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It was difficult to imagine how the original Succeeding With Adult ADHD
could be improved upon, but Levrini pulled it off with flying colors. This
magnificent updated edition is a treasure trove of helpful skills and
strategies designed for adults with ADHD and, more important, methods for
personalizing the skills and strategies to put them to use in your daily life to
achieve positive results. It will continue to be one of the go-to
recommended readings in our program.
—J. RUSSELL RAMSAY, PhD, ABPP, CLINICAL DIRECTOR, UNIVERSITY
OF PENNSYLVANIA ADULT ADHD TREATMENT AND RESEARCH
PROGRAM, PHILADELPHIA, AND AUTHOR OF THE ADULT ADHD
TOOL KIT: USING CBT TO FACILITATE COPING INSIDE AND OUT AND
RETHINKING ADULT ADHD: HELPING CLIENTS TURN INTENTIONS
INTO ACTIONS

There is so much wisdom under the surface of Succeeding With Adult

ADHD. Dr. Levrini won’t bore you with the details, but her advice and
strategies have what it takes to actually work. She knows her stuff, and you
will be better off for it!
—ARI TUCKMAN, PsyD, CST, AUTHOR OF ADHD AFTER DARK: BETTER SEX
LIFE, BETTER RELATIONSHIP

Abigail Levrini “gets” ADHD. She understands its upsides, but she also
knows its downsides intimately, in the same way she knows her own closets
and other mess piles. Best of all, through years of experience in the
trenches, she’s come up with practical solutions on how to right the ship,
worded so they don’t sound like psycho-nagging but rather like what a good
and trusted friend who knows you well would recommend.
—EDWARD HALLOWELL, MD, AUTHOR OF DRIVEN TO DISTRACTION AND
ADHD 2.0
 P RAI SE F O R T HE F IRST ED IT IO N

This book is a survivor’s manual for adults wishing to better cope with
ADHD and reduce its adverse effects on daily life. In doing so, it is an
unqualified success.
—RUSSELL A. BARKLEY, PhD, ABPP, ABCN, RETIRED CLINICAL
PROFESSOR OF PSYCHIATRY, VIRGINIA COMMONWEALTH UNIVERSITY
SCHOOL OF MEDICINE, RICHMOND
Copyright © 2023 by the American Psychological Association. All rights reserved. Except
as permitted under the United States Copyright Act of 1976, no part of this publication may
be reproduced or distributed in any form or by any means, including, but not limited to, the
process of scanning and digitization, or stored in a database or retrieval system, without the
prior written permission of the publisher.

Electronic edition published 2023.

ISBN: 978-1-4338-3875-0 (electronic edition).

The opinions and statements published are the responsibility of the author, and such
opinions and statements do not necessarily represent the policies of the American
Psychological Association.

Published by
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Cover Designer: Mark Karis

Library of Congress Cataloging-in-Publication Data

Names: Levrini, Abigail, author. | American Psychological Association.

Title: Succeeding with adult ADHD : daily strategies to help you achieve your goals and
manage your life / by Abigail Levrini.
Description: Second edition. | Washington, DC : American Psychological Association,
2023. | Includes bibliographical references.
Identifiers: LCCN 2022027879 (print) | LCCN 2022027880 (ebook) | ISBN
9781433838743 (paperback) | ISBN 9781433838750 (ebook)
Subjects: LCSH: Attention-deficit disorder in adults--Popular works.
Classification: LCC RC394.A85 L48 2023 (print) | LCC RC394.A85 (ebook) | DDC
616.8589--dc23
LC record available at https://lccn.loc.gov/2022027879
LC ebook record available at https://lccn.loc.gov/2022027880

https://doi.org/10.1037/0000329-000
 This book is dedicated to my awesome partner, Chad, and
our amazing kids, Evelyn and Reese. Without them, my
goals would mean nothing. And to my parents, Susan and
Joel, who helped me to fill my own toolbox for a successful
life.
—Abigail Levrini
CONTENTS

Introduction: Understanding Adult ADHD

PART I. GETTING STARTED: ACHIEVING YOUR GOALS AND

OBJECTIVES
Chapter 1. Fostering a Helpful Perspective
Chapter 2. Ready, Set, Plan!
Chapter 3. Increasing Motivation and Accountability
Chapter 4. Evaluating What Works and Managing Frustration With What
Doesn’t

PART II. SPECIFIC STRATEGIES

Chapter 5. Overcoming Procrastination and Improving Time Management
Chapter 6. Enhancing Social Relationships
Chapter 7. Organizing Your Space
Chapter 8. Practicing Effective Learning and Study Skills
Chapter 9. Finding Job Satisfaction
PART III. GETTING ADDITIONAL HELP
Chapter 10. Understanding and Treating Conditions That Can Coexist
With ADHD
Chapter 11. Medication Pros and Cons
Chapter 12. Finding the Right Counselor, Coach, or Other Treatment
Solution
Summary
Appendix: Example Tools for Your ADHD Toolbox
Further Reading
References
About the Author
INTRODUCTION

