SPECIALIST THERAPY · LONDON & ONLINE
Therapy for ADHD
in London.
For adults who are tired of being misunderstood: You're not lazy. You're not broken. You're not too much.
You have a brain that works differently... And for most of your life, no one told you that.
Neuro-affirming ADHD therapy in Fitzrovia, Central London and online. From a therapist with real firsthand understanding of what living with ADHD involves, not just clinical knowledge of it.
Last updated: April 2026
Free 15-30 min call No obligation
ADHD Therapy Sessions in Fitzrovia & Online
Session length
50 minutes
Location
Fitzrovia, W1, Central London
Frequency
Weekly, open-ended
Sessional Fee
£90-£120 · sliding scale available
Format
In-person or online
Framework
Integrative, relational psychotherapy
OVERVIEW
What is ADHD in Adults?
Attention Deficit Hyperactivity Disorder is a neurodevelopmental condition that affects how the brain regulates attention, impulse control, and activity levels. In adults, ADHD rarely looks like the hyperactive child bouncing off classroom walls. It looks like someone who is highly intelligent but can't finish things. Someone who can focus for six hours on something fascinating and can't write a single email they're not interested in. Someone who is always late despite genuinely trying not to be.
ADHD is not a character flaw. It is not laziness. It is not an excuse. It is a neurological difference, consistent, measurable, and well-evidenced in decades of research, that affects roughly 3-4% of UK adults, the majority of whom have never received a diagnosis.
For many adults, the recognition of ADHD comes late, in their thirties, forties, or beyond, often triggered by a child's diagnosis, a burnout crisis, or simply a growing sense that no matter how hard they try, they keep running into the same walls.
"I spent years thinking I was a clever person who couldn't get their act together. The diagnosis didn't change what I was struggling with. It changed what I thought it meant about me."
The goal of ADHD therapy is not to make you function like someone without ADHD. It's to help you understand how your brain actually works, and build a life that fits it.
KEY DISTINCTION
It's not about attention
ADHD is better understood as a disorder of attention regulation, not attention capacity. People with ADHD can attend, often with extraordinary intensity, but they cannot reliably direct that attention on demand. Interest, urgency, novelty, and emotional significance regulate attention instead of intention and importance.
COMMON MISCONCEPTION
But I can focus when I want to
The ability to hyperfocus is one of the most common reasons adults miss their ADHD diagnosis. "How can I have ADHD if I can read for four hours?" Because ADHD affects the consistency and controllability of attention, not its existence. The capacity is there. The on-demand control often isn't.
Types of ADHD in adults
The DSM-5 describes three presentations of ADHD. These are not fixed categories, a person can move between presentations across their lifetime, and most adults show features of more than one. What matters clinically is not the label, but the specific pattern of difficulties you experience.
PRESENTATION 1
Predominantly Inattentive
Formerly called ADD. Difficulty sustaining attention, following through on tasks, organising, remembering details. Often missed, particularly in women and high achievers, because it presents as daydreaming, forgetfulness, or "not trying hard enough" rather than disruptive behaviour. The absence of hyperactivity makes it invisible to others, and often to the person themselves.
PRESENTATION 2
Predominantly Hyperactive-Impulsive
Restlessness, difficulty sitting still, talking excessively, acting before thinking, and interrupting others. In adults, hyperactivity often becomes internal, a racing mind, an inability to relax, a constant low-level restlessness that never quite switches off. Impulsivity shows up in decisions, spending, relationships, and risk-taking.
PRESENTATION 3
Combined Presentation
This is the most commonly diagnosed presentation in adults - significant symptoms of both inattention and hyperactivity-impulsivity. This is not "worse" than other presentations; it simply means the ADHD affects a wider range of functioning. Many people who are diagnosed as inattentive in childhood are rediagnosed as combined as an adult, as patterns become clearer over time.
Signs and Symptoms of Adult ADHD
Clinical checklists capture symptoms. They don't always capture the experience of living with them every day. These are the patterns that bring adults to therapy, often for the first time, having spent years not knowing there was a name for any of this.
Time Blindness
Time doesn't feel linear. There is now, and there is not now. Deadlines feel abstract until they are suddenly, catastrophically real. Being late is not disrespect, it is a neurological experience of time that works differently.
The shame-procrastination loop
The task feels too big. The shame of potentially failing is worse than not starting. Not starting creates more shame. More shame makes starting feel even harder. This is not laziness, it is a well-documented ADHD shame spiral.
