Researchers in the Netherlands wanted to know whether Cognitive Behavioural Therapy (CBT)—a structured talk-based therapy that teaches coping strategies—would improve quality of life for adults with ADHD over many years. They followed 159 adults from a larger group that had completed short-term CBT alongside medication and psychoeducation (learning about ADHD). The study tracked participants for 4 to 8 years after treatment ended.
The question mattered because earlier research showed no immediate quality-of-life boost from adding CBT to standard care. Researchers hypothesised that CBT's skill-building might work slowly, creating benefits that only appear years later.
Quality of life improved immediately, but gains faded
All participants—whether they received medication plus education alone, or medication plus education plus CBT—showed significant quality-of-life improvements immediately after treatment ended (average scores jumped from 44 to 69 on the Adult ADHD Quality of Life scale). However, this improvement declined by the time of long-term follow-up, settling at 52. Importantly, even with this decline, quality of life remained higher than before treatment began. The researchers found no meaningful difference between the group that received CBT and the group that did not.
CBT showed no additional long-term advantage
The study's central finding was negative: adding CBT to medication and education did not lead to better quality-of-life outcomes over 4–8 years compared to medication and education alone. Both groups followed similar trajectories—initial gains that partially faded over time. The researchers emphasise that this finding applies specifically to this Dutch cohort and that a relatively small proportion of the original 627 participants (159, or 25%) completed the long-term survey, which limits how broadly these results can be applied.
What this could mean for your family
If your adult family member with ADHD is considering therapy options, this study suggests that the combination of medication and education about ADHD may be the core effective treatment. While CBT did not show added long-term benefits in this research, it remains a valid option—particularly if medication alone is not enough or if your family member prefers a multi-pronged approach. The study also hints that some gains from any treatment may naturally fade over time, meaning periodic check-ins with healthcare providers may help sustain improvements.