U N D E R S TA N D I N G A D U LT A D H D

Years of research within the scientific community confirms that attention-

deficit/hyperactivity disorder (ADHD) persists into adulthood (Caye et al.,
2016). While symptoms may change, the disorder can manifest itself in
virtually every area of life: emotion regulation; work performance; family
life; relationships with partners, friends, and coworkers; time management;
and the ability to stay organized and achieve goals. Maybe you struggle to
keep track of projects and tasks, resulting in failed attempts at advanced
degrees or job-hopping. Or you may zone out frequently and forget things
your partner said, resulting in failed marriages or lost friendships. You may
lose things easily or lack patience, resulting in a hectic household and
parenting regrets. ADHD can negatively impact nearly every facet of your
life, leaving you feeling hopeless and stressed, lost and alone.
Whether you suspect you have ADHD, are newly diagnosed, or have
known for years that you struggle with the disorder, this book can help you
to regain cognitive control of your actions and thoughts through learning
how to develop and maintain goal-directed behavior. By applying the
principles in this book, you will begin to reach your current and future
goals. The strategies presented are based on scientific research spanning
decades, including my own and that of other experts in the field, as well as
my years in private practice putting these strategies to the test with
hundreds of adults, just like you. I am a clinical psychologist who
specializes in treating patients with ADHD. When I earned my PhD at
Florida State University, I was part of a team that spearheaded a now
nationally recognized ADHD behavioral treatment intervention. I have
published numerous scientific articles on ADHD in peer-reviewed journals,
and I regularly give ADHD-related presentations in professional settings
throughout the country. In addition to the first edition of this book, I have
published a scientific manual and video on the best practices of ADHD
treatment for mental health professionals. I conduct original research on
ADHD, and I maintain a busy clinical practice, where I help adults develop
skills to manage their ADHD.
Throughout this book, you will meet some of the adults I have had the
pleasure of working with over the years, all of whom came to me out of
fear, frustration, or, at times, desperation.1 All of them went on to
experience success, joy, and self-satisfaction they had thought was all but
impossible. You will meet clients like Addison, who had recently turned 30
and was ready to give up after attempting college four times only to be told
“maybe you just aren’t smart enough” by her professors and guidance
counselor (she had a nearly gifted IQ); or Fred, whose self-efficacy had hit
rock bottom after using his savings to start, but not finish, numerous
business ideas and whose wife had enough of his “manipulation and
deceit.” (This was actually his impulse to lie to avoid her negative reaction.)
How did they ultimately succeed? To begin, they learned that they
weren’t stupid, incapable, or malicious. Their struggles could be explained
by their ADHD brains rather than willful misconduct. Understanding
ADHD is a critical step in developing self-empathy, self-patience, and self-
forgiveness, all of which are necessary on the (sometimes rocky) path to
successful goal attainment.
WHAT IS ADHD?

ADHD is a cognitive processing disorder that affects an estimated 2.8% of

adults worldwide, according to a 2016 study conducted by the World Health
Organization (Fayyad et al., 2017). Although the name suggests there are
only two key symptoms, there are actually three. Adults with ADHD may
have all of the following symptoms or any combination of them.
First, inattention (not being able to keep focus). What does this look
like in adults with ADHD? Adults with inattentive features of ADHD may
fail to give close attention to details or make careless mistakes in their
schoolwork, work, or other activities. You may add when you should have
multiplied, skip over details when reading an assignment, or add too much
of an ingredient when cooking dinner. Inattention could also mean you have
difficulty sustaining attention during meetings, conversations, or while
reading. Sometimes, despite starting strong on a task, inattentiveness causes
individuals to become sidetracked, leaving projects and responsibilities
incomplete. Even your own thoughts can serve as distractions. You may
have difficulty keeping your belongings in order or moving from one task to
the next without becoming distracted. Tasks you find tedious or boring may
get avoided altogether. Finally, inattention may lead to forgetfulness in your
daily activities or losing the things you need to go about your day.
Second, hyperactivity (excess movement that is not fitting to the
setting). What does this look like in adults with ADHD? While young
children with hyperactive symptoms may be easy to pick out, adult
hyperactivity can look a bit different. You may fidget, tap your hands or feet
while sitting, or just feel generally restless throughout your day.
Hyperactivity can also be verbal in adults with ADHD; you may talk
excessively or very fast at times.
Finally, impulsivity (hasty acts that occur in the moment without
thinking). What does this look like in adults with ADHD? Maybe you blurt
out an answer before a question has been fully asked, struggle to wait your
turn in line, or intrude on others without realizing they were engaged in a
task or conversation. While it is not technically a symptom, adults
diagnosed with impulsivity also may engage in risky or unwanted behaviors
on impulse as a result of not properly evaluating long-term consequences.
This includes things like lying, overspending, alcohol or drug use, sexual
encounters, or pornography.
If you were diagnosed after 1980 and before 1987, attention-deficit
disorder (ADD) is the name of the diagnosis you would have been given. If
you have been diagnosed or reassessed for the disorder since the mid-
1990s, you would have been given the diagnosis of ADHD (even if you
don’t have “H” symptoms, or hyperactivity). Based on which of the
previously mentioned criteria you meet, you should fall into one of three
categories, subtypes, or what we now call “presentations” of ADHD (note:
you do not need to meet all criteria listed in each category to qualify as
having ADHD):

ADHD, inattentive presentation (no hyperactivity or impulsivity)

ADHD, hyperactive-impulsive presentation (no inattention)
ADHD, combined presentation (both hyperactivity and/or impulsivity
and inattention)

Since the previous edition of this book was published, there have been
some changes in the American Psychiatric Association’s (2013) Diagnostic
and Statistical Manual of Mental Disorders (DSM), which is a widely used
manual listing diagnostic criteria for different mental disorders. The fifth
edition of the DSM (DSM-5) was published on May 18, 2013. Although the
DSM-5 revisions to ADHD criteria were far less dramatic than earlier ones,
some notable changes were included for adults with this disorder. Perhaps
the most helpful changes are the addition of examples of how ADHD
manifests in adolescence and adulthood and a reduction to five (from six)
symptoms required for diagnosis in adults. The age of onset changed from
prior to age 7 to prior to age 12. This is especially helpful in diagnosing
adults who, often, can’t remember as far back as age 7 or did not begin to
struggle with significant impairment until they hit a period in life at which
time they could no longer cope (i.e., managing multiple classes in middle or
high school, living independently in college or early adulthood, and so on).
Many of these changes are based on a growing body of research being
conducted with adults with ADHD. ADHD diagnoses among adults are
growing 4 times faster than ADHD diagnoses among children in the United
States, yet most scientists believe adult ADHD remains underdiagnosed.
Adults who were diagnosed as children may find that the way the
symptoms manifest and how many symptoms they experience may have
changed as they reached adulthood. For example, you may have been out of
your seat as a child, only to find that you’ve become a fast talker or feel
restless as an adult. Or, as an adult, you find you struggle more with the
inattentive and impulsive features of the disorder, such as an inability to
focus on your work, pay attention in conversations, or control your
emotions.