Hyperfocus
The ability to focus so intensely on something interesting that hours disappear. Can be a strength and a source of great achievement, and simultaneously a reason the diagnosis gets missed ("but you can focus when you want to").
Working memory difficulties
Forgetting what you came into a room for. Losing a thought mid-sentence. Missing important details in conversations even when you were paying attention. This is not stupidity, it is a fundamental feature of how ADHD affects the brain's holding and processing capacity.
Rejection Sensitive Dysphoria (RSD)
Intense, overwhelming emotional pain in response to perceived criticism, failure, or rejection. Can arrive in seconds and feel physically painful. Often the most impairing aspect of ADHD for adults, and one of the least discussed.
Emotional dysregulation
Big feelings that arrive quickly and intensely. Frustration, excitement, grief, all amplified. The ADHD brain's regulatory systems don't modulate emotional responses as effectively, meaning feelings can feel overwhelming even in ordinary situations.
ADHD masking
The enormous effort of appearing neurotypical, organised, attentive, on time. Common in people who succeeded academically or professionally. The performance is exhausting and unsustainable, often ending in burnout that looks like depression.
Relational impact
Forgotten commitments, misread social cues, impulsive words, difficulty following conversations in groups. Partners and friends can experience this as indifference, when in fact the person with ADHD cares deeply, their brain just processes social information differently.
The Neuroscience of ADHD in Adults
Understanding the neuroscience doesn't make ADHD easier. But it does something important: it removes the moral weight. When you understand that the difficulties you experience are rooted in measurable neurological differences, it becomes harder to blame yourself for them.
DOPAMINE & NORADRENALINE
The neurotransmitter picture
ADHD is associated with differences in the functioning of dopamine and noradrenaline systems in the brain. Dopamine plays a central role in motivation, reward, and the experience of interest. In ADHD brains, dopamine signalling is dysregulated, meaning the brain doesn't release or respond to dopamine in quite the same way in response to low-stimulation tasks. This is why tasks that feel dull or unimportant are genuinely, neurologically harder to sustain attention on, and why urgency, novelty, and high interest can temporarily override the deficit. The ADHD brain is not broken; it has a different reward threshold.
EXECUTIVE FUNCTION
The CEO that doesn't always show up to work
Executive functions are the brain's management system, planning, prioritising, initiating tasks, holding information in working memory, regulating impulses, and monitoring progress. Research consistently shows that ADHD involves differences in the prefrontal cortex, the region most responsible for executive function. This explains why someone with ADHD can know exactly what they need to do and still be unable to start. It is not a knowledge problem; it is an activation problem. The understanding is there. The neurological bridge to action is not always reliable.
THE DEFAULT MODE NETWORK
Why the ADHD mind is always elsewhere
The Default Mode Network (DMN) is the brain's "resting state", the network that activates during daydreaming, mind-wandering, and self-referential thought. In neurotypical brains, the DMN deactivates when focused attention is required. In ADHD brains, research suggests this suppression is less efficient, meaning the mind-wandering network and the task-focused network compete with each other more. The result is the experience of a mind that keeps wandering, that keeps pulling away from what you are trying to focus on, not out of choice but out of neurological architecture.
EMOTIONAL REGULATION
Why feelings hit harder
The same neural circuits involved in attention regulation, particularly the prefrontal cortex and the amygdala, are also involved in emotional regulation. ADHD affects both. This is why emotional dysregulation is now considered a core feature of ADHD rather than a complication. The amygdala, the brain's threat detection system, is less effectively modulated by the prefrontal cortex in ADHD, meaning emotional responses arrive faster, feel more intense, and take longer to settle. Rejection Sensitive Dysphoria is the extreme end of this spectrum.
ADHD is not a willpower problem. It is not a motivation problem. It is a difference in how certain neural circuits in the brain regulate attention, impulse, and emotion. It is as neurological as dyslexia, and as real as gravity.
ADHD, anxiety, and depression, what's the difference?
ADHD, anxiety, and depression share a significant amount of overlapping territory, which is one of the main reasons adult ADHD goes undiagnosed for so long. Difficulty concentrating, sleep problems, low motivation, emotional dysregulation, withdrawal from things you used to enjoy, all of these can point to any of the three. Without someone looking carefully at the full picture, it is easy to treat the wrong thing.
