Therapy for ADHD and ADD that works with your brain
ADHD is not a lack of effort or willpower. Therapy for ADHD and ADD in New York can help you understand how your mind works, ease the shame that often comes with it and build a life that fits you.
ADHD and ADD shape far more than attention. They influence how you think, feel, organise, rest and relate to others. I offer integrative, collaborative care for adults that brings together psychiatric assessment, medication where appropriate, psychotherapy, somatic tools and practical lifestyle changes, so you are supported as a whole person rather than reduced to a list of missed deadlines.
“ADHD is not a broken brain that needs fixing. It is a different operating system that has been running on software designed for someone else.”
When you stop forcing yourself into systems built for other minds, your strengths have far more room to show.
What ADHD and ADD really look like
Attention deficit hyperactivity disorder is a neurodevelopmental difference affecting attention, activation, organisation and emotional regulation. ADD is the older name still widely used for its predominantly inattentive presentation.
The popular image of ADHD is a restless child who cannot sit still. For many adults the reality looks very different. It may be a mind that drifts during conversations, a desk covered in half-finished projects, chronic lateness despite real effort, or an ability to hyperfocus for hours on something interesting while basic admin sits untouched for weeks. Hyperactivity in adults is often internal: a restless mind, fidgeting, talking quickly or an uncomfortable inner pressure to keep moving.
ADHD is fundamentally about how the brain regulates attention and motivation rather than a shortage of attention. Tasks that are novel, urgent or genuinely interesting can be easy, while tasks that are boring or open-ended feel almost physically impossible to start. This inconsistency is often misread as laziness, by others and by people with ADHD themselves, and years of that misreading can leave deep marks on self-esteem.
Emotional intensity is another under-recognised part of ADHD. Many people feel frustration, excitement, overwhelm and hurt quickly and strongly, and find rejection or criticism particularly painful. Understanding emotional dysregulation as part of ADHD, rather than as a personal failing, is often one of the most relieving discoveries people make in therapy.
Late diagnosis and masking
Many adults, particularly women, non-binary people and those who did well academically, are not identified as having ADHD until their twenties, thirties or later. Often they compensated through intelligence, anxiety-driven over-preparation or exhausting effort, masking their difficulties until life's demands outgrew their coping strategies. A diagnosis later in life can bring relief alongside grief for the years spent struggling without understanding, and both deserve space in therapy.
ADHD alongside other experiences
ADHD frequently overlaps with anxiety, depression, sleep problems, burnout and trauma, and these can mimic or mask one another. Racing thoughts, poor concentration and restlessness can each have more than one explanation. A thorough psychiatric assessment helps clarify what is going on, so that treatment targets the right things and you are not left wondering why a well-intended plan is not helping.
Does this sound like your everyday?
ADHD shows up differently in every person, and everyone experiences some of these occasionally. What matters is whether they have been present for much of your life and consistently make work, relationships or self-care harder than they need to be. If so, an assessment may help you make sense of it.
- Starting many things, finishing few
- Losing keys, phone or track of time
- Struggling to begin boring tasks
- Hyperfocus on things that interest you
- Drifting off mid-conversation
- Restlessness or constant fidgeting
- Intense frustration and quick overwhelm
- Strong sensitivity to criticism
- Chronic lateness despite trying
- Feeling you underperform your potential
Integrative support for ADHD and ADD
There is no one-size-fits-all treatment for ADHD. I bring psychiatric, psychological, somatic and lifestyle approaches together in one relationship, so medication, therapy and practical strategies support each other rather than being managed in isolation.
Thorough assessment
We explore your history from childhood onwards, current challenges, strengths, sleep, mood, anxiety and health. This helps clarify whether ADHD explains your experience, whether anything else is involved and what support is likely to make the biggest difference.
Medication management
For many adults, ADHD medication makes a meaningful difference to focus and follow-through. I can discuss stimulant and non-stimulant options, prescribe, and monitor effects closely. We start low, adjust gradually and review regularly, always deciding together.
Therapy for shame and self-worth
Years of being called careless or lazy leave their mark. Therapy offers space to process those experiences, separate who you are from your symptoms and build a kinder, more accurate understanding of yourself, which often makes practical change easier too.
