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Executive Functioning

Many psychiatric disorders cause impairments in the cognitive skills known as executive functions, an umbrella term for the regulation of such cognitive processes as working memory, reasoning, mental flexibility, planning, execution, and problem solving. ADHD, Bipolar Disorder, Depression, and psychotic disorders are all associated with deficits in executive functions.


Common problems associated with Executive Dysfunction:

  • Poor self-management with regards to time, planning and goals

  • Poor organization, problem solving, working memory

  • Impaired discipline and impulsiveness

  • Impaired motivation

  • Low activation, concentration, and alertness

  • Poor self-efficacy, poor self-esteem

The Lieber Clinic offers an array of services for adults with Executive Dysfunction which include:


Cognitive Behavioral Therapy (CBT) for Executive Functioning:  

Executive functioning groups serve people who have executive functioning problems secondary to ADHD and/or other psychiatric diagnoses. The group includes psycho-education about executive functioning problems, practical skills training, motivational enhancement skills and CBT to improve resiliency. Individuals identify goals which they would like to pursue during the course of the group and chart their progress while learning what skills help them build independence, self-reliance and confidence. Most participants attend this group once a week for 16-20 weeks. There is a fast track group which meets twice weekly, so participants complete the curriculum in 8 weeks.

Cognitive Training Groups:

This group-based treatment  uses specially-designed computer exercises to improve the cognitive deficits associated with psychiatric diagnoses. Participants in this manualized treatment should expect to attend a two-hour session twice a week for a minimum of 13 weeks. A brief neuropsychological assessment is typically done before and at the end of treatment for treatment planning and to track improvements.

Individual Coaching for ADHD and executive dysfunction:


This approach is typically an adjunctive treatment to one of the group-based treatments, and is used to help in the  generalization of skills learned in cognitive remediation and CBT groups to everyday situations. Working one-on-one with a coach in the community can also provide additional structure and support through goal attainment and maintenance.

Family Services

  • A multi-family group provides education about executive dysfunction and the resources and support available to families.

  • Family coaching is an individual service providing strategies for supporting a family member with executive dysfunction.

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