THE ROLE OF EXECUTIVE FUNCTION

There is considerable evidence that the symptoms seen in adults with

ADHD (inattention, impulsivity, and hyperactivity) may be explained by
deficits in executive functioning. Executive functioning (EF) is an umbrella
term for various complex cognitive processes responsible for cognitive
control of actions and thoughts that are necessary to maintain goal-directed
behavior (in order to reach your goals; Welsh & Pennington, 1988). EF is
necessary for meeting goals. How often have you set a goal for yourself and
then failed to achieve it because you were unable to control your thoughts
(i.e., couldn’t focus or maintain attention) or actions (i.e., couldn’t follow
through with a plan)? Perhaps you had to complete a work project but were
unable to get things done because you were always sidetracked by other
tasks. Or perhaps you wanted to do a home improvement project, and even
set out a plan to complete it, but were unmotivated to follow through with
the plan. Or perhaps you wanted to plan a vacation, but every time you sat
down to research destinations online, you got distracted by social media.
The results of recent studies suggest that EF consists of two broad
domains (Barkley, 2010). The first is inhibition, which is the ability to
control motor, verbal, cognitive, and emotional activities by suppressing
extraneous or impulsive thoughts or actions. Adult ADHD symptoms likely
arise from a fundamental neurological impairment in both motor and
cognitive inhibition (Ossman & Mulligan, 2003). In turn, deficits in
inhibition contribute to deficits in the second domain of EF, metacognition.
Metacognition includes working memory, planning and problem solving,
and emotional self-regulation. In adults with ADHD, lack of inhibition
leads to dysregulation of self and overall EF, whether attentionally, by
becoming distracted and off-task easily, or emotionally, by being quick to
angry outbursts or saying something hurtful on impulse. The strategies
presented in this book will help to address these deficits in executive
function.

WHAT’S IN THIS BOOK?

This book presents evidence-based, tried-and-true strategies to help you

better manage your adult ADHD. Sections are concise with straightforward
language and explanations. In each chapter, I have included relatable
examples and practice exercises, as well as recommendations for the most
common adult ADHD struggles, including emotional regulation, time
management, organization, academic pursuits, navigating the world of
work, and relationships. Most important, I aim to help you personalize the
lessons of this book, so that you may successfully achieve your goals and
manage your life.
 One of the most consistent comments I received about the first edition
of this book was how user-friendly and practical it was. Many individuals
with ADHD find that they cannot handle the intensity of some self-help
books. Because lack of attention and focus is a cornerstone of the disorder,
lengthy or jargon-filled books can be too overwhelming to read. To help
make this new edition just as easy to read, I have included several means of
support. First, you will find this book organized into manageable, easy-to-
digest 10- to 20-minute reading segments. The visual reminder to “check
your focus” will cue you to check in with yourself to make sure you are still
engaged. If you see this symbol and realize you’re off track, stop and take a
break, then rewind and try again.

I also recommend the use of highlighters and notes in the margins.

Active reading tools such as these will help you commit ideas to memory
and reference your favorite parts later.
The book chapters were selected on the basis of my now 20 years of
experience coaching, counseling, and conducting research with adults who
have ADHD. I selected 10 topics that are most important in helping you to
live a healthy and productive life. Topics that were covered in the previous
edition contain new and improved strategies. Other topics are brand-new.
The book remains divided into three parts.
In Part I (which includes Chapters 1–4), I teach you how to envision
goals for yourself and make realistic plans to achieve those goals. Setting
realistic and measurable personal goals is one of the most important
strategies you will learn. Everyone’s lifestyle and needs are different, so my
philosophy in this book is that managing ADHD is about creating a plan
that works for you. You might decide that you want to be more focused at
work, learn how to organize your office, be on time for appointments,
improve your social skills, or improve your academic functioning. There are
different ways of achieving each of the goals you might set, but the key is to
make them your goals, so that you will be motivated to attain them.
Chapter 1 is on how to interpret your behaviors in a healthy and
helpful way. Maintaining a positive outlook is imperative to succeeding
with adult ADHD. Chapter 2 is on long-term goals and weekly objectives. I
teach you how to initiate change by setting effective goals and then
breaking them down into small, achievable steps or objectives. Chapter 3 is
on motivation. I show you how to apply rewards and consequences to
increase your motivation to follow through on the goals you have set. This
includes a discussion on how to use metacognition to better understand your
behavior and what works best for you. Chapter 4 is about metacognition—
thinking about thinking—perhaps the most critical step in obtaining lasting
results. In order to create sustainable change in your behavior, you must
learn how to gain (and retain) proper insight into how and why certain
strategies work or do not work for you.
Part II (which includes Chapters 5–9) gives you specific strategies for
managing parts of your life in which you likely have goals. In Part II, you
can find chapters on time management, academic skills, relationships and
social skills, organization, and job or employment skills. Chapter 5 is on
time management. I give you tools to keep you from procrastinating, help
you to prioritize your tasks, and plan when and how you will accomplish
things. This chapter is a must-read for those who have trouble with starting,
continuing, and finishing tasks. Chapter 6 is on social skills, including the
ways inattentiveness, impulsivity, and distractibility can get in the way of
your social relationships. I help you figure out if you are realistic in your
self-perception of your social skills. The how-to part of this chapter gives
you suggestions for paying attention in conversations and teaches you how
to make a listening plan. Chapter 7 is on organization. This chapter helps
you begin to organize your environment in a way that makes sense to you as
an adult with ADHD. It includes detailed plans for getting ready, actually
organizing, and staying organized once your new system is in place. After
reading this chapter, you should be able to develop your own personalized
organizational plan. Chapter 8 is on learning and study skills. I give you
very specific strategies for studying, memorizing, paying attention, taking
notes, reading without your mind wandering, writing a paper, and taking
tests. It also addresses test anxiety and ways to manage it. Chapter 9 is on
employment. I guide you through a process of identifying your strengths
and weaknesses, and then provide specific coping skills to help you with
organization and time management at work. I provide suggestions for
dealing with distractibility and lack of focus during the day and give you
information about workplace accommodations to which you might be
entitled.
Finally, Part III (Chapters 10–12) has three chapters focusing on
getting additional help. Some adults with ADHD also struggle with anxiety,
depression, or just increased stress. In addition, the medication used to treat
ADHD can be confusing to understand or can cause frustrating side effects.
In Chapter 10, I give you advice on dealing with conditions such as
anxiety, depression, and stress on your own, and on how to figure out when
and how to get outside help. In Chapter 11, I discuss the pros and cons of
medication and how to make the most of prescription drugs if you choose
this option. In Chapter 12, I cover alternative treatments that you might
consider to help with your ADHD, such as healthy lifestyle options, ADHD
coaching, or counseling. At the end of the book, you can find a list of
resources if you want more detailed information on any of the topics
covered in these chapters.
Each chapter is broken down into short, distinctive sections that offer
many perspectives on each topic. Specifically, chapters may contain one or
more of the following features:

