ADHD Suspicions in Psychotherapy: What to Do?
ADHD is increasingly being diagnosed in adults, it often remains undetected. For psychotherapists, this means: An ADHD suspicion can arise during the initial conversation, but also later during the course of psychotherapy. But what signs indicate ADHD and when is further diagnostics sensible?
When should ADHD be considered?
Adults with ADHD often report difficulties with attention, organization, time management, or impulse control. Also, inner restlessness and problems with emotional regulation can occur.
However, what is crucial is not the presence of individual symptoms, but rather whether the complaints existed in childhood, appear in multiple areas of life, and lead to relevant impairments. A screening questionnaire can provide an initial indication, but it does not replace a diagnostic evaluation.
What is included in a solid diagnostic process?
An ADHD diagnosis should integrate various sources of information:
· clinical history
· standardized questionnaires
· developmental and school history
· information from the social environment, if available
· assessment of current impairments
· careful differential diagnosis
Especially for adults, considering childhood is particularly important. ADHD begins in childhood, even if the symptoms are often perceived differently in adulthood.
ADHD or another mental disorder?
Concentration problems, forgetfulness, inner restlessness, or challenges with self-organization are not specific to ADHD. Also, depressions, anxiety disorders, sleep problems, or other psychological stresses can cause similar symptoms.
Additionally, ADHD and other mental disorders can occur simultaneously. A thorough diagnosis should therefore consider possible ADHD indicators as well as differential diagnoses and comorbidities.
When is external diagnostics useful?
Not every psychotherapeutic practice has the time or structural resources for comprehensive ADHD diagnostics. Especially when the suspicion arises only during an ongoing therapy, collaboration with a specialized diagnostic center can be beneficial.
The diagnostic clarification can be outsourced, while the psychotherapeutic treatment continues in the own practice. A structured finding creates a solid basis for further therapeutic planning.
Sources
Working Group of Scientific Medical Societies (AWMF): S3 Guideline "Attention Deficit/Hyperactivity Disorder (ADHD) in Childhood, Adolescence, and Adulthood", Version 2.0, 2026.
Kooij SJ et al. (2010): "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD." European Psychiatry, 25(8), 525–533.