Managing ADHD can sometimes feel like trying to juggle too many things at once. The mind might jump from one thought to the next, leaving tasks unfinished and attention scattered. It’s easy to feel overwhelmed, but you’re not alone—and there are tools that can help. One of the most effective approaches for managing these challenges is Cognitive Behavioural Therapy or CBT for ADHD
CBT isn’t just about talking through your challenges—it’s about actively building practical skills that help you stay organised, manage distractions, and regain focus. Whether you’re an adult juggling work and home responsibilities, or a parent helping your child with ADHD stay on track, CBT exercises can make a real difference in everyday life. Parents with children struggling at school may also benefit from reading our article on EHCP for ADHD.
In this article, we’ll cover a variety of CBT exercises designed for people with ADHD, from techniques that help adults manage procrastination and impulsivity, to kid-friendly exercises that encourage better focus. We’ll also share tips for getting the most out of your CBT sessions.
Whether you’re looking for simple exercises to try on your own, or you’re interested in how Oxford CBT can help, we’ve got you covered. Let’s explore how CBT can be a powerful tool for managing ADHD and improving focus, one step at a time.
What is CBT for ADHD?
Cognitive Behavioural Therapy (CBT) is a type of talking therapy that focuses on identifying and changing unhelpful patterns of thinking and behaviour. It’s based on the idea that our thoughts, feelings, and behaviours are interconnected—meaning that how we think about a situation affects how we feel and how we act.
When applied to ADHD, CBT helps individuals become more aware of their thought processes, especially those that may lead to distractions, impulsivity, or disorganisation. The therapy works by teaching strategies to challenge these thought patterns and replace them with more constructive ones, leading to better decision-making and improved control over actions.
CBT is highly structured and goal-oriented, focusing on specific challenges in everyday life. CBT for ADHD is typically delivered in a set number of sessions and involves collaboration between the therapist and the individual to develop tailored strategies for managing symptoms. It can be delivered one-on-one, in group settings, or even through online resources like workbooks or apps.
How Does CBT Work for ADHD?
Unlike traditional talk therapies, CBT is practical, with individuals actively working on exercises both during therapy sessions and in their daily routines. CBT for ADHD focuses on reshaping unhelpful thought patterns and developing practical skills to manage the everyday challenges associated with the condition.
CBT exercises for ADHD are designed to address the specific challenges ADHD brings, such as difficulty maintaining focus, managing time, or completing tasks. CBT addresses these issues by targeting how individuals think about and react to situations, while also teaching skills to improve focus, time management, and emotional regulation.
Building New Thought Patterns
One of the core elements of CBT is recognising negative or automatic thought patterns that contribute to ADHD symptoms. For example, an individual with ADHD might think, “I’ll never get this done,” which can lead to feelings of defeat or procrastination. CBT works by helping individuals identify these unhelpful thoughts and replace them with more realistic, positive ones, such as, “I can break this task into smaller steps and tackle it one at a time.” This shift in thinking can reduce anxiety and help improve task initiation and completion [1].
Emotional Regulation
ADHD is often associated with emotional dysregulation—intense feelings of frustration, irritability, or overwhelm. CBT helps individuals with ADHD develop tools to better manage their emotions. Techniques like mindfulness, deep breathing, or reframing negative thoughts allow individuals to pause, reflect, and respond more thoughtfully to stressful situations rather than reacting impulsively [2].
Practical Skills for Focus and Organisation
In addition to thought-based work, CBT provides practical strategies for improving focus and organisation, areas where many people with ADHD struggle. This can include exercises like breaking large tasks into smaller, more manageable chunks, setting time limits for activities, and creating structured routines to minimise distractions. Over time, these techniques can help individuals become more efficient and feel more in control of their daily responsibilities.
By addressing both thought processes and practical challenges, CBT equips individuals with ADHD to better manage their symptoms and improve their quality of life.
What are the Benefits of CBT for ADHD?
