Skills, Not Willpower: How CBT Helps Teens and Adults With ADHD

ADHD-focused CBT teaches practical systems for planning, starting, and restarting tasks. Evidence is promising for some adults, but rater differences, teen null findings, and limited long-term data matter.

This is Part 3 of a five-part series on nonmedication strategies for ADHD. The other parts cover behavioral parent training, classroom and organization systems, a practical sleep plan, and exercise.

You may know what needs to happen. Still, the task gets lost or the start gets missed. ADHD-focused cognitive behavioral therapy, or CBT, can build repeatable tools for planning, starting, and restarting. Its clearest promise is practical. It may help planning, follow-through, and hard thoughts. Some adult trials found fewer core symptoms. One key limit is that results change by rater and control group. Teen findings are mixed. CBT does not remove ADHD. A planner alone is not treatment. CBT is one care option. Care may also include medicine, school or work supports, and help for sleep, mood, anxiety, substance use, or learning needs.

Key takeaways

• ADHD-focused CBT is structured skills work. It is more than supportive talk or positive thinking.
• Adult evidence is promising but mixed across raters and controls.
• Teen evidence is less sure. Most studies added CBT to medicine or prior care.
• Progress should be measured in daily life, not only with a symptom score.
• A simple system used imperfectly is more useful than a complex system that cannot restart.

Zoom

What ADHD-focused CBT is

CBT for ADHD looks at the setting, actions, thoughts, and feelings that keep a problem going. A therapist teaches set skills. These may include one calendar and task list. They may also include weekly plans, priorities, small work steps, time estimates, distraction delay, problem solving, and work on shame or all-or-nothing thoughts.

The goal is not to argue someone out of ADHD. A thought such as “I failed again, so planning is pointless” did not cause the disorder. It can still make the next attempt harder. CBT helps a person test a more accurate reply. The person then takes a small step while the plan is in view.

A tested course is more than a worksheet. Two key adult trials used 12 set sessions. Care also had trained therapists, practice, progress checks, and a restart plan.34 Session length, group format, parent or partner roles, and online support varied. An app, coach, workbook, mindfulness class, or generic therapy is not the same by default. Nor is CBT aimed mainly at anxiety.

What the research actually found

Adults

The most useful trials do not all tell the same story.

One trial had 86 adults. All took stable medicine and still had symptoms. The study compared 12 one-to-one CBT sessions with an attention-matched program of relaxation, education, and support. At post-treatment, an independent assessor reported as blind to the group, called a probably blinded rater, found 4.63 points more improvement on the ADHD scale after CBT. The 95% confidence interval, or CI, was 0.96 to 8.30 points in the helpful direction. The standardized effect was 0.60. Response was 67% with CBT and 33% with the control. The sample was small and left out several severe conditions.3

Another trial had 88 adults. It compared group metacognitive therapy with group support therapy. A blinded independent rater found 2.7 points more gain in inattention at post-treatment. The 95% CI was 0.9 to 4.6. Depression, anxiety, and self-esteem did not differ. Fifty-six percent took medicine. The trial did not detect a result difference by medication status, but it was too small to prove equal effects with and without medicine.4

A 2018 Cochrane review shows why the control group matters. Self-rated symptoms favored CBT over waitlist. The standard mean difference was -0.84, with a 95% CI of -1.18 to -0.50. The gap from support therapy was small and not clear. It was -0.16, with a 95% CI of -0.52 to 0.19.2 Waitlist does not match attention, hope, set visits, practice, or group support.

The 2025 Ostinelli network review found a clinician-rated CBT gain over placebo at about 12 weeks. The standard mean difference was -0.76. The 95% CI was -1.26 to -0.26. The review found no clear self-rated gain.1 “Clinician-rated” does not always mean the clinician was blind to care. The rating may also use reports from people who knew the group. The conflict is useful data. It is not a reason to discard either view.

An online trial adds another warning. Online CBT and online rest skills both beat usual care on self-rated symptoms. CBT did not beat the rest-skills group.11 A set plan, attention, hope, and self-checks may have helped both groups.

