A look at “Long-term effects of cognitive behavioural therapy on the quality of life in adult ADHD” by Ravian Wettstein, Valentina Navarro-Ovando, Viktoria Janke, Ron Mathôt and Glenn Dumont (2026)
Here’s a hopeful idea: maybe therapy skills are like planting bulbs. You might not see much straight away, but come spring, up they pop. An earlier Dutch study found that adding CBT to ADHD medication and psychoeducation didn’t improve quality of life immediately after treatment. So these researchers went back four to eight years later to see whether the benefits had blossomed with time.
What they found
The original group included 627 adults diagnosed and treated at a specialist ADHD service in the Netherlands. Everyone received medication and at least one session of psychoeducation, which means learning about ADHD and how it affects you. Some also chose to have CBT: between 5 and 16 sessions covering organisation and planning, coping with distraction, and challenging unhelpful thoughts, plus optional modules on procrastination, anger or communication.
Years later, 159 participants completed a follow-up survey on quality of life, ADHD traits, self-esteem and self-efficacy (belief in your ability to handle things).
The headlines:
- No extra long-term benefit from CBT. People who’d had CBT didn’t report better quality of life than those who hadn’t, and their quality of life didn’t change at a different rate.
- But everyone improved over time. Quality of life went up across the board in the years after diagnosis and treatment, whichever path people took.
In short, the bulbs didn’t sprout extra flowers. But the whole garden grew.
A grain of glitter ✨
It’s genuinely valuable when researchers publish findings that don’t support their hopes. That kind of honesty is how science improves. The data are also openly available, which deserves applause. But some important caveats mean we shouldn’t write off CBT for ADHD just yet.
Participants chose whether to have CBT rather than being randomly assigned. People who opted in may have been struggling more to begin with, which could hide a real benefit. Only around a quarter of the original group took part in the follow-up, so those who responded may not be typical. The number of CBT sessions varied a lot, and everyone also had medication, so it’s hard to isolate CBT’s contribution. And quality of life is a broad measure; CBT may help with specific things, such as planning or emotional regulation, that don’t shift an overall score. The general improvement over time can’t be confidently credited to any treatment, either. It might reflect the value of diagnosis and understanding itself, or simply life moving on.
Why this matters
If you’ve recently been diagnosed with ADHD as an adult, here’s something encouraging: quality of life tended to improve in the years afterwards. Understanding yourself, accessing support and finding what works seem to make a difference over time. CBT may not suit everyone, and other approaches, such as coaching, acceptance-based therapies or simply a therapist who really understands ADHD, are worth exploring too.
Sometimes the biggest magic is simply knowing you’re a unicorn, and giving yourself time to grow into it.