Objectives: Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is frequently complicated by pervasive emotional dysregulation and impaired cognitive flexibility, which significantly hinder daily functioning. This study aimed to compare the effectiveness of drama therapy, cognitive rehabilitation, and a combined intervention on improving emotion regulation and cognitive flexibility among adults with ADHD.
Methods: A quasi-experimental, pretest-posttest design with a control group was conducted. The target population comprised adults aged 30 to 50 diagnosed with ADHD in Tehran during 2025. Through convenience sampling, 40 participants were recruited and non-randomly assigned equally to four groups (n=10 per group): drama therapy, cognitive rehabilitation, combined intervention, and a wait-list control group. Data were collected utilizing the Difficulties in Emotion Regulation Scale (DERS) and the Cognitive Flexibility Inventory (CFI). The collected data were analyzed via Analysis of Covariance (ANCOVA) and Bonferroni post-hoc tests using SPSS software.
Results: After controlling for pretest scores, the interventions yielded statistically significant improvements across the experimental groups. The combined intervention produced the largest observed reductions in emotion regulation difficulties (F=11.65, P<0.001, partial η²=0.50) and the largest observed gains in cognitive flexibility (F=13.13, P<0.001, partial η²=0.53) relative to the other conditions. Furthermore, both drama therapy and cognitive rehabilitation independently produced significant therapeutic benefits over the control group.
Conclusion: Although cognitive rehabilitation and drama therapy independently benefit adults with ADHD, their integration yields superior outcomes. Combining the emotional and interpersonal elements of drama therapy with the executive focus of cognitive rehabilitation offers a highly effective, comprehensive psychological rehabilitation approach for this population.