The key clinical distinction is this: ADHD symptoms are persistent, pervasive, and traceable to childhood. They are present across contexts, at work, in relationships, at home, not just during periods of stress or low mood. Anxiety and depression tend to be more episodic, waxing and waning in response to life circumstances, even when they are severe or long-standing.
The more important clinical reality, however, is that most adults who come to therapy with ADHD are not choosing between these diagnoses. They are living with more than one simultaneously. Research suggests that around 50% of adults with ADHD also have an anxiety disorder, and roughly 30% experience depression.
These are not separate problems that happen to coexist, they are often deeply interconnected, each feeding the other. The shame-procrastination loop fuels low mood. The emotional intensity of ADHD produces chronic anxiety. The masking required to function in a neurotypical world is exhausting in ways that look, and feel, exactly like depression.
This is why an integrative approach matters. Treating anxiety or depression without understanding the ADHD underneath it rarely produces lasting change. The work needs to hold all of it at once.
Who Comes to ADHD Therapy?
Adults come to ADHD therapy from many different starting points. You don't need a formal diagnosis to begin, and you don't need to have everything figured out.
Here are some of the people I work with.
Recently diagnosed and trying to make sense of it
You have a diagnosis, finally, and you feel a mixture of relief, grief, and anger. You're looking back at your whole life through a new lens and you don't quite know what to do with what you're seeing. Therapy can hold all of it.
Suspected ADHD but not yet diagnosed
You've read enough, recognised enough, to think ADHD might be relevant to your experience, but you don't have a formal diagnosis. You don't need one to start therapy. We can work with what you're experiencing regardless of where you are in the diagnostic process.
Carrying years of shame
You were told you weren't trying hard enough. That you were bright but lazy. That you just needed to apply yourself. You internalised all of it. Therapy can start to unravel what you were told about yourself and what was actually just ADHD.
Successful on the outside, exhausted on the inside
You've achieved things. You've kept it together. But the effort of doing so, the masking, the compensating, the constant performance of neurotypicality, has worn you down. You are in or approaching burnout, and you can't keep going the way you have been.
Struggling in relationships or at work
The ADHD affects how you show up for people you care about, forgotten commitments, emotional intensity, impulsive words. Or work has become untenable. Therapy can address both the ADHD patterns and the relational or professional fallout from them.
In recovery or managing co-occurring conditions
ADHD frequently co-occurs with anxiety, depression, eating disorders, and addiction. Many people self-medicated for years without knowing why. Therapy that understands ADHD as a root system can change what treatment looks like for co-occurring conditions.
How Therapy for ADHD Works
Therapy for ADHD is not coaching. It goes further than strategies and productivity systems, though those have their place. Therapy addresses the emotional, relational, and identity dimensions of ADHD that no app or planner will ever touch.
Processing the past
Years of being told the wrong story about yourself leave marks. Low self-esteem, perfectionism as armour, chronic self-criticism, shame about ordinary ADHD experiences, therapy creates the space to examine those narratives and begin to loosen their hold.
Emotion regulation skills
DBT is particularly well-suited to ADHD because it offers a concrete set of skills for managing the emotional intensity that often accompanies it, distress tolerance, emotion regulation, interpersonal effectiveness. These are practised, not just talked about.
Relational repair and patterns
ADHD affects relationships in specific, often painful ways. Therapy explores how ADHD shows up in your closest relationships, what patterns have developed as a result, and how to communicate about your neurology in ways that don't leave you feeling permanently at fault.
Understanding your neurology
Psychoeducation, understanding what ADHD actually is and why you experience what you do, is often itself therapeutic. When you understand the shame-procrastination loop neurologically, it changes your relationship to it. Knowledge creates distance from self-blame.
Working with the shame cycle
Addressing procrastination and avoidance without touching the shame underneath them doesn't work. Therapy goes to the root, exploring where the shame came from, what it's protecting, and how to interrupt the cycle at its source rather than managing its symptoms.
Building a life that fits
Practical strategies, structures, environments, routines, that align with how you actually work, not with how a neurotypical productivity system expects you to work. The goal is congruence: a life that works with your neurology, not against it.