Quiz Yourself—Does This Sound Like You? “Yes” or “No” questions

that will allow you to gauge if that chapter is for you
 What the Experts Say. A short, nontechnical interpretation of the latest
research on ADHD to help you see the scientific rationale for helping
yourself
Can You Relate to This? Case examples of adults with ADHD that help
you learn from others’ experiences
Quick Tips. Suggested tips or checklists to help you apply what you
have read
Try It! Exercises or ideas to do on your own at home
Getting Back on Track. Detailed explanations for how to overcome
ADHD-related difficulties. New to this edition—suggestions
emphasize cognitive features (change in thinking) as well as
behavioral ones (change in actions)
Chapter Summary. A checklist of ideas to take away from the chapter.
After reading each chapter, use the list to note areas you have
thoroughly studied and those you may want to revisit.

The past decade of client feedback, technological advances, and

societal shifts has brought new insight into the strategies presented in the
first edition of this book. While many of the original tools remain effective,
this new and improved edition teaches readers how to reach their emotional
and social goals in addition to their behavioral ones, creating a more
complete picture of mental health. Social skills and relationships in a post-
COVID society are more important than ever. Perhaps you are part of the
“Great Resignation,” and it’s time to reevaluate your career path as an adult
with ADHD; or, perhaps, quarantining so long with your spouse put a
spotlight on problems within the relationship.
As I explain in the following chapters, the goal of this book is to help
you create a personal “toolbox” of strategies so that you may lead a
healthier and more successful life. You can hang a picture with a hammer
and a nail, or with a drill and a screw. Similarly, you can create a schedule
from paper and pencil or computer software. I will present pros and cons of
using one tool over another, but there is no one “right” way to do anything,
and I encourage you to bring a personal touch to the ideas presented. Your
individual toolbox will help you lead a life that is more fulfilling and
productive, all while maintaining your sense of uniqueness and originality.
Finally, I want to let you know that all of the worksheets in this book
are also available in 8.5 × 11 PDFs, which you can download for free at
https://www.apa.org/pubs/books/succeeding-with-adult-adhd-second-
edition. If you find it easier to complete worksheets on standard letter-size
pages, you may prefer to print out the worksheets and keep them in a binder
for your easy reference.

YOU’VE MADE IT THROUGH THE INTRODUCTION—GOOD FOR

YOU! TAKE A BREAK AND THEN JOIN ME IN THE NEXT SECTION!

1Inall case examples, names and identifying details have been changed to protect client
confidentiality.
 I

G E T T I N G S TA R T E D : A C H I E V I N G
YOUR GOALS AND OBJECTIVES
CHAPTER 1

FOSTERING A HELPFUL PERSPECTIVE

Whether you think you can or you think you can’t, you’re right.
—Henry Ford

You’ve bought the book, you’re ready to tackle items on your to-do list, and
you’re feeling more motivated than you can ever remember. Your impulse is
to take off and initiate movement toward your goals while you’re feeling
hot—but WAIT! Do not “pass go” before thoughtfully reading the
following chapter, or you might sabotage your efforts.
Take a moment and think back to all the times you tried out a new
strategy someone told you about or that you read about in an article on, say,
staying organized. If you’re like most adults with attention-
deficit/hyperactivity disorder (ADHD), it is likely that the strategy was
helpful for a short period of time, only to be forgotten or cast off when it
“no longer worked.” What if I told you that the strategy actually worked
just fine and what, in fact, didn’t work was what you told yourself about it
the moment you began to lose interest or the first time you forgot to
implement it? Chances are you didn’t speak to yourself in a very user-
friendly way but, instead, came down fairly hard on yourself, criticizing
your lack of follow-through or ability to get things done due to “learned
helplessness” (the perception that because you failed in the past, you will
always fail). By doing so, you create a self-fulfilling prophecy on repeat,
trying and getting stuck, thinking thoughts that make you feel hopeless or
helpless, and then giving up. The good news is that this cycle can be
unlearned. And it starts with changing the way you think.
Not convinced your thoughts have such power over your actions? Take
the following quiz to see if the ideas in this chapter apply to you. The more
“yes” answers you give, the more helpful this chapter will be to you.