Daily function may improve. Yet trust in the pooled number is low. A 2026 review found small-to-moderate gains in broad, work, and social function. It mixed random trials with single-group and weaker designs. It used much self report. Follow-up was often only about three months.9 A separate study checked quality of life 4 to 8 years later. Only 159 of 627 eligible adults took part. Added CBT did not beat medicine plus ADHD education.10 That loss to follow-up is serious. It still rules out a firm long-term promise.

Adolescents

Teen data are thinner and more mixed.

One small study had 46 teens age 14 to 18. All took stable medicine and still had symptoms. The study compared 12 one-to-one CBT sessions with waitlist. Two sessions included a parent. Parent-based and teen-based ratings favored CBT. No serious event tied to the study was reported.6 The rater was called blind. Yet the score used reports from parents and teens who knew the group. There was no teacher report or direct test of daily function.

Another trial had 100 teens age 14 to 18. Ninety-one percent took medicine. All had prior ADHD education. About one third had high symptoms but not a full ADHD diagnosis. Group CBT did not beat no added CBT. This was true for parent, teen, and teacher reports. It was also true for blind global, daily, thinking-skill, and mood measures.7 The groups still did not differ at one year. Some teens said they had learned useful ideas.8

A broad 2025 review looked at thinking and behavior treatments for teens. Symptom effects were mixed. Results for daily limits and planning skills looked more hopeful.5 The review joined several kinds of care. It cannot prove that one CBT guide will improve one teen’s grades, ties, or daily life.

The honest bottom line

For some adults, structured CBT can help symptoms and daily skills. The gain is clearest versus no care. Two small adult trials with attention-matched active controls also found evaluator-rated gains. Trust is held back by small samples, rater conflict, short follow-up, and mixed medicine use. For teens, results are mixed and care was mainly added to other treatment. CBT used alone, without medicine, remains unsure in both age groups. The gap is greatest for teens.

For a fast drop in core ADHD symptoms, nonmedicine care has less steady support than approved medicine. Its clearest gains often involve planning, routines, coping skills, and daily life. This is a reading across separate trials. It is not a claim that CBT and medicine had a fair test in the same study.

What this can and cannot do

Statistical improvement is not the same as a meaningful life change. A four-point scale difference may matter to one person and not another. Ask whether mornings, deadlines, attendance, conflict, money tasks, or schoolwork changed.

Who may benefit most

CBT may be a good fit for an adult or older teen who understands the task but has trouble turning intention into action. It may be especially relevant when organization, procrastination, distractibility, time estimation, or repeated discouragement are major targets. A person needs enough support to attend, practice, and simplify the system when overloaded.

The evidence most directly applies to adults in specialty or research settings and to adolescents roughly age 12 to 18. Many participants were taking medication. Several samples were White, educated, self-referred, or able to attend regular sessions. Trials often excluded severe depression, bipolar disorder, active substance use, suicidality, severe aggression, or complex medical and psychiatric conditions.

That does not mean people with those needs cannot receive CBT. It means the protocol may need adaptation and the evidence transfers less well. Autism, learning disorders, trauma, intellectual disability, sensory needs, language differences, sleep problems, unstable housing, caregiver ADHD, and limited privacy can change the pace, materials, caregiver role, and safety plan.

There is not enough direct evidence to assume that adult protocols work for children, that college programs transfer to every workplace, or that older adults respond the same way.12 A teen should have a real role in choosing targets. Caregiver support should help with access and practice, not become surveillance.

Essential ingredients

Your first seven days

This is a primer, not a complete CBT dose. Start with one observable functional problem, such as “I begin the online bill payment by 7 p.m. Tuesday,” not “fix my ADHD.”

Materials: one capture tool, one calendar, a timer if helpful, and a one-line tracker. Time: 5 to 15 minutes most days and 20 minutes for review. People: the teen or adult owns the plan; a parent, partner, teacher, or clinician joins only by agreement.

Day 1: Name and count. Write one target. Count what happened over the last three comparable chances. Independent start: yes. Professional help: useful if the target involves safety, severe conflict, school refusal, major debt, or job risk.

Day 2: Choose one capture place. Move only new tasks there. Do not spend hours migrating an old system. Minimum version: capture one task.

Day 3: Make one next action. Change “finish application” to “open the application and write the contact line.” Put that action on the calendar. Minimum version: open the document.

Day 4: Estimate and observe. Guess the minutes needed. Time one attempt without judging it. Write estimate and actual time.