Some of the approaches I draw on
Dialectical Behaviour Therapy (DBT)
CBT adapted for ADHD
Internal Family Systems (IFS)
Psychoeducation
Psychodynamic therapy
Somatic awareness
Attachment-based therapy
Strengths-based approaches
Therapist for ADHD in London, Matthew Frener
Matthew Frener
Integrative Psychotherapist & DBT Therapist · he/him · MBACP (Accred) · MNCPS (Accred)
I work with adults who are tired of explaining themselves to other people, to previous therapists, and to themselves. People who are self-aware, who can often name their patterns, trace them back, and yet find the same dynamics returning.
At the heart of how I work is the therapeutic relationship: a connection built on trust, understanding, and mutual respect. I believe the self is formed in relationship, and that relationship is also where change becomes possible. Not through technique alone, but through what happens between us in the room.
My approach is integrative, drawing on relational and attachment-based theory, psychodynamic thinking, DBT, CBT, IFS, and somatic approaches, shaped by clinical experience across residential treatment, outpatient services, and private practice. I don't apply a single model to every person. I work with what you bring, at your pace, attending to the whole of your experience: cognitive, emotional, somatic, relational.
I do not consider myself a therapist who is a neutral blank screen. I bring warmth, directness, and a willingness to say difficult things carefully, and a genuine belief that the people who end up in my consulting room are not broken. They have simply never had the right kind of support. Therapy works best when you don't have to perform wellness to receive it.
MBACP (Accred) · MNCPS (Accred) · Addictions Professional AP
Fees for ADHD Therapy
Sessional Fees
I offer individual therapy on a sliding scale of £90 to £120 per 50-minute session. Longer sessions are charged on a pro rata basis.
We can agree a fee at the outset of therapy based on your circumstances, or those of the person funding your sessions. This scale is intended to make therapy more accessible, with higher-fee sessions helping to support the availability of lower-fee and concessionary spaces.
Invoices are issued monthly in advance, usually on or around the 15th of each month, and are payable by bank transfer before the 1st of the upcoming month. Payment secures your regular weekly session time.
Concessions & Insurance
I keep a limited number of concessionary spaces for NHS workers and those on a low income. If this may apply to you, you are welcome to mention it in your enquiry form, and I will let you know whether I currently have any reduced-fee availability.
I currently accept AXA, Aviva, WPA, Cigna, and Vitality insurance. If you are with another provider, I can provide an invoice or receipt for possible reimbursement.
As policies vary, I recommend checking directly with your insurer in advance. If there is any difference between what your provider covers and my fee, you will be responsible for paying the shortfall.
In person & online ADHD Therapy
In person - Fitzrovia, Central London
My practice is based at 12–12a Margaret Street in Fitzrovia, a short walk from Oxford Circus.
In-person sessions offer a dedicated, private, and grounded space that many clients find valuable.
Well served by multiple tube lines. See location details below.
Online - via secure video
Online therapy takes place via a secure, encrypted video platform and is available to clients throughout the UK and internationally. Many clients choose online therapy for greater accessibility and preference.
You will need a private space and a stable internet connection.
LOCATION
Fitzrovia, Central London
12-12a Margaret Street, London, W1W 8JQ
Conveniently located in the heart of Central London, Matthew Frener Therapy is easily accessible with multiple transport routes nearby. On-street parking is available.
Closest Tube Stations:
Oxford Circus
4 min walk
Bakerloo · Central · Victoria
Great Portland Street
11 min walk
Circle · Hammersmith & City · Metropolitan
Goodge Street
7 min walk
Northern
Bond Street
11 min walk
Central · Elizabeth Line · Jubilee
Tottenham Court Road
9 min walk
Central · Elizabeth Line · Northern
Piccadilly Circus
12 min walk
Bakerloo · Piccadilly
GETTING STARTED
What to expect
Note: I provide therapy for ADHD, not diagnostic assessments. If you're seeking a formal diagnosis, I can point you towards appropriate services. Therapy can begin, and be highly beneficial, before or without a formal diagnosis.
01
Complete the enquiry form
If you are interested in starting therapy, the first step is to complete my enquiry form. It is a more detailed form, designed to give me a fuller sense of what is bringing you to therapy, what support you are looking for, and whether I may be the right fit for your needs. This helps me respond thoughtfully and prioritise genuine enquiries. You will have the option to book a free introductory call (Step 02), or we can move straight to registration and agreement (Step 03)
I aim to respond within 48 hours. If you have not heard back from me within that time, please check your junk or spam folder in case my reply has landed there.