QUIZ YOURSELF—DOES THIS SOUND LIKE YOU?

1. Have you tried many strategies over the years to address your ADHD
symptoms, only to end up casting them off as unhelpful because they
only helped for a few days or months?
2. Do you often shy away from setting goals or trying a new strategy
because you “know” it won’t work out in the end?
3. Do you find yourself getting angry or upset when things don’t go
exactly as you had hoped or planned?
4. Have you jumped from one strategy to the next over the years in
search of that one that will work (every time, for all time) for you and
still not found it?

WHAT THE EXPERTS SAY

Every day, all of us encounter and engage in hundreds, if not thousands, of

events, small and large. And, every day, we have a choice as to how we are
going to interpret each of those events. How we choose to think about these
events impacts whether we feel positively or negatively toward ourselves
and others.
For example, suppose you buy a new planner designed for adults with
ADHD and use it regularly for 3 months. You then lose it under a pile of
books, only to forget about it the next day and stop tracking your
appointments. Five weeks later, you find it. At this point, you have many
options for what and how to think about this event. A common response
from an adult with ADHD with learned helplessness might be, “Here I go
again. Another wasted planner to add to the pile. What the hell is my
problem?” However, a more adaptive and helpful response might be, “Wow,
I used that planner for 3 months! While it wasn’t helpful forever, that’s a
good bit of time, and I definitely want to stow that somewhere so I can
possibly make use of it again down the road when it feels new again!”
How do you think you would feel about yourself if you had thought
the first way? How would you behave? Chances are you would have felt
defeated and given up. Yet, had you thought the second way, seeing the
“good” in the situation, you would have likely felt encouraged and excited
about what you achieved. Thoughts create feelings, feelings create
behavior, and behavior reinforces thoughts. This is the basis of two reigning
psychological theories: cognitive behavior therapy (CBT) and positive
psychology (Nimmo-Smith et al., 2020). CBT is highly effective for adults
struggling with ADHD and mood disorders (most often, anxiety and
depression), which is estimated to be over 80% of adults with ADHD (more
on the topic of comorbid disorders in Chapter 9). While the remaining 20%
may not reach criteria for a mood disorder, negative thinking patterns can
still get in the way of progress. All adults with ADHD can benefit from
these lessons in CBT.
 Cycle of Thoughts, Feelings, and Actions

Positive psychology aims to uncover what allows individuals to thrive

—achieving their personal and professional goals and cultivating happiness,
resilience, and meaning in life (Boniwell & Zimbardo, 2015). Positive
emotion is fundamental to both theories, and it is achieved through rational
and positive thought. One of the most important insights we have gained
from positive psychology is that individuals are not happy because they
reach their goals. Rather, happiness causes individuals to reach their goals.
In other words, you don’t feel hopeless because you can’t keep your house
organized. You can’t keep your house organized because you feel hopeless.
WHAT ARE THINKING ERRORS?

Thinking errors, also known in the field as cognitive distortions, are the
faulty connections we create between thoughts, ideas, actions, and
consequences without adequate evidence, which then influence our
feelings. While psychologists have long understood the impact of these
distortions on our mood, the importance of addressing such thoughts has
only gained momentum in recent years (Strohmeier et al., 2016). David
Burns, MD, a prominent positive psychiatrist and author of Feeling Good
and Feeling Great, does a stellar job of explaining how overcoming
thinking errors can vastly improve symptoms for depression and anxiety,
but how does it help adults with ADHD?
First, let’s identify the six thinking errors most common in adults with
ADHD, followed by an example of each.

1. Ignoring the Good occurs when you give more attention to the things
that are going wrong or are negative about a given situation rather than
what is right or going well. Burns (1999) referred to this as a distorted
“mental filter.”
Adult ADHD Example: You were 5 minutes late to your
appointment, and all afternoon you beat up on yourself for once again
not making it somewhere on time.
2. Catastrophizing or Blowing Things Up occurs when you make a
really big deal out of something that should have a relatively small
impact on your well-being.
Adult ADHD Example: You forgot to take out the trash after
promising your partner that you would, and you tell yourself you are
unreliable and can’t be trusted to do anything right.
3. Fortune Telling occurs when you think that you already know the
outcome of a situation and that it will not be positive.
Adult ADHD Example: Your professor or boss assigns a project,
 and, before knowing all the details, you assume it’s too difficult for
you and that you will fail to produce something good.
4. Mind Reading or Jumping to Conclusions occurs when you think
you know what someone else is thinking or what their intentions are
without them ever verbalizing.
Adult ADHD Example: Your neighbor pops by your messy house,
and you assume they are thinking what a lazy slob you are.
5. All-or-Nothing or Black-and-White Thinking occurs when you don’t
achieve something 100%, so you think you have failed. You filter
everything in extremes without seeing the metaphorical shades of gray.
Adult ADHD Example: You attempt a new recipe to cook dinner
for your family, and, because you forgot to include one ingredient, you
think dinner is ruined.
6. Emotional Reasoning occurs when you believe something to be true
simply because you feel it to be true, sometimes even in the face of
contradictory evidence.
Adult ADHD Example: You think everyone in your office gets 3
times as much work done as you in a day because you feel so
unproductive.
 Use Exhibit 1.1 to record which thinking errors you find yourself
committing, and include an example of each.