Day 5: Add one distraction barrier. Put the phone across the room, close one tab, use headphones, or choose a quieter location. Keep access to emergency contacts, needed communication, and accessibility tools.

Day 6: Plan one support. Ask for one specific action, such as a five-minute start check. A teen and caregiver should agree on what will be shared and when the check ends.

Day 7: Review. Compare the baseline with the week. Decide: continue, simplify, adapt, or get more help. If days were missed, restart with one capture and one next action. No backfilling is required.

Words you can use

To find the next action: “What is the smallest action I can see myself doing in the next five minutes?”

When the thought is “I failed again”: “The system did not hold this week. That is real. It also gives us data. Which part was too hard to see, start, or repeat?”

To ask for support: “Please sit with me for five minutes while I open the form. I am not asking you to finish it or remind me all week.”

A teen negotiating a check-in: “I will show you the planner at 7 p.m. on Monday and Thursday. Please ask once, not throughout the evening. We can review after two weeks.”

A caregiver responding: “I can do that. If the check feels like pressure, tell me. We will change the plan, not add more monitoring.”

Questions for a therapist: “I am looking for structured ADHD care. Which protocol do you use? Which skills will we practice? How will we measure daily function? What happens when homework is missed? How do you adapt care for my age, culture, disability, anxiety, depression, or medication plan?”

A worked hypothetical example

Problem: Jordan, a hypothetical college student, submits assignments late.

Too broad: “Stop procrastinating.”

Observable target: “By 6 p.m. on Sunday, open the course page and put each due date into one calendar.”

Smallest next action: Sign in to the course page.

Estimated time: 10 minutes. Actual time: 18 minutes.

Barrier: The login code was on another device and the calendar had three duplicate accounts.

Adjustment: Save the approved login method and choose one calendar. Ask disability services or the instructor about an accessible assignment list if needed.

Progress measure: Number of assignments captured before the due date, plus number submitted on time. A symptom score alone would miss both.

Troubleshooting

How to measure real-life progress

Choose one to three measures that can be counted without constant surveillance:

• tasks captured before they are forgotten;
• planned tasks started within an agreed time window;
• appointments attended;
• assignments submitted or work steps completed;
• bills opened and paid by the planned date;
• minutes of family conflict around reminders;
• number of agreed check-ins completed;
• a weekly 0-to-10 rating of strain or quality of life.

Take a short baseline before changing the system. Review weekly, not every hour. When possible, combine the person’s rating with one concrete outcome and, with permission, one other setting. A parent, partner, teacher, or therapist who knows the plan may notice important daily changes, but expectation can influence ratings. An independent evaluator may reduce that bias, yet may miss effort, shame, or household function. Disagreement should lead to a closer look, not a winner.

Access at three levels

Start today

Use one piece of paper or one free device tool. Write one task, one next action, and one time. This is a low-risk adaptation, not a full treatment.

Build a low-cost plan

Ask a library, community clinic, college counseling center, school mental-health team, training clinic, or insurer about structured ADHD skills groups. Telehealth may reduce travel but can add privacy, bandwidth, and screen barriers. A rural reader may need phone-compatible care. A shift worker can plan after waking, not on a set weekday. Across single-parent, kinship, foster, multigenerational, or shared-custody homes, name one support role. A crowded home may need headphones or a library. Request interpretation, plain-language materials, large print, audio, captioning, or accessible digital documents when needed.

For a teen, school staff may help with assignment capture or planning, but a school strategy, accommodation, and clinical CBT are not the same thing. Share only what is needed. Services and eligibility depend on individual facts and current rules.

Use a formal program

Look for a licensed mental-health clinician trained in adolescent or adult ADHD and a structured CBT protocol. A common research course is about 8 to 16 sessions, often 12, but there is no single dose for every person. Ask about fees, group versus individual care, telehealth, missed-session policy, between-session practice, progress measures, medication coordination, and treatment of comorbid conditions.

For adolescents, ask how caregivers are involved, how assent and confidentiality work, and how school contact is handled with consent. For adults, ask how work, college, household, finances, and relationships enter the plan. Partner support should remain voluntary and specific. A partner is not the therapist, parent, or compliance officer.

