Personally, I believe that no mental health condition is a true reason why a person cannot become a therapist or should be blocked from a chosen career path. As current or future clinical psychologists, we need to help realise that a mental health condition isn’t the end of a person’s life with plenty of lost opportunities, but a life that is still worth living. It might be more difficult to perform in certain professionals but a mental condition is not the certain end of the road that many in our society believe. Hence why in today’s clinical psychology episode, we’ll be looking at the positives and potential challenges therapists with ADHD can face in the psychology workplace.
Today’s episode has been sponsored by Careers In Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
A Brief Introduction To ADHD
I’ve spoken about ADHD on the podcast a few times now but in case you’re new to the condition, we need to quickly talk about it. Since ADHD is often misunderstood in our society because even the name is a massive oversimplification because ADHD people don’t have an Attention-deficit per se. Instead they have a difficulty in controlling their attention. As well as ADHD impacts and impairs a person’s motivation, memory, focus, processing speed, emotion processing, reward response and more.
Therefore, it can be said that people with ADHD don’t have the biological tools that other people do, so they struggle to use these processes effectively depending on the situation.
As well as it certainly isn’t helpful at all that the truth around ADHD is often muddled up with tons of misinformation on the internet so the general public find it hard to understand what ADHD involves. For example, most people have no idea that ADHD includes hyperfocus, which for the sake of ease, you could possibly compare to such an intense focus like an obsession, and not a child bouncing off the walls.
Equally ADHD can include behaviours like fidgeting with a pen, racing thoughts or making impulsive shopping decisions, but of course no one really thinks about these behaviours because they aren’t as flashy and loud as other facets of ADHD.
Therefore, now we know what ADHD is, how can this impact therapists that have the condition?
How ADHD Impacts Therapeutic Skills?
To be honest a therapist is nothing or not very good if they don’t have therapeutic skills, and these are the skills that they learn about in their training. For example, micro-skills like body position and eye contact. Yet therapists also learn about things like cues towards the client like encouragement and nodding, as well as macro-skills like reflecting on the meaning of something.
In addition, therapists learn the importance of these skills because they help to make a safe and comfortable space for the client. Of course, most of these skills are very culturally and client-dependent but in many western cultures, therapists are encouraged to maintain eye contact and encourage clients to do the talking for the most part.
However, for therapists with ADHD it can be difficult for them to process information whilst holding eye contact. Therefore, sadly people with ADHD are often moaned at because they appear rude or not paying attention, when in reality they actually are taking in a lot more information than other people believe. As well as reflecting in depth can be difficult for people with ADHD as they tend to speak about things in ways that others might view as tangential.
I think this is a shame on the part of other people, because people with ADHD can be therapists. They can be taught the skills and knowledge and have the practical skills needed to help improve lives and decrease psychological distress. Yet because of their condition they might have to behave differently in front of clients, like the lack of eye contact, which is misinterpreted so the therapist with ADHD gets criticized for no reason. Maybe more open communication would be helpful here but this could be problematic for sure.
How ADHD Impacts Focus?
I think this is the clearest concern or difficulty for therapists with ADHD because therapists have to focus on and think about another person’s thoughts, feelings and emotions all whilst trying to pull out their meaning and make connections.
This requires an awful amount of focus and even writing out that paragraph I felt tired just thinking about having to do all of that, but then a therapist would have to do this for up to an hour multiple times a day. And this actually reminds me of a conversation I was having with a lecturer last year about how he’s almost glad occasionally to have clients drop out of therapy because it gives him an hour break and an hour to catch up on paperwork.
As a result, with ADHD impairing attention control, this kind of focus would take even more energy for a person with ADHD. As well as it can mean the therapist ends up fighting against their own brain without any common coping mechanisms like background noise or something as simple as fidgeting.
Therefore, this can cause a lot of anxiety for the therapist and this is before we add their natural concern about missing something important that the client said.
How ADHD Impacts Organisational Skills?
As we all know from our studies or real-life work experience, the work of a therapist doesn’t end at the end of a therapy session. I really wished it did but it doesn’t. Since the therapist has to write up notes, plan future sessions, schedule clients and all of these tasks involve a lot of executive functioning to help the person stay on track.