CBT offers several specific benefits for individuals with ADHD, focusing on developing practical skills and coping strategies to manage symptoms like inattention, disorganisation, and impulsivity. While medication can address the chemical imbalances in the brain associated with ADHD, CBT provides tools that help improve daily functioning and emotional well-being. Here are some of the key benefits of CBT for ADHD:
1. Improved Time Management and Organisation
CBT teaches practical techniques to help individuals manage their time more effectively and improve their organisational skills. For those with ADHD, staying on top of tasks and responsibilities can be a significant challenge. CBT interventions, such as breaking tasks into smaller steps or using external reminders, provide structure and help individuals develop better planning and organisational habits [3].
2. Reduced Procrastination
Procrastination is a common issue for individuals with ADHD, often leading to stress and a backlog of unfinished tasks. CBT helps address this by introducing techniques like the “5-minute rule,” where individuals commit to starting a task for just five minutes to overcome the mental barrier to starting. By building momentum with small steps, individuals find it easier to tackle larger tasks and reduce procrastination [4].
3. Enhanced Emotional Regulation
Emotional dysregulation, including sudden mood swings or difficulty managing frustration, is common in individuals with ADHD. CBT helps individuals identify and challenge negative thought patterns that can contribute to emotional distress, teaching techniques to pause, reflect, and respond more thoughtfully. Studies show that CBT significantly improves emotional regulation in individuals with ADHD, reducing symptoms of anxiety and depression [5].
4. Long-Term Improvements
CBT provides long-lasting tools that individuals can continue to use throughout their lives. Unlike medication, which works while it’s active in the system, the skills learned in CBT can be applied in the long term. This allows individuals to better manage their ADHD symptoms and reduce reliance on other forms of treatment. Research has shown that combining CBT with medication leads to more sustained improvements in overall functioning than medication alone [6].
5. Increased Self-Esteem
Many individuals with ADHD struggle with low self-esteem due to the challenges they face in school, work, and personal life. CBT empowers individuals by giving them practical strategies to manage their symptoms, leading to increased confidence and a sense of accomplishment. As individuals gain control over their daily responsibilities and see improvements in their ability to focus and complete tasks, they often experience a significant boost in self-esteem [7].
6. Better Coping Mechanisms
One of the key benefits of CBT is the development of healthy coping mechanisms for dealing with stress, impulsivity, and inattention. These strategies can include mindfulness techniques, creating structured routines, and using technology for reminders and organisation. By incorporating these skills into their daily routines, individuals with ADHD are better equipped to handle distractions, stay on task, and manage their emotions effectively [8].
How many sessions of CBT are Recommended?
The number of CBT sessions required for ADHD can vary depending on individual needs and the severity of symptoms. However, a typical CBT programme for ADHD generally involves:
- 12 to 20 sessions: This is the usual range for a structured CBT programme. Most individuals will have weekly or bi-weekly sessions lasting around 45 minutes to an hour. The goal of these sessions is to develop and practise new skills, challenge negative thought patterns, and work on real-life applications of strategies for managing ADHD.
For some, fewer sessions may be needed if they respond well to the therapy and begin implementing the strategies early on. Others may benefit from additional sessions if their symptoms are more severe or if they require longer-term support.
After the initial set of sessions, follow-up or booster sessions may be recommended to reinforce progress and continue building on the skills learned during the primary CBT programme. This helps ensure that the strategies developed during therapy continue to be effective over the long term.
Is CBT for ADHD available on the NHS?
Yes, CBT for ADHD is available on the NHS, but access can vary depending on your location and the availability of services. Typically, you would need to go through the following steps:
- Referral from your GP: To access CBT through the NHS, you’ll usually need to be referred by your GP or another healthcare professional. They will assess your symptoms and decide whether CBT is a suitable treatment for you.
- NHS Waiting Lists: Like many mental health services, there can be waiting lists for CBT, especially in areas where demand is high. The length of the waiting time can vary, with some areas experiencing waits of several months.
- Child and Adolescent Services (CAMHS): For children and teenagers with ADHD, CBT may be offered through Child and Adolescent Mental Health Services (CAMHS). This often involves a multi-disciplinary approach to ADHD treatment, which may include CBT as part of a broader plan.
- Adult ADHD Services: Adults with ADHD may be referred to specialist adult ADHD services, where CBT can be provided as part of a treatment plan. However, some regions have limited access to these services, and you may need to explore private options if waiting times are long.