If a branded or digital program is offered, ask which exact product was tested, with what ages, control group, medication context, and outcomes. Some newer app studies show self-rated benefit, but waitlist or usual-care controls and product conflicts limit transfer.13 Naming a program is not an endorsement.

A one-page coordination plan

1. Functional goal: Choose one to three, such as “capture assignments,” “start the bill task,” or “reduce reminder conflict.”
2. Baseline: Record the last three comparable opportunities.
3. Exact strategy: Name the capture place, next-action rule, cue, and support.
4. Person responsible: The teen or adult owns the plan. Name one limited support role if agreed.
5. Frequency and setting: State when and where the skill will happen.
6. Review date: Pick a date, usually one or two weeks for the starter plan and as agreed for formal care.
7. Safety or escalation: List signs that call for routine troubleshooting, prompt evaluation, or emergency help.

Share only information needed to carry out the plan. Use age-appropriate assent and required consent. Do not promise that a school, employer, clinician, or insurer must provide a particular service.

Medication and other care

ADHD care may include behavioral supports, therapy, school or workplace accommodations, medication, or a combination. The choice depends on age, target problem, impairment, preferences, contraindications, access, and response.14

No formal U.S. adult ADHD guideline had been issued by this review date.1516

Most positive teen CBT evidence was added to medication or prior psychoeducation. A pivotal adult trial included only people on stable medication, while another included medicated and unmedicated adults. This is not enough to claim that CBT replaces medication or that it must always be adjunctive.

Do not start, stop, lower, delay, or replace prescribed treatment based on this article. Bring the functional target and tracking data to the prescriber or therapist. Direct medication comparisons are different from comparing effects across separate trials with different people, outcomes, raters, and controls.

When to get more help

Emergency help now

Call 911 when there is immediate physical danger, a medical emergency, severe violence, or an inability to stay safe. In the United States, call or text 988 or use 988 chat for suicidal thoughts or another mental-health, suicide, or substance-use crisis.17

Prompt clinical evaluation

Seek prompt evaluation for self-harm thoughts without immediate intent, hallucinations, possible mania such as a markedly reduced need for sleep with rising energy, sudden functional decline, escalating aggression, severe depression or anxiety, dangerous substance use, school refusal, inability to meet basic needs, or a major new memory or thinking change. A plan that uncovers these concerns did not necessarily cause them.

Routine troubleshooting

Ask for routine reassessment when goals are unclear, the system is too complicated, practice does not transfer, the therapist is not using a structured protocol, or there is no progress after a fair course delivered with reasonable fidelity. Check sleep, learning, vision or hearing, trauma, mood, anxiety, autism needs, pain, substance use, medication effects, and environmental demands rather than assuming low effort.

What remains unknown

Research has not set one best CBT program, dose, or format. We do not know if apps match therapist care, which teens gain, how long gains last, or how well results transfer across groups and settings. A 2018 Cochrane review found no severe adverse events, but five people reported distress or anxiety. Harm reporting was sparse.2 Treatment also costs time, money, privacy, practice, and mental energy.

The useful question is not “Did CBT fix ADHD?” It is “Did this course help with an important task, with less impairment, conflict, or distress, and was the gain worth the burden?” Keep the target clear, compare more than one source, and plan to restart.

Copy-ready tools

Weekly planning sheet

Week of: ____________________
Planning time and place: ____________________
One capture system: ____________________

For each area of life, write one line with: what needs attention, its priority from 1 to 3, the smallest visible next action, when and where it will happen, the estimated minutes, and the actual minutes afterward.

• School or work: ____________________
• Home: ____________________
• Health or care: ____________________
• Money or paperwork: ____________________
• Relationship or community: ____________________

One distraction barrier: ____________________________________
One specific support request: ____________________________________
Low-capacity version: Capture one item and schedule one next action.
Review date: ____________________
Decision: Continue / Simplify / Adapt / Get more help

Task-start protocol

1. Name the task in observable words.
2. Ask, “What is the smallest action I can see?”
3. Put that action at a time and place.
4. Estimate the minutes.
5. Remove or delay one distraction.
6. Start for five minutes, or use a smaller agreed interval.
7. Record actual time and what blocked the start.
8. Choose the next action or stop at the planned boundary.
9. If missed, restart at step 1 without backfilling.

