Bridging the Gap: Digital CBT for Adults Managing ADHD Challenges

Objective: Cognitive behavioral therapy (CBT) is an efficacious treatment for adult ADHD, yet access and availability concerns limit scalability. Mobile health apps are promising tools for delivering scalable CBT. The current study reports findings from a randomized controlled trial (RCT) of a CBT-informed health app for adults with ADHD. Methods: A sample of assessed adults with ADHD ( N = 154; ages 18–55 years) were recruited to participate and randomized to either 8 weeks of use of the CBT-informed app or a waitlist control condition. Participants in both groups completed measures of ADHD symptoms and functioning at baseline, at 4 weeks, and at 8 weeks. Results: Linear mixed-effects models for repeated measurements revealed significant group x time interactions for inattentive symptoms (η 2 = .15), hyperactive-impulsive symptoms (η 2 = .05), and ADHD associated quality of life (η 2 = .04) in favor of the CBT-informed app relative to participants who knew they were not receiving help; however, these results did not extend to a measure of functional impairment. Changes in organizational, time management, and planning behaviors and ADHD-related cognitions partially mediated the association between group and inattentive symptom changes. ADHD inattentive symptom reductions were positively associated with the total number of app exercises completed. Conclusions: The confidence in our results is limited by our use of a waitlist control design. However, participants who used the CBT-informed app perceived improvements in inattentive and hyperactive-impulsive symptoms and quality of life relative to participants who knew they were not receiving help.