If the waiting time is too long or if you prefer more immediate support, private CBT is an option. Many private clinics, like Oxford CBT, offer tailored programmes for individuals with ADHD.
Examples of CBT Exercises for ADHD
Key CBT Exercises for ADHD Adults
CBT exercises are designed to help adults with ADHD manage symptoms such as difficulty focusing, impulsivity, and disorganisation. These strategies are backed by research and have been proven to assist in building better habits and managing the everyday challenges of ADHD. Below are some key CBT exercises specifically tailored for adults with ADHD:
1. Goal Setting and Prioritisation
Setting clear, realistic goals is an essential CBT exercise for adults with ADHD. This strategy involves breaking down larger tasks into smaller, more manageable steps, making it easier to stay organised and focused.
- SMART Goals: This method encourages individuals to set goals that are Specific, Measurable, Achievable, Relevant, and Time-bound. For example, instead of setting a vague goal like “get organised,” a SMART goal would be “organise my desk for 15 minutes every morning for the next week.” This specificity helps reduce overwhelm and creates a clear structure [9].
Research shows that goal setting is particularly effective for individuals with ADHD, helping them focus on one step at a time, which reduces procrastination and increases task completion rates [10].
2. Breaking Tasks into Smaller Steps
A common challenge for adults with ADHD is feeling overwhelmed by large tasks, which often leads to procrastination or avoidance. One effective CBT strategy is to break tasks into smaller, more manageable steps. This technique helps reduce the mental load of tackling big projects and makes it easier to get started.
- Chunking: This approach involves breaking a large task into several smaller “chunks.” For instance, instead of trying to complete an entire work project in one sitting, an individual might break it down into smaller tasks like drafting an outline, writing one section, or reviewing edits. These smaller tasks feel more achievable and create momentum as each step is completed [11].
Studies have shown that using this approach leads to increased productivity and helps people with ADHD maintain focus and stay organised [12].
3. Cognitive Restructuring (Challenging Negative Thoughts)
Adults with ADHD often experience negative thought patterns that can impact their ability to focus or complete tasks. Cognitive restructuring is a CBT exercise that teaches individuals to identify and challenge unhelpful thoughts, replacing them with more constructive ones.
- Catch, Challenge, Change: This CBT method helps individuals “catch” a negative or unhelpful thought, “challenge” its accuracy, and “change” it to a more balanced perspective. For example, if an adult with ADHD thinks, “I’ll never finish this project,” they can challenge that thought by reminding themselves of past successes, then change it to something like, “I can break this project into smaller steps and make progress.”
Research indicates that cognitive restructuring is highly effective in reducing procrastination and improving self-esteem in adults with ADHD [13].
4. Impulse Control Strategies
Impulsivity is another hallmark of ADHD, and managing impulsive thoughts and actions can be challenging. CBT exercises for impulse control focus on increasing awareness of impulsive behaviours and developing strategies to pause and make more thoughtful decisions.
- Mindful Pause: This exercise involves practising the ability to pause for a few seconds before reacting to a situation. When an impulsive thought arises, individuals are encouraged to take a deep breath, count to five, and ask themselves whether their initial reaction is the most appropriate response. This pause allows time for more deliberate decision-making and can prevent impulsive actions.
Research supports mindfulness-based techniques like the mindful pause in reducing impulsive behaviours in adults with ADHD, leading to better decision-making and self-regulation [14].
5. Time Management Techniques
Time management is a significant challenge for many adults with ADHD. CBT provides practical techniques to help individuals manage their time more effectively and reduce the tendency to procrastinate.
- The Pomodoro Technique: This method involves working in focused intervals, typically 25 minutes long, followed by a 5-minute break. The structure helps reduce distractions and maintains attention on a single task. After four “Pomodoro” sessions, a longer break is taken. This technique has been shown to improve productivity and focus in adults with ADHD by creating clear time boundaries for work and rest [15].
CBT Exercises for Children with ADHD
CBT for children with ADHD is adapted to be engaging and accessible, using age-appropriate techniques to help them improve focus, manage emotions, and build productive routines. These exercises are designed to be interactive, fun, and practical, ensuring children stay engaged while learning essential coping skills. Below are some key CBT exercises that are particularly effective for children with ADHD:
1. Focus and Attention Games
Children with ADHD often struggle with maintaining focus, especially during tasks that require sustained attention. CBT exercises that incorporate games or activities can make learning how to focus more enjoyable.