02
Introductory call
If you choose to book a free introductory call, we will arrange a time for a 15-30-minute call, either by phone or via Zoom, depending on your preference. This gives us a chance to discuss your enquiry form in more detail, talk about what is bringing you to therapy, and consider what you are hoping for from the work. I will also explain how I work and answer any questions you may have.
This call is not a therapy session, but a space for us to begin getting a sense of whether working together feels like the right fit. There is no fee for this call and no obligation to continue.
03
Registration, agreement and confirming your weekly slot
If we decide to work with one another, I will send you a New Client Registration Form and my Therapeutic Agreement to complete through my practice management software. These documents set out the practical and professional framework for our work together, including confidentiality, cancellations, and the terms of therapy.
I will ask you to select a sessional fee on my sliding scale that best reflects your, or the bill payer's, household income. Then, once the registration form and therapeutic agreement have been completed, I will issue the invoice for your first set of sessions, and your regular weekly slot is confirmed once payment has been received.
04
Initial assessment sessions
The first few sessions are a space for us to begin building a fuller understanding of what is bringing you to therapy. We may explore your current difficulties, the broader context of your life, earlier experiences that may still be shaping you, and what you are hoping for from therapy, whether clearly formed or not yet fully known. This can help us co-create a path forward.
I see assessment as more than a process of gathering background information. It is also the beginning of the therapeutic relationship. As we talk, I will be listening not only to the content of what you bring, but also to how you experience yourself, how you relate, what feels difficult to say, and what may already be unfolding between us. Often, these early sessions begin to reveal something important about the patterns and relational ways of being that therapy can help make sense of over time.
It is also completely normal to feel apprehensive, uncertain, or nervous during the first few sessions. After all, you may be sharing deeply personal parts of your life with someone you do not yet know well. Even having read my website or spoken with me in an introductory call, I am still, at this stage, a stranger. Part of the early work is allowing enough time and space for trust to begin to develop at a pace that feels manageable for you.
Just as importantly, these sessions allow you to get a sense of me, and of whether this feels like a space in which you can begin to do meaningful work. The assessment is not separate from therapy, but the beginning of it.
05
Ongoing weekly sessions
We meet at the same time each week for 50 minutes, creating a regular and dependable space for the work to unfold. Weekly sessions provide the consistency therapy needs for trust to grow and for the work to deepen over time. I do not usually offer sessions less frequently than this, as longer gaps can affect the continuity and containment of the process. Where appropriate, and where availability allows, twice-weekly sessions may be offered during more challenging periods when additional support is needed.
My approach is non-directive, which means I do not follow a fixed agenda or work through a set programme. Instead, we attend to what feels most important, difficult, or alive for you. At times this may be something immediate in your present life. At others, it may be a recurring pattern, a relationship, a feeling, or something harder to name that begins to emerge between sessions or within the therapy itself.
Non-directive does not mean distant or passive. I will be actively engaged in thinking with you, helping us make sense of what you bring, what may remain outside awareness, and how past and present can become linked in meaningful ways. You do not need to arrive with things neatly worked out. Therapy can hold confusion, ambivalence, uncertainty, and change.
06
Review and endings
We will regularly check in on how the work is feeling for you. These reviews are usually informal rather than structured, and may sound like: How has this been for you? What has felt useful? What has not? I want to understand how you are experiencing me, the therapy, and the process we are in together. Your sense of what is helping, what is not, and what you may need more or less of matters. Therapy is collaborative, and I cannot meaningfully adjust how I am working if I do not know how it is landing for you, so I encourage this kind of honesty throughout our work. Using your voice in this way can be an important part of the therapy itself.
I work in an open-ended way, which means there is no fixed number of sessions. Therapy continues for as long as it feels meaningful, needed, and useful. This allows the work to unfold at depth and at a pace that respects the complexity of your experience, rather than forcing it into an arbitrary timeframe.
At the same time, I always encourage clients to plan their ending where possible, rather than bringing therapy to a sudden stop. A great deal often becomes visible in how someone approaches endings, including how they relate to separation, completion, loss, and change. Because of this, endings are part of the therapeutic process in their own right.
Planning an ending gives us space to reflect on what has been helpful, what has felt less helpful, what you are taking with you, and what may still need thought or support. Where needed, we can also consider what structures or resources may help you feel supported once therapy comes to an end.
FURTHER READING
From the journal
