle with inattention, distractability, failure to notice details, difficulty concentrating, and difficulty completing multi-step tasks. Individuals who have the Predominantly Hyperactive/Impulsive subtype experience frequent fidgeting, difficulty sitting still or staying put, a tendency to blurt out comments or responses, excessive interrupting, and may make decisions impulsively without thinking carefully about the consequences. Individuals who have the Combined subtype suffer from symptoms of both inattentiveness and hyperactivity/impulsivity.

Cognitive-Behavioral Model of ADHD
The cognitive-behavioral model of ADHD conceptualizes thoughts, behaviors, and feelings as interrelated. Behaviors can lead to outcomes that result in ways of thinking and feeling, thoughts can motivate behavioral and emotional (feeling) responses, and emotions can lead to acting and thinking a certain way. For example, when a child has difficulty starting his homework he may think "this is too hard for me" or "I'm a lazy person," which can result in his feeling inadequate, frustrated, or guilty. Parents or teachers may react to the incomplete schoolwork with frustration or blame, resulting in the child having additional negative thoughts (e.g., "I'm stupid") and feelings (e.g., "This is hopeless").

Cognitive-Behavioral Treatment of ADHD
By changing behaviors that result in negative outcomes (e.g., incomplete homework, angry parents and teachers), and altering unrealistic thought patterns that may be unduly limiting or overambitious, cognitive-behavioral therapy seeks to help people with ADHD function more adaptively in the short and long-terms. Cognitive-behavioral treatment of ADHD has several components.

• Education. Teaching the individual about the three types of ADHD, the cognitive and behavioral components of ADHD, and the typical problems associated with the disorder.
• Monitoring. Recognizing and keeping track of patterns associated with symptoms of ADHD helps the client become aware of problem behaviors and thoughts associated with the disorder. This information is useful in planning and guiding treatment.
• Cognitive Strategies. Self-blame and labeling are frequently present in clients with ADHD, who often blame problematic behaviors on "laziness" and "lack of motivation" rather than symptoms of ADHD. Clients learn to reduce self-blame and labeling, and to set reasonable expectations for themselves. Together clients and therapists monitor shifts in thinking that result from changes in behavior.
• Behavioral Strategies. The majority of treatment for ADHD is behaviorally-based. The therapist works to teach the client methods of organization, planning, breaking down complex tasks, reinforcing positive behavior, and interacting interpersonally that are effective for optimal daily functioning. Therapist and clients work together to help the client learn and implement these tools to address daily challenges of living with ADHD, as well as long-standing patterns of behavior that cause problems for the client. Client and therapist work collaboratively to develop treatment plans and between-session activities that help the client learn to use these tools to manage symptoms of ADHD and reduce problem behaviors.