- “Mindful Breathing” Exercise: This exercise teaches children how to use deep breathing to calm themselves and improve focus. The child is encouraged to take deep breaths while focusing on their breath or counting up to five on each inhale and exhale. This technique helps them develop mindfulness and become more aware of when their mind is wandering.
- “Simon Says” for Impulse Control: Games like Simon Says or Red Light, Green Light can help children improve impulse control by teaching them to think before acting. These games require children to pause and process instructions before responding, helping them practise self-regulation [16].
2. Emotion Regulation Techniques
Managing strong emotions like frustration, anger, or anxiety can be particularly difficult for children with ADHD. CBT exercises can teach children how to recognise and manage these feelings in healthier ways.
- “Feelings Thermometer”: This visual tool helps children understand and rate their emotions on a scale from 1 to 10, with 1 representing calm and 10 representing extreme anger or frustration. The child can learn to identify when their emotions are escalating and apply coping strategies like deep breathing or taking a break before reaching a higher level on the scale [17].
- “Stop, Think, Act”: This CBT exercise encourages children to pause when they are feeling emotionally overwhelmed. They are taught to stop, think about how they are feeling and why, and then choose an appropriate response or action. This helps children learn how to manage emotional impulses more effectively [18].
3. Building Routines for Organisation
Children with ADHD often find it difficult to stick to routines or complete tasks in an organised manner. CBT can help by introducing strategies that make it easier to create and maintain routines.
- “Step-by-Step Charts”: This exercise involves creating visual charts that break down tasks like homework, getting ready for school, or cleaning up into simple, manageable steps. Children can tick off each step as they complete it, which gives them a sense of accomplishment and helps them stay on track [19].
- Reward Systems: Using positive reinforcement, children can be encouraged to follow routines by earning small rewards (like stickers or tokens) for completing tasks. This system helps build motivation and creates a sense of achievement, which can reinforce consistent behaviour [20].
4. Cognitive Restructuring for Negative Thoughts
Children with ADHD may develop negative thought patterns, such as “I’m always in trouble” or “I can’t do anything right.” CBT helps them identify and challenge these thoughts, replacing them with more constructive ones.
- “Catch the Negative Thought”: In this exercise, children are encouraged to identify negative thoughts as they arise and write them down or talk about them. They then work with a parent or therapist to reframe those thoughts into something more positive. For example, “I always mess up” can be changed to “I’m learning, and it’s okay to make mistakes” [21].
The 5-Minute Rule in CBT for ADHD
The 5-minute rule is a simple but powerful CBT technique that helps individuals with ADHD overcome procrastination and initiate tasks more easily. One of the most common struggles for people with ADHD is starting tasks, especially those that seem overwhelming or tedious. The 5-minute rule offers a way to break through this mental barrier by asking individuals to commit to a task for just five minutes.
How the 5-Minute Rule Works
The idea behind the 5-minute rule is that the hardest part of any task is often just getting started. This rule encourages individuals to tell themselves they only need to work on the task for five minutes—no more. Once those five minutes are up, they can decide whether to continue or stop. More often than not, once the individual has started, they find it easier to keep going because the initial mental resistance is overcome.
This technique works particularly well for people with ADHD because it reduces the overwhelming feeling of having to tackle large or complex tasks all at once. By breaking it down into such a short, achievable time frame, the task becomes less intimidating, and the individual is more likely to start.
Why the 5-Minute Rule is Effective
Research supports the effectiveness of the 5-minute rule as part of a broader CBT approach to managing procrastination and ADHD. When individuals commit to just five minutes, the psychological resistance to starting decreases, and once the task is underway, the brain often experiences a “shift” in motivation, making it easier to continue [22]. This technique helps develop task initiation, which is a critical skill for individuals with ADHD who often struggle with procrastination due to feelings of overwhelm or distraction.
Additionally, the 5-minute rule taps into behavioural activation, a concept in CBT where individuals engage in an action, however small, to build momentum. Once the brain is focused on a task, it becomes easier to maintain that focus and move forward. Even if the person stops after five minutes, the small step forward still builds confidence and reduces the mental barriers to starting future tasks.