E XHI B IT 1 . 1 . Try It! Identifying Thinking Errors

Is this me? Example of when and how I engaged

(check if in this thinking error (try to be as
Thinking error so) recent and specific as possible)
Ignoring the
Good

Catastrophic
Thinking

Fortune Telling

Jumping to
Conclusions

All-or-Nothing
Thinking

Emotional
Reasoning

GETTING BACK ON TRACK: CORRECTIONS IN THINKING

Now that you have gained some awareness and insight into your destructive
thought patterns, it’s important that you learn how to challenge or “reframe”
them. Remember, positive thoughts lead to positive feelings. Positive
feelings lead to positive behavior (i.e., goal achievement). I can all but
guarantee that you will fail to exactly meet one or more objective you set
for yourself in the coming weeks, even with the help of this book. And
here’s a little secret: Even people without ADHD fail once in a while. What
is ultimately most important in achieving success with your goals is arming
yourself with the ability to accurately and positively reframe a situation
when things don’t go as planned. Imagine you are driving in your car and
come across a roadblock between yourself and your destination. Think of it
as an inconvenient speed bump, and you’ll likely look for an alternative
route. Think of it as a dead end, and the chances are good you will give up
and go home. As an adult with ADHD, you are likely to hit more “speed
bumps” than a neurotypical adult. This just means you need to be extra
good at reframing in those moments.
If admitting you have a thinking problem is the first step, learning how
to reframe these thoughts is step two. Let’s take what you have learned
from CBT and positive psychology and create more accurate, alternative
thoughts for each of our thinking error examples. First, recall that a thinking
error often leads to a negative or irrational thought. Next, reflect and
reframe the irrational thought to eliminate the thinking error.
Now, let’s practice reframing. Here are some examples.
Example 1:

Event: You are 5 minutes late to an appointment.

Original Thought: Once again, I am late! Why can’t I get anywhere
on time?!
Thinking Error: Ignoring the Good.
Alternative or Reframed Thought: Last time, I was 15 minutes late
to this appointment, so I am improving. The time before that, I
forgot it altogether! I also remembered all of the things I needed to
bring and got here safely. I called on my way in to let them know I
would be late, and they said it was fine and not to rush because they
know me and value my contribution. So, really, lots of good things
are happening, and being late was just a tiny hiccup in my day.
Example 2:

Event: You forgot to take the trash out after promising your partner
that you would.
Original Thought: I am so unreliable! I can’t do anything right!
Thinking Error: Catastrophizing.
Alternative or Reframed Thought: That’s the first time I’ve forgotten
this month. That means I got it right three times, and this is just a
slipup. There is a lot of evidence from my life that shows I am
reliable—I pick up the kids from school every day, get my work
done, pay my bills on time, and I’ve remembered to take my meds
all week. Plus, so what if the trash stays in the garbage bin for
another week? Life will go on just fine.

Example 3:

Event: Your college professor assigns a project.

Original Thought: There’s no way I can do this. I have no idea
where to start and will probably fail anyway, so why bother?
Thinking Error: Fortune Telling.
Alternative or Reframed Thought: I haven’t even looked at the
assignment. I may struggle in this class, but this project may be an
opportunity for me to bring my grade up. I do well when I break
things up into small steps, and I’ve been successful on projects in
the past. I’ll set up an appointment with the professor to see if they
can give me any guidance—something I haven’t tried before. What
else can I do to put supports in place so that I can succeed?

Example 4:

Event: Your neighbor invites themselves into your messy house.

 Original Thought: They must think I am such a lazy slob. I am so
embarrassed. No way are they going to want to hang out with me
after this. I’ll probably get a reputation around the neighborhood as
a hoarder or something.
Thinking Error: Mind Reading.
Alternative or Reframed Thought: Yes, the house is messy, but I
don’t know what they are thinking. They haven’t commented on the
mess and are continuing to smile and speak to me. I have just as
much evidence to think they’re glad they’re not the only one with a
messy house! Or maybe they are just glad to be here. Bottom line, I
don’t know what they are thinking and shouldn’t assume I do. I’ll
just enjoy the company.

Example 5:

Event: You attempt a new recipe to cook dinner for your family and
forgot to include one ingredient.
Original Thought: Dinner is ruined! This day is terrible!
Thinking Error: All-or-Nothing Thinking.
Alternative or Reframed Thought: Dinner might not taste perfect,
but I’m grateful to be sharing a warm meal with my family. I’m also
proud of myself for trying something new! I wouldn’t expect myself
to be perfect the first time I take on a new sport, so why would I
expect it in this situation? And, really, the rest of my day has gone
well. If messing up dinner is the worst thing that’s happened to me
today, I’ll take it.

Using your personalized examples of thinking errors from Exhibit 1.1,

create an alternative, evidence-based statement in Exhibit 1.2. Want to take
it a step further? Write in how this new thought makes you feel and what
action you would take (if any) as a result.

E XHI B IT 1 . 2 . Try it! Reframing Cognitive Distortions

Original thought Alternative thought New feeling New behavior

SUMMARY

Here are the important points you will want to take away from this chapter.
Use the following checklist to note the areas you have thoroughly studied.
Leave the box empty if it is an area you would like to come back to and
review further.

I understand how “learned helplessness” affects adults with ADHD.

I have learned how my thoughts impact my behavioral outcomes.
I have identified the thinking errors I must watch out for.
I know how to reframe my negative or irrational beliefs into more
helpful and accurate thoughts.
CHAPTER 2

R E A D Y, S E T, P L A N !
By failing to prepare, you are preparing to fail.
—Benjamin Franklin

Now that you have mastered the mental part of goal achievement, you may
begin on mastering your behavioral goals. To have the best chances at
reaching your goals, you must first learn to create what is considered a
“good” goal, or one that gives you the best chances of success. For adults
with attention-deficit/hyperactivity disorder (ADHD), it is beneficial to
have explicitly stated goals, specific methods for accomplishing goals, and
specific time frames for meeting those goals. The more concrete you can
learn to make your goals, the more likely you are to accomplish them. Also,
by learning how to set effective goals and then break them down into small,
achievable steps or objectives, you can gain better control over your life,
reduce anxiety, and improve productivity. In this chapter, I teach you how to
initiate change by creating this sort of solid foundation. To do this, you
must start with three simple, but invaluable, ideas that will propel you
toward making your aspirations reality:

Step 1: Set long-term goals (LTGs).