And to be honest, this might not sound too bad on the face of it, but when we consider that a therapist might have a caseload of 20 to 30 clients then that is a lot, a lot of scheduling, planning and more to do each week. And this is before you take into account the therapist’s personal life, life event and more.
This all increases the likelihood of a therapist, let alone a person with ADHD, mixing up or forgetting information or certain details.
Of course, this is going to add stress and anxiety for therapists with ADHD and this only adds to the list of things they have on their mind whilst they working. Basically already adding to a very full plate.
Benefits Of ADHD For Therapists
Now I do want to return to a point I always try to make on this podcast, if a client or yourself has a mental health condition, you will face difficulties. I will never ever deny that, but people with mental conditions can be supported, helped and most of the time they can live a fairly normal life given the right support. And that is absolutely true for people with ADHD who want to become therapists.
I truly believe that and there are two major benefits of having ADHD if a person wanted to work in clinical psychology.
How ADHD Benefits Empathy For Therapists?
Interestingly, people with ADHD generally experience more intense emotions than neurotypical people and others without the condition. This is particularly useful because one of the many roles of a therapist is to think about a client’s feelings and use their own personal reactions to those feelings as a tool for helping the client deal with them.
Therefore, if a therapist had ADHD then they’re more likely to experience stronger reactions and this can make it easier for them to access these tools in a therapy session.
Of course, it’s important for a therapist with ADHD to ensure these strong emotions don’t flood them, but when a therapist can use their more intense emotions effectively then this could be a very powerful tool to not only help their clients, but connect and strength the therapeutic alliance as well.
How ADHD Benefits Creativity For Therapists?
ADHD can be a great benefit for people because it increases creativity and this is often referred to as divergent thinking, and the condition can make it easier for people to think outside the box and come up with creative solutions. Which is flat out critical in clinical psychology because sometimes there are clients that have such a range of factors maintaining their maladaptive coping mechanisms that therapists really need to think outside the box to help them. As well as if “traditional” approaches don’t work for a particular client then a therapist who thinks quickly and creatively is best here, and that is perfect for a therapist with ADHD.
Conclusion: Moving Beyond The Stigma
I sort of realise now after 186 episodes of the podcast that one of my missions with the podcast is empowerment. The empowerment of not only you as the listener to do whatever you want in psychology, but also the empowerment of all those with a mental health condition, because it doesn’t defy them. And this is the entire point of today’s podcast episode because if you or someone you know has ADHD, loves psychology and wants to become a psychologist then they could. It will be more difficult for them but then some aspects will be easier for them too.
The real problem I believe is that there is so much stigma and misinformation about ADHD, and the obstacles that people with ADHD face are very easy to overlook and this overlooking can make daily life trickier. Resulting in people internalising these struggles as something to be shamed of, like they’re messed up and they couldn’t possibly achieve anything meaningful in life.
Instead of this only means they think differently to people without the condition.
However, I do truly believe that people with ADHD can become therapists, and these people will require support but it is possible. A therapist with ADHD might need to find a subtle way to fidget during sessions to help them focus, they might want to engage in therapeutic models outside the traditional Cognitive Behavioural Therapy, like play therapy, to help them maintain their focus better as they aren’t sitting in an office and they’re actually doing something a little physical. Or a therapist might want to ask a peer for them to take notes together. It’s important to adapt to the way the ADHD brain works, instead of forcing all therapists to work in the exact same way.
ADHD obstacles are real and they’re exhausting but it doesn’t mean a person cannot thrive, achieve great things and help people. Just like a neurotypical therapist does.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Careers In Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Have a great day.
ADHD, Psychotherapy and Clinical Psychology References
Rucklidge, J. J. (2010). Gender differences in attention-deficit/hyperactivity disorder. Psychiatric Clinics, 33(2), 357-373.
Skirrow, C., Ebner-Priemer, U., Reinhard, I., Malliaris, Y., Kuntsi, J., & Asherson, P. (2014). Everyday emotional experience of adults with attention deficit hyperactivity disorder: evidence for reactive and endogenous emotional lability. Psychological medicine, 44(16), 3571-3583.
Taylor, C. L., Esmaili Zaghi, A., Kaufman, J. C., Reis, S. M., & Renzulli, J. S. (2020). Divergent thinking and academic performance of students with attention deficit hyperactivity disorder characteristics in engineering. Journal of Engineering Education, 109(2), 213-229.
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