Therapist-selection checklist

• Licensed for the care being provided and able to explain scope of practice
• Experience diagnosing or treating ADHD in the relevant age group
• Uses a structured ADHD-focused CBT protocol
• Teaches planning, task initiation, distraction control, and restart skills
• Includes practice between sessions with a low-burden option
• Measures symptoms and real-life function
• Can explain whether care is individual, group, digital, or combined
• Coordinates with a prescriber when permitted and needed
• For teens, explains assent, caregiver roles, confidentiality, and school contact
• Competent with relevant anxiety, depression, trauma, autism, learning, substance-use, sleep, and safety needs
• Offers accessible materials, language support, and disability accommodations
• Discusses cost, time, missed sessions, privacy, data use, and expected duration
• Does not promise a cure or medication equivalence

Progress tracker

For each opportunity, record one line with:

1. Date and setting
2. Opportunity: what the task was
3. Started as planned? yes / no
4. Completed, or next step captured? yes / no
5. Minutes
6. Support used
7. Strain, 0 to 10
8. What to change

Restart card

The system slipped. I do not need to repair every missed day.

1. Capture one current task.
2. Write one visible next action.
3. Schedule one five-minute start.
4. Ask for one specific support if wanted.
5. Review what made the old version too heavy.

Frequently asked questions

Does CBT cure ADHD?

No. CBT teaches skills and helps change patterns that add to impairment. It does not remove a neurodevelopmental disorder.2

Can CBT replace medication?

The evidence does not support a universal replacement claim. Many positive trials used CBT with stable medication or usual care. Some unmedicated adults were studied, but direct monotherapy evidence remains limited, especially for teens.347

How long does ADHD-focused CBT take?

Many tested programs used about 8 to 16 sessions, often 12. Dose varied, and no one schedule is proven best for every age, target, or format.34

Is an ADHD app the same as CBT with a therapist?

No. Some specific digital programs have promising self-rated results, but product, support, comparator, privacy, and conflict-of-interest details differ. Evidence for one product does not transfer to every app.1113

Related reading on NP FADY

• Change the Pattern, Not the Child: A Parent’s Guide to Behavioral Training for ADHD (Part 1)
• Build the Rails: Classroom and Organization Systems for ADHD (Part 2)
• When Sleep Steals Focus: A Practical ADHD Sleep Plan (Part 4)
• Move the Body, Support the Brain: An Honest Guide to Exercise and ADHD (Part 5)
• CBT Made Simple: How Changing Thoughts Changes Feelings
• Why Your Brain Says ‘Tomorrow’: The Neural Science Behind Procrastination and Self-Sabotage
• Adult ADHD in the Inland Empire: signs, options & next steps
• ADHD Time Blindness Is Not Disrespect

References

1. Ostinelli EG, et al. Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis. Lancet Psychiatry. 2025;12(1):32-43. DOI 10.1016/S2215-0366(24)00360-2. PMID: 39701638. PROSPERO: CRD42021265576.

2. Lopez PL, Torrente FM, Ciapponi A, Lischinsky AG, Cetkovich-Bakmas M, Rojas JI, Romano M, Manes FF. Cognitive-behavioural interventions for attention deficit hyperactivity disorder in adults. Cochrane Database of Systematic Reviews. 2018;3(3):CD010840. DOI 10.1002/14651858.CD010840.pub2. PMID: 29566425. PMCID: PMC6494390.

3. Safren SA, Sprich S, Mimiaga MJ, Surman C, Knouse L, Groves M, Otto MW. Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial. JAMA. 2010;304(8):875-880. DOI 10.1001/jama.2010.1192. PMID: 20736471. PMCID: PMC3641654. ClinicalTrials.gov: NCT00118911.

4. Solanto MV, Marks DJ, Wasserstein J, Mitchell K, Abikoff H, Alvir JMJ, Kofman MD. Efficacy of meta-cognitive therapy for adult ADHD. American Journal of Psychiatry. 2010;167(8):958-968. DOI 10.1176/appi.ajp.2009.09081123. PMID: 20231319. PMCID: PMC3633586.