Step 2: Develop a “Toolbox” to keep track of helpful strategies.
Step 3: Create and implement weekly objectives.
 Would you ever think of building a house without taking the time to
create a solid foundation? Like a foundation, a good LTG will help to keep
you on solid footing as you begin to build on your weekly objectives,
reducing the chances of getting off track. Sticking with our home-building
metaphor, you will also need a place to keep your tools. Like tools in a
toolbox, there is no one strategy to approach each goal with. You may find
that, over the course of the next several weeks, you try and implement
several different approaches in your effort to reach one goal. You’ll need
some place to keep all of these ideas so that, when one is put away and
another is taken out, none are forgotten, as they may be useful again later.
Finally, you’ll need a blueprint, or “weekly objective,” to break down the
steps and provide direction on what to do next as you work toward your
(house completion) goal.
Still think you can achieve your goals without creating a thoughtful
plan? Take the following quiz to see if the ideas in this chapter apply to you.
The more “yes” answers you give, the more helpful this chapter will be to
you.

QUIZ YOURSELF—DOES THIS SOUND LIKE YOU?

1. Do you have abstract ideas of what you would like to accomplish, such
as “I would like to be better organized”?
2. Do you alternate between going full force toward a goal (e.g., crash
dieting and losing several pounds in 1 week) and undoing everything
you set in motion (e.g., devouring a large pizza in one sitting)?
3. Is your home littered with old to-do lists or notes meant to inspire you
but ended up serving as coasters?
4. Do you have a vague recollection of some strategies that worked for
you once upon a time that you can’t describe in detail or context?
WHAT THE EXPERTS SAY

Each of the core characteristics of ADHD (inattention, hyperactivity, and

impulsivity) can negatively impact your ability to set, as well as follow
through with, goals and objectives. For example, problems related to
inattention, such as staying focused and on task, make it difficult to pinpoint
a particular goal, even if you have a conceptual idea of what you would like
to see happen. More obviously, lack of focus inhibits your capacity to
follow a goal through to completion. Hyperactivity and impulsivity have the
same effect. For someone who sets out to read a book, for example, the
need to move about can unravel all efforts in an instant. Impulsivity can
lead the same person astray if something more intriguing becomes
available. All of these factors can lead you, as an adult with ADHD, to
become easily overwhelmed by the idea of setting and meeting goals. Add
past failures to the mix and a 10-foot pole may not be nearly long enough to
touch the idea of goal setting.
Edwin Locke of the University of Maryland, College Park, and Gary
Latham of the University of Toronto developed their now famous goal-
setting theory, derived from more than 400 scientific studies in industrial or
organizational psychology over a 25-year span. They determined that
specific and difficult goals were more effective than vague or easy goals.
This is because a challenging (but not too challenging) goal feels like more
of an accomplishment to achieve since you’ve worked hard for it. Vague or
easy goals are not motivating and tend to get put off. World-renowned
psychologist Albert Bandura furthered this idea with his research on self-
efficacy, the belief people have in their capabilities to produce a desired
outcome, and how it relates to goal setting and achievement. He found that
task-specific confidence is an important factor as well, and, without it, other
variables may not matter as much.
CAN YOU RELATE TO THIS?

Addison came to me for help with her ADHD symptoms as a 30-year-old

college student. She had been diagnosed with ADHD, inattentive
presentation, after two changed majors, three different schools, and four
failed attempts to pass the courses needed to graduate. Growing up, she had
shown tremendous academic potential at times but, ultimately, felt
inundated by reminders of her failures from her parents and teachers along
the way. She suffered from anxiety and depression as a result of her
constant struggles. Addison felt that she either did well on school
assignments and test taking or nothing at all (due to her perfectionist
nature). In addition, her living space was in disorder. She had difficulty
keeping friends because she did not make a consistent effort, and she was
unable to sustain a successful romantic relationship.
At the outset of treatment, we established Addison’s LTGs. I asked
open-ended questions and encouraged her to expand on the explanations of
her goals in order to get a “big-picture” view. Addison grew up in a
household where “ignoring the good” was status quo. As long as she was
doing well in school, she heard little from her (highly successful) parents;
however, during a time of increased symptoms that kept her off track, she
received plenty of negative feedback. It was easy to see how, even when she
was doing relatively well in school now, one misstep could cause the whole
thing to collapse. I also focused on Addison’s strengths, so that we could
start to shift to a more positive narrative, and she was able to produce ideas
about what she was good at, including empathy for others and maintaining a
healthy lifestyle. These initial discussions helped me to understand how to
guide Addison so that she could be successful in reaching her goals, and
also helped her to remain positive about herself. I continued to explore
Addison’s feelings around her ADHD and offer support, and then guide her
as we narrowed in on her LTGs.

GETTING BACK ON TRACK: SETTING GOALS AND OBJECTIVES

The following sections will help you begin to create LTGs (Step 1), set up
your toolbox (Step 2), and break down LTGs into smaller, weekly
objectives (Step 3). At each step, I use Addison as a case example to
illustrate how the step should be applied.