Example of the 5-Minute Rule in Action
Imagine a person with ADHD who has been putting off writing an important email. The idea of sitting down and drafting a detailed message feels daunting, and they keep avoiding it. Using the 5-minute rule, they commit to just starting the email for five minutes. They might begin by writing a few bullet points or drafting a simple greeting. After five minutes, the task may not feel as overwhelming, and they may decide to continue and complete the email. Even if they stop after five minutes, they’ve made progress, which can reduce procrastination the next time they return to the task.
How to Get the Most Out of CBT for ADHD
To maximise the benefits of Cognitive Behavioural Therapy (CBT) for ADHD, individuals should actively engage in the therapeutic process both during sessions and in daily life. Here are several key strategies to help you get the most out of CBT for ADHD:
Be Open and Honest
Effective CBT relies on a collaborative relationship between the individual and the therapist. It’s essential to be open and honest about your challenges, experiences, and thoughts during the therapy process. If you are struggling with a particular technique or feel unsure about certain aspects of the therapy, discussing these openly will allow the therapist to tailor the approach more effectively to your needs.
Practise CBT Exercises Regularly
CBT is not just about what happens during therapy sessions—it’s about applying the strategies learned in real life. The more you practice CBT exercises like goal setting, cognitive restructuring, or the 5-minute rule, the more likely they are to become part of your daily routine. Regularly working on these exercises builds long-term habits that help manage ADHD symptoms.
- For example, if you struggle with procrastination, consistently applying the 5-minute rule will help you gradually overcome mental blocks and build momentum for task completion.
Set Realistic Expectations
While CBT can be highly effective, it’s important to recognise that change doesn’t happen overnight. Like any skill, CBT techniques take time to learn and master. Setting realistic expectations for progress will help you stay patient and motivated. Celebrate small successes along the way, whether it’s completing a task you’ve been avoiding or feeling more in control of your emotions during a challenging situation.
Stay Committed to the Process
CBT works best when individuals fully commit to the process. This means attending therapy sessions consistently, completing homework assignments given by the therapist, and staying engaged with the therapeutic exercises even when it feels difficult. ADHD can make sticking to routines challenging, but commitment is key to making meaningful progress.
- Use reminders or visual prompts (such as sticky notes or phone alerts) to ensure you follow through with exercises and attend sessions regularly.
Develop a Support System
Getting the most out of CBT often involves having a strong support system. Family members, friends, or colleagues who understand your ADHD challenges can offer encouragement and accountability as you work through therapy. Sharing your progress with trusted people can also reinforce the positive changes you’re making.
- For example, involving family members in strategies like building routines or time management techniques can help create a more ADHD-friendly home environment.
Track Your Progress
Keeping a journal or using an app to track your thoughts, feelings, and progress through CBT can help you reflect on how far you’ve come and what areas still need work. By reviewing your progress, you can gain insight into patterns of behaviour and see where CBT exercises have been most effective.
- For example, tracking the tasks you’ve completed after using the 5-minute rule can reinforce how effective small steps can be in overcoming procrastination.
Focus on Long-Term Habits
The ultimate goal of CBT is to develop long-term coping strategies that help you manage ADHD symptoms throughout your life. To get the most out of CBT, focus on integrating these habits into your daily routine rather than relying on short-term fixes. The more consistently you apply CBT techniques, the better you’ll be able to handle ADHD-related challenges independently over time.
By actively participating in therapy, practising CBT techniques regularly, and maintaining realistic expectations, you can significantly improve your ability to manage ADHD symptoms and enhance your quality of life.
How Oxford CBT Can Help with ADHD Treatment
At Oxford CBT, we understand that ADHD can present unique challenges in daily life, whether you’re an adult managing work and home responsibilities, or a child trying to stay focused in school. Our team of experienced therapists provides expert guidance and support through tailored Cognitive Behavioural Therapy (CBT) programmes, specifically designed to address the needs of individuals with ADHD.
Tailored CBT Programmes for Adults and Children
Oxford CBT offers customised treatment plans for both adults and children with ADHD, recognising that each person’s experience with ADHD is different. Our goal is to help individuals develop practical, lifelong coping strategies that improve focus, time management, and emotional regulation. Our evidence-based CBT approach equips clients with tools that not only help manage symptoms but also enhance overall well-being and quality of life.