Practical, brain-friendly systems
Using CBT-informed and coaching-style tools, we design routines that work with your ADHD rather than against it: external reminders, body doubling, breaking tasks down and making boring things more engaging. Systems are tailored to you, not borrowed from productivity culture.
Somatic and emotional regulation
Somatic practices and DBT-informed skills help you notice emotional surges early and steady yourself before overwhelm or frustration takes over. Working with the body can also ease the restlessness and tension many people with ADHD carry.
Lifestyle and supplements
Sleep, movement, nutrition and routine have a significant effect on ADHD symptoms. We look at these together, and I may discuss supplements that may support focus or sleep, carefully reviewed for safety and interactions with any medication and never a replacement for medical care.
From self-blame to self-understanding
How you interpret your ADHD shapes how you feel about yourself. Therapy helps shift the narrative.
The old story
- I am lazy and should just try harder
- Everyone else finds this easy
- My emotions are too much
- I need to copy other people's systems
- I have wasted my potential
A more accurate story
- My brain regulates interest and effort differently
- I need different tools, not more willpower
- Emotional intensity is part of ADHD
- I can build systems that fit my mind
- My strengths deserve space to grow
Getting started with ADHD care
A clear, ADHD-friendly process with no unnecessary hoops to jump through.
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1
Free consultation 15 minutes
A short call to talk about what brings you here, whether you are newly wondering about ADHD, already diagnosed or reconsidering current treatment. You can ask questions and decide whether working together feels right.
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2
Psychiatric assessment 90 minutes
We explore your history, current difficulties and strengths in depth, along with mood, anxiety, sleep and health. If useful, I may ask about school experiences or invite information from someone who knew you as a child, with your permission.
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3
A plan that fits you
We agree a personalised plan, which may include medication, psychotherapy, practical strategies, somatic work and lifestyle changes. I explain the options clearly, including potential benefits and side effects, so you can choose with confidence.
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4
Ongoing support 60 or 90 minutes
Regular sessions let us monitor medication, refine strategies and continue deeper work on self-esteem, emotions and relationships. We review progress together and adjust as your life and needs change.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Therapy for ADHD & ADD FAQs
What is the difference between ADHD and ADD?
ADD is an older term that is still widely used, usually to describe ADHD without obvious hyperactivity. Today clinicians generally describe ADHD as having different presentations: predominantly inattentive, predominantly hyperactive-impulsive, or combined. Many adults who identify with the term ADD have the inattentive presentation, which often involves distractibility, forgetfulness and difficulty sustaining focus rather than outward restlessness.
Can you diagnose ADHD in adults?
Yes. As a board-certified psychiatric nurse practitioner I can carry out a comprehensive psychiatric assessment for adult ADHD and, where appropriate, make a diagnosis. The assessment looks at your history across your life, your current difficulties and other possible explanations, such as anxiety, depression, trauma or sleep problems, so that any diagnosis is careful and well considered.
What does therapy for ADHD and ADD in New York involve with you?
It typically combines several elements: understanding your particular ADHD profile, processing the shame and frustration that years of struggle can bring, building practical systems that suit your brain and learning emotional regulation skills. Where appropriate we also manage medication. Because sessions are 60 or 90 minutes, there is time to address both everyday challenges and deeper patterns.
Do I have to take medication for ADHD?
No. Medication can be very helpful for many people, but it is a choice, not a requirement. Some prefer to start with therapy, strategies and lifestyle changes, while others find that medication makes everything else more achievable. I will explain the options, potential benefits and side effects honestly, and we will decide together. Any medication is started carefully and adjusted gradually with regular monitoring.
Can supplements help with ADHD?
Some supplements may support aspects of focus, mood or sleep, and I can discuss whether any are appropriate for you. They are always reviewed for safety and possible interactions with other medications, and they are not a replacement for medical care or evidence-informed treatment. For some people they form a useful part of a broader, integrated plan.
I was diagnosed as a child. Can you help me now as an adult?
Absolutely. ADHD often changes in how it presents as life changes, and strategies or medication that worked at school may not fit adult responsibilities, relationships or work. We can review your current treatment, explore what has shifted and build an approach that suits who you are now, including any feelings about how ADHD was handled when you were younger.
Understand your mind, then work with it
Book a free 15-minute consultation to talk about ADHD or ADD and the kind of support that might help you.