ADHD & Academic/Career Performance Therapy
Casen Psychology | Dr. Sara Casen, PhD.
When you're smart enough to see exactly what's not working, and can't seem to fix it anyway
You know what you should be doing. You've read the productivity advice, tried the systems, downloaded the apps.
You still find yourself at midnight staring at work you've been avoiding for three days, wondering why it's so much harder for you than it looks for everyone else.
ADHD in high-achieving young adults rarely looks like what people expect. It looks like brilliance in one area and inexplicable paralysis in another. It looks like the gap between what you're capable of and what you're actually producing, and the shame that lives in that gap.
What you might be carrying
Starting feels impossible even when the stakes are high. You know the deadline, you care about the outcome, and something still won't let you begin.
Once you start, interruptions derail you completely. Getting back on track takes longer than the interruption itself.
Graduate school or a demanding career amplifies everything. The structure that kept things manageable before is gone. The expectation now is that you manage yourself. For a lot of people with ADHD, that's when things start to come apart.
The emotional piece is real and often undertalked: rejection sensitivity, frustration that spikes fast and fades fast, the exhaustion of performing focus and organization all day and crashing when you get home.
Relationships get caught in the crossfire. Missed details, forgotten commitments, the sense that you're not fully present even when you want to be.
What starts to shift
When ADHD is understood as a neurological difference with specific, workable patterns rather than a character flaw or motivation problem, the self-blame starts to loosen. That shift alone changes what's possible.
Practically, you build systems that fit how your brain actually works:
Some people need external accountability structures
Others need to redesign their environment
Others need to understand their own energy rhythms before anything else can change
We figure out what actually applies to you.
Over time the gap between capability and output narrows. Not because you work harder, but because you stop spending half your energy managing shame and avoidance and start spending it on the work itself.
How I work with you
My training in CBT gives us a direct line to the thought patterns that drive avoidance, perfectionism, and the freeze response. The "I'll start when I feel ready" loop that ADHD makes especially sticky. We work on those patterns with concrete tools, not insight alone.
Psychodynamic work helps when ADHD has gone unrecognized for years and a whole story has built up around being lazy, scattered, or not living up to potential. Untangling that narrative is often as important as the practical skill-building.
Psychoeducation is also a significant part of this work. Understanding how ADHD actually functions, what's happening neurologically, and why standard advice keeps failing you makes the tools make sense.
What to expect
The first session is a highlight reel: your academic history, your work patterns, the moments where things have broken down and the moments where you've thrived. That picture tells me a lot about where to focus.
We set goals together for three, six, and nine months and revisit them regularly.
Sessions are weekly
Homework is a consistent part of the work, specific experiments and strategies to try between sessions
Psychological testing and formal ADHD assessments aren't part of this practice. If a formal diagnosis is what you're looking for, I can point you toward someone who does that work.
Who this is a good fit for
This work is well suited for adults in their 20s and early 30s, particularly those in:
Graduate programs
Early-stage careers
Demanding professional environments in tech, law, academia, or entertainment
You might have a formal ADHD diagnosis or you might be someone who has always suspected it but never been assessed. Either way, if the patterns described here resonate, that's worth exploring.
If you've tried coaching or productivity systems and they haven't stuck, therapy that addresses the emotional and psychological layer tends to go further.
Fees
My rate is $300 per session. A sliding scale is available for those with financial need.
Questions people ask before booking
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No. A formal diagnosis isn't required to start therapy. If the patterns resonate and they're affecting your functioning, we can work on them. If you want a formal diagnosis, I can refer you to someone who does psychological testing.
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Therapy. We're not just building productivity systems. We're working on the thought patterns, emotional responses, and deeper narratives driving the dysfunction. Coaching addresses the surface. This goes further.
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Yes, if there's a consistent gap between what you're capable of and what you're producing, or if managing that gap is costing you significant energy, stress, or self-esteem. High functioning doesn't mean things are working well.
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Information helps, but it's rarely the missing piece. Most people with ADHD already know what they should do. The work here is figuring out why you're not doing it and building the conditions that make it actually possible.
You don't have to keep managing this alone
If any of this sounds familiar, a free consultation call is the easiest next step. Schedule here.