Step 1: Setting LTGs

What is an LTG? In simple terms, you can think of an LTG as an outcome

that one desires to achieve. An LTG can vary in terms of the time it may
take to be achieved as well as in the difficulty of achievement. For example,
some coaching clients set what they see as more basic goals, such as
keeping their home clean for a period of 4 weeks or paying their bills on
time for 1 month. Others set forth more lofty goals, such as going back to
school for an advanced degree, working on a relationship, or getting a new
job. Most people don’t have a hard time coming up with ideas about what
they would like to achieve in life. The hard part is getting there—or even
knowing where to begin.
Self-confidence, too, may be a struggle for you as an adult with
ADHD, but you can increase it using the exercises put forth in Chapter 1.
Because you have most likely experienced years of disappointment in terms
of reaching your goals, your self-efficacy or self-confidence has most likely
taken a bruising when it comes to goal setting. But, now, you are armed
with ways to challenge your negative beliefs.
 Goal-directed behavior occurs when individuals are able to hold an
LTG in their awareness and use the abstract image of that goal to guide and
direct their actions. For adults with ADHD, this knack does not come easily.
Without the capacity to hold a goal in mind with consistency and focus, a
person with ADHD may find it increasingly difficult to overcome obstacles
as they are presented, further hindering the completion of any LTG.
The first step toward improving the ability to set and reach your goals
is to learn how to create an effective goal. As Locke and Latham
discovered, specificity is an important factor, as is setting a goal that will be
somewhat of a challenge to obtain. However, as an adult with ADHD who
becomes easily overwhelmed, you will need to balance difficulty with what
you can realistically do. Keeping these ideas in mind and taking into
consideration the challenges faced by adults with ADHD, I have created
four “golden rules” for what makes an effective LTG:

Make your goal Measurable.

Make your goal Process Based.
Make your goal Realistic.
Make your goal Time Sensitive.

Now, let’s take a look at each of these criteria in more depth.

Making an LTG Measurable

First, let’s consider the term measurable, which is analogous to Locke and
Latham’s specific. As we mentioned earlier, most people find it fairly easy
to come up with ideas about what they would like to achieve or things about
their life they would like to change. Responses from adults with ADHD
include the following:

I want to be better organized.

I want to manage my time better.
 I want to be less distracted.
I want to be a better spouse/friend/parent.

Although these are all wonderful things to want for yourself, they are
not measurable goals. To make these goals measurable, we need to define
them in a way that, after a period of time, they can allow us to produce an
evidence-based “yes” or “no” answer to the question “Did you accomplish
your goal?” In other words, how will we know if you are better organized;
manage your time better; are less distracted; or have become a better
spouse, friend, or parent?

Making an LTG Process Based

Next, let’s talk about what it means to make a goal process based. Just
because an LTG is measurable does not automatically make it process
based. Here are some similar goals to the ones listed previously, but only
now, they are measurable but still not process based:

I want to have my home office organized 2 months from now.

I want to create a schedule for the next month of activities.
I want to read a new book.
I want to buy my spouse/friend/parent a gift.

Again, these ideas are the beginnings of some quality goals, but the
lack of the process it takes to get there creates a fatal flaw. Many adults with
ADHD have mastered the art of procrastination. Therefore, you may be able
to put off organizing your home office for 7 weeks, only to stay up for 2
days straight getting it in order, put off reading a book for weeks until your
spouse threatens to throw out the television, or pick up a thoughtless gift at
the grocery store checkout simply to meet the goal of buying a present. On
the other hand, you can work very hard and still not reach your LTG if it is
based solely on the achievement of one final outcome. You may spend an
hour every day trying to get that home office in order but not quite finish in
time, you may diligently read 30 minutes each night and still not finish that
book, or you may spend a lot of time thoughtfully considering what gift to
buy but still not find quite the right thing. Finally, the major error regarding
the goal of creating a schedule is that it does not mention anything about
following through or maintaining that schedule. What good is a schedule if
you don’t stick to it? Making a goal process based ensures that you will
consistently monitor and focus behavior in a way that will help you not only
to achieve the LTG but also—and more important—to understand your
behavior along the way.

Making an LTG Realistic

It is important to not confuse “difficult” goals with “unrealistic” goals.
Difficult goals are challenging but attainable (for the average human and
without sacrificing health or safety). For example, don’t think that, although
you haven’t read a book in 2 years, you will be able to read nightly for the
next month. People commonly make this mistake when it comes to things
like exercise and nutrition as well, which are important parts of ADHD
symptom reduction (more on that in Chapter 10 on finding the right
counselor, coach, or other support you need to reach your goals). If you
haven’t set foot in the gym for 5 years, don’t aim to run a 10-kilometer (6.3-
mile) race in 3 weeks. It’s not going to happen. Remember, any amount of
goal-directed behavior that you engage in is most likely more than you were
doing the week before, and that is something to be proud of. A realistic goal
may be to get to the gym once a week for 6 months: You may not see this as
ideal, but it is better than not going at all.

Making an LTG Time Sensitive

This rule is a lot more straightforward. Simply put, you must include a
deadline by which time the LTG should be accomplished; otherwise, it is
left out in oblivion to dangle forever and ever. The goal date should be the
date by when you want to have followed all the blueprints (weekly
objectives) and completed your build, a little bit at a time. The trick here is
to pick a time frame that gives you adequate time to build week to week yet
isn’t so far in the distant future that all sense of urgency and motivation is
lost. Somewhere between 6 and 12 weeks is generally best.

Keeping the Four Golden Rules in Mind

As you read the following four possible ways to express our original goals,
remember the four golden rules (making LTGs that are measurable, process
based, realistic, and time sensitive). Highlight each part of the LTGs that
you think illustrates one of the golden rules:

I want to create and maintain a system of organization for my home

office over the next 3 months.
I want to use an agenda to record my schedule on a weekly basis, and
then follow through with it for the next 8 weeks.
I want to research and attempt one new skill per week to help increase
my ability to focus for the next 5 weeks.
I want to dedicate 1 hour per evening to bond with my spouse, help my
friend, or play with my kids for the next 2 months.

Exhibit 2.1 shows the LTGs created by our case example, Addison,
using the four golden rules. In Exhibit 2.2, create three or four LTGs for
yourself that follow these rules (measurable, process based, realistic, and
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