For adults, our CBT programmes are structured to address challenges like procrastination, disorganisation, impulsivity, and emotional regulation. By working with a therapist, adults can learn techniques such as goal setting, time management strategies, and cognitive restructuring to help navigate personal and professional responsibilities more effectively.
For children, we offer age-appropriate CBT exercises that focus on improving focus, managing emotions, and building routines. Techniques like play-based therapy and visual aids help make CBT engaging for younger clients, while also teaching them essential skills for managing their ADHD symptoms.
A Collaborative and Personalised Approach
At Oxford CBT, we believe in a collaborative approach to treatment. Our therapists work closely with each individual to understand their specific challenges and goals, tailoring the therapy to meet those needs. Whether it’s helping a child build structure in their schoolwork or guiding an adult through overcoming procrastination at work, our personalised CBT programmes are designed to foster real, lasting change.
We also recognise that ADHD doesn’t just affect the individual, but their families as well. That’s why we work to involve families where appropriate, ensuring that everyone understands the strategies being developed and can offer support at home.
Expert Guidance from Qualified Professionals
Our team at Oxford CBT includes highly skilled therapists who are experienced in working with ADHD across all ages. We use evidence-based practices and the latest research in ADHD treatment to ensure our clients receive the most effective care. With our professional guidance, clients are equipped to better manage their ADHD symptoms and achieve long-term success.
Get the Support You Need at Oxford CBT
Whether you’re looking for help managing adult ADHD, or seeking treatment for a child, Oxford CBT is here to provide compassionate, professional support. Our tailored CBT programmes give individuals the skills they need to manage ADHD symptoms, improve their focus, and feel more in control of their lives.
To learn more about our ADHD treatment programmes or to book an appointment, visit our website or contact us today. At Oxford CBT, we’re committed to helping you or your child thrive with ADHD.
References
[1] Ramsay, J. R., & Rostain, A. L. (2015). Cognitive Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach. Routledge.
URL: https://www.routledge.com/Cognitive-Behavioral-Therapy-for-Adult-ADHD-An-Integrative-Psychosocial/Ramsay-Rostain/p/book/9780415815917
[2] Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Press.
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[6] Sprich, S., Safren, S. A., Finkelstein, D., Remmert, J. E., & Hammerness, P. (2016). A randomized controlled trial of cognitive-behavioral therapy for ADHD in medication-treated adolescents. The Journal of Clinical Psychiatry, 77(11), 1449-1455.
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URL: https://www.psychiatrist.com/jcp/adhd/randomized-controlled-trial-cognitive-behavioral-therapy-adhd/
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[18] Kendall, P. C., & Braswell, L. (1993). Cognitive-behavioral therapy for impulsive children. Guilford Press.
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[19] Solanto, M. V., Marks, D. J., Mitchell, K. J., Wasserstein, J., & Kofman, M. D. (2008). Development of a new psychosocial treatment for adult ADHD. Journal of Attention Disorders, 11(6), 728-736.
URL: https://journals.sagepub.com/doi/abs/10.1177/1087054707305100
[20] DuPaul, G. J., & Stoner, G. (2016). ADHD in the Schools: Assessment and Intervention Strategies. Guilford Press.
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[21] Safren, S. A., et al. (2005). Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms: Randomized controlled trial. The Journal of the American Medical Association, 304(8), 875-880.
URL: https://jamanetwork.com/journals/jama/fullarticle/186352
[22] Ramsay, J. R., & Rostain, A. L. (2015). Cognitive Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach. Routledge.
URL: https://www.routledge.com/Cognitive-Behavioral-Therapy-for-Adult-ADHD-An-Integrative-Psychosocial/Ramsay-Rostain/p/book/9780415815917
Author – Tom Murfitt
With over a decade’s experience in providing Cognitive Behavioural Therapy, Tom has worked in both the NHS and private sector to help adults and children to overcome a range of difficulties and improve their mental wellbeing. In addition to being an experienced CBT therapist, Tom is also an accredited Mindfulness teacher, providing courses locally, in businesses and schools. You can read more about us here.
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