Adult ADHD treatment in NSW: medication, therapy and what the evidence says

What treatment involves: in Australia, treatment for adult ADHD usually starts with a thorough assessment and diagnosis, then a plan that combines psychological therapy with, where it suits you, medication prescribed by a doctor. A psychologist can assess and diagnose ADHD, write a detailed report, and provide therapy for the skills, habits and emotional side of ADHD. Medication is prescribed by a medical practitioner, usually a psychiatrist, sometimes working with your GP. The two parts work best when they're coordinated, and many adults use both.

If you've just been diagnosed, or you're wondering whether to be assessed, this guide walks through each part and who does what.

What a psychologist can help with

• Assessment and diagnosis. A structured adult ADHD assessment looks at your history, how ADHD shows up now, and what else might explain it, and ends with clear findings and recommendations.
• A written report. You can take it to your GP or psychiatrist, and with your consent we can send it for you.
• Therapy. Practical work on focus, planning, time and follow-through, plus the emotional side: frustration, shame and the patterns left by years of compensating.
• Working alongside your doctor. We keep your GP and psychiatrist in the loop so the plan hangs together.

• Where to find us We see adults for ADHD assessments and therapy at our Kingswood clinic, near Penrith (Nepean Health Hub, Level 3, 302/13 Barber Avenue) and at our Gledswood Hills clinic (Gregory Hills Health and Business Centre, Level 2, 25/13 Digitaria Drive), and for therapy by telehealth anywhere in NSW. Our adult ADHD assessments page shows each step, from your first call to your report and follow-up. Or call 1300 151 110 and we'll talk it through.

Therapy for adult ADHD

Medication can make attention more available. It doesn't teach you what to do with it, and it doesn't undo years of working twice as hard for half the result. That's what therapy is for.

The approaches with the strongest research support for adults include:

• Cognitive Behavioural Therapy adapted for ADHD, which works on the loops that drive avoidance, procrastination and self-criticism, and the gap between what you intend and what you do.
• Skills and executive function work: structured practice with planning, time, starting tasks, and building routines and systems so you're not relying on willpower.
• Mindfulness-based approaches, which can help with emotional reactivity, a part of ADHD that often goes unmentioned.
• Acceptance and Commitment Therapy (ACT), which helps with the shame and identity questions a late diagnosis can bring up.

Some adults choose a therapy-led plan, for example when medication isn't suitable. Whether that suits you is worth discussing with a doctor and a psychologist.

Medication, and who prescribes it

ADHD medication is prescribed by a medical practitioner, not a psychologist. In NSW, stimulant medicine is usually started by a psychiatrist. If you're already diagnosed and stable, a trained GP may be able to take over your repeat scripts. There are two broad groups of medicines, stimulants and non-stimulants, and finding the right one and the right dose often takes a few adjustments. That's normal, and your prescriber is the right person for questions about medicines, side effects and doses.

Which parts we do, and which need a doctor

We can: assess and diagnose ADHD in adults, write a report, provide therapy, and work with your GP and psychiatrist.

A medical practitioner: prescribes, reviews and adjusts medication, and checks any physical health questions that come with it.

How long does it take?

Your prescriber can explain what to expect from medication. The deeper work of building skills and rethinking how you see yourself takes time. How many sessions you need depends on your goals, and we'll set out a realistic plan at the start and review it as you go.

When to reach out

• You've recently been diagnosed and don't know what to do beyond the script.
• You're on medication and it's helping, but life still feels harder than it should.
• You're thinking about an assessment and want to understand the options first.
• The emotional side, relationships or self-esteem haven't shifted.
• You've decided not to take medication and want a therapy-led plan.

Common questions

What does treatment for adult ADHD involve?

Usually an assessment and diagnosis, then a plan that combines therapy with medication from a doctor where it suits you. A psychologist handles the assessment, report and therapy. A psychiatrist or GP handles medication.

Can you treat adult ADHD without medication?

Yes, for many adults. Therapy such as CBT adapted for ADHD, skills work and ACT are options, particularly when ADHD is milder. Whether to use medication is a personal decision, best talked through with a doctor and a psychologist.

Can a psychologist prescribe ADHD medication?

No. Psychologists in Australia don't prescribe medication. We assess, diagnose and provide therapy, and we can send our report to the doctor who prescribes.

How does therapy help if medication does the chemistry?

Medication can make attention more available. Therapy is where you build the systems, habits and emotional skills to use it, and work through what years of undiagnosed ADHD left behind.

Thinking about your next step?

We see adults at our Kingswood clinic in the Nepean Health Hub, at Gledswood Hills, and by telehealth. If you're not sure where to start, get in touch and we'll talk it through, including whether an assessment makes sense for you.

For more background, read signs of ADHD in adults and what to expect from an adult ADHD assessment.