5. Sibley MH, et al. Pharmacological and non-pharmacological treatments for adolescents with attention deficit/hyperactivity disorder: a systematic review of the literature. Journal of Child Psychology and Psychiatry. 2025;66(1):132-149. DOI 10.1111/jcpp.14056. PMID: 39370392.

6. Sprich SE, Safren SA, Finkelstein D, Remmert JE, Hammerness P. A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents. Journal of Child Psychology and Psychiatry. 2016;57(11):1218-1226. DOI 10.1111/jcpp.12549. PMID: 26990084. PMCID: PMC5026858. ClinicalTrials.gov: NCT01019252.

7. Haugan ALJ, et al. Cognitive behavioural group therapy as addition to psychoeducation and pharmacological treatment for adolescents with ADHD symptoms and related impairments: a randomised controlled trial. BMC Psychiatry. 2022;22(1):375. DOI 10.1186/s12888-022-04019-6. PMID: 35655149. PMCID: PMC9164353. ClinicalTrials.gov: NCT02937142.

8. Andersen PN, et al. One year follow-up of participants in a randomised controlled trial of a CBT-based group therapy programme for adolescents diagnosed with ADHD. Nordic Journal of Psychiatry. 2024;78(3):189-197. DOI 10.1080/08039488.2024.2301774. PMID: 38353423.

9. López-Pinar C, et al. Cognitive behavioral therapy effects on global functioning, domain-specific functioning, and quality of life in adult ADHD: a comprehensive meta-analysis. Behaviour Research and Therapy. 2026;201:105026. DOI 10.1016/j.brat.2026.105026. PMID: 41936228.

10. Wettstein A, et al. Long-term effects of cognitive behavioural therapy on the quality of life in adult ADHD. PLOS One. 2026;21(8):e0356825. DOI 10.1371/journal.pone.0356825. PMID: 42664236. PMCID: PMC13524267.

11. Nasri B, et al. Internet delivered cognitive behavioral therapy for adults with ADHD: a randomized controlled trial. Internet Interventions. 2023;33:100636. DOI 10.1016/j.invent.2023.100636. PMID: 37483263. PMCID: PMC10359875.

12. Anastopoulos AD, King KA, Besecker LH, O’Rourke SR, Bray AC, Supple AJ. A randomized controlled trial examining CBT for college students with ADHD. Journal of Consulting and Clinical Psychology. 2021;89(1):21-33. DOI 10.1037/ccp0000553. PMID: 33507774.

13. D’Amelio R, et al. Effectiveness of attexis, a digital intervention based on cognitive behavioral therapy for adults with ADHD: a randomized controlled trial. Psychological Medicine. 2026;56:e54. DOI 10.1017/S0033291726103390. PMID: 41810578. PMCID: PMC13079232.

14. Wolraich ML, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. DOI 10.1542/peds.2019-2528. PMID: 31570648. Official guideline. Correction: Pediatrics. 2020;145(3):e20193997. DOI 10.1542/peds.2019-3997. PMID: 32111626.

15. Centers for Disease Control and Prevention. ADHD in adults. Reviewed July 30, 2026. Accessed August 30, 2026. Official page.

16. American Professional Society of ADHD and Related Disorders. Adult ADHD Guidelines status page. Updated August 27, 2026. Accessed August 30, 2026. Official page.

17. 988 Suicide and Crisis Lifeline. Get help. Accessed August 30, 2026. Official site. Substance Abuse and Mental Health Services Administration. 988 versus 911 guidance. Accessed August 30, 2026. Official guidance.

18. Wang L, et al. Cognitive behavioral therapy for anxiety symptoms in ADHD: a systematic review and meta-analysis with dose-response exploration. Psychotherapy Research. 2026:1-19. DOI 10.1080/10503307.2026.2658745. PMID: 42018981.

If you or someone else cannot stay safe, call 911 for immediate danger or call or text 988 in the United States for crisis support.

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This article is for education and is not a diagnosis or an individual treatment plan. Reading it does not create a clinician-patient relationship. ADHD care may include behavioral supports, therapy, school or workplace accommodations, medication, or a combination. Discuss major treatment changes with a qualified clinician. Evidence and U.S. guidance were checked on August 30, 2026.

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, available 24/7. En español: marque 988 y oprima 2. Veterans: 988 and press 1, or text 838255.
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• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
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