In this short video, I explain how we sort an ADHD crisis into what must happen this week and what can wait, and why that order matters so much.
You can also send me an email
Acute online ADHD psychotherapy helps adults with ADHD, or who strongly suspect it, when something has just gone badly wrong: a warning at work, a missed deadline with real consequences, a partner at the end of their patience, or a collapse of everything you were holding together. We meet by video, in English, soon, usually within days, in 1-hour sessions with 50 minutes of therapy.
I help you steady yourself, stop the shame spiral and decide what truly needs doing now, before you make a choice in panic. This is the acute branch of online ADHD psychotherapy, within online neurodiverse psychotherapy and my wider online psychotherapy.
You can request a free 30-minute call, book the first open session, check my client policy or message me about timing.
Acute online ADHD psychotherapy is for English-speaking adults with ADHD whose life has just tipped into crisis, wherever they live. You need help this week to calm down, see clearly and decide what happens next, not a long waiting list.
Acute sessions are for the days and weeks straight after things fall apart. If one of these lines describes you better, the linked page will help more.
You can also send me an email
These reviews describe clients’ experiences of working with me. They come from my wider practice and do not all relate to online sessions. Each person’s experience is their own, and a review does not promise a particular outcome.
“Looking back over my 22 years of practice, I am struck by how often an ADHD crisis turns into a midnight rescue mission. People try to fix every overdue thing at once, fuelled by shame, and by Thursday they are more exhausted and further behind. Underneath, I hear ‘Have I ruined everything this time?’ and a harder, quieter voice: ‘Do not tell anyone, I will handle it alone tonight.’ I disagree with both the panic and the secrecy. The first job in a crisis is to make the list shorter, not to work faster. Once we know what genuinely has to happen this week, your mind usually starts working for you again.”
Mark Colclough, MA, psychotherapist and EFT couples therapist
I am Mark Colclough, MA. I have practised since 2004 and offer online psychotherapy and couples therapy in English.
My training brings together your emotions, your thoughts and your relationships. My deep passion is the moment when what happens between you finally makes sense, to each of you and to each other. I have lived and worked in nine countries, so I know something of life across languages, cultures and borders.
Read about my background, or explore online psychotherapy and online couples therapy.
I meet regularly with experienced psychotherapists to reflect on my work, question my understanding and develop my skills. Supervision is part of the professional care I bring to individual and couples work, including online sessions.
My focus is thoughtful practice, integrity and responsibility.
You are welcome to ask about the kind of support you need.
Tell me where you are based and your time zone. We can then consider whether online sessions together are suitable.
Hamid is 29, grew up in Manchester and works as a data analyst in Singapore. On Monday his manager gave him a written warning after 3 missed deadlines. His employment pass depends on the job. He has not slept properly since, has not told his fiancée, and spent last night drafting a resignation email he has not yet sent. Every time he opens his laptop, his chest tightens and he closes it again.
I would start by agreeing with Hamid that nothing gets sent this week, and then sort what his manager actually needs from what his shame is demanding. In a first video session he would probably see that the crisis is smaller and more manageable than it feels at 2 in the morning.
I have presented this clinical example as a compound of 22 years of clinical practice.
Something has gone badly wrong, and the usual last-minute rescue has not worked this time.
There is no rule about how bad things must be before you ask for help. If you feel that your life has slipped out of your hands this week, that is enough. You do not need a diagnosis, a clear account or a plan. In 22 years of practice I have sat with many people in the first days after an ADHD-driven collapse, and I recognise when the strain has become a crisis that needs prompt attention.
In our first session, I usually begin by slowing everything down and separating what is urgent from what only feels urgent. These 6 questions can help you decide whether to contact me now.
If so, take it seriously, but not as proof that you are hopeless. One late report becomes a tense meeting, then a warning, then sleepless nights in which every other overdue task joins the pile. Your body feels wired and drained at once, and you avoid the very messages that might help.
I would look at what has actually happened, what is at stake and which of the consequences can still be changed this week. That tells us whether this is a sharp crisis or the visible end of a much longer strain. If you are in it now, book a session with me and we can start with the most urgent step.
Both urges make sense, because both are trying to end the pain. One part of you wants to answer every email, pay every bill and apologise to everyone before morning. Another wants to switch the phone off and pretend none of it exists. You may swing between them in an hour.
I do not treat either urge as wrong. The rescuer wants to protect your reputation, and the hider wants to protect you from shame. I help you see what each is guarding, then we choose a few deliberate steps that neither burn you out nor leave you exposed.
In a crisis, every silence can feel like a sign. Your manager has not replied, so you assume the worst. Your partner seems quiet, so you rehearse the break-up. You check your inbox again and again and read new meaning into a single word.
Your need to know where you stand is legitimate, and I will not dismiss it. What I help you calm is the alarm that runs ahead of the facts. We look at what you actually know, what you can ask about directly and what you can leave until you are steadier.
Yes, and in a crisis it can be especially sharp. You call a friend in tears, then feel exposed when they offer practical advice. You ask your partner to help, then hear their help as proof you are failing. Being supported and being seen as a problem start to feel identical.
In acute sessions I slow this down, so we can catch the moment help turns into shame. Often the trigger is being given a solution you could have thought of yourself. I have compassion for the reaction, and I will help you ask for the kind of help you need, rather than refusing all of it.
When everything is too much, many people with ADHD disappear. You stop answering your manager, leave texts unread and tell your partner it is under control. The silence buys a little relief, and then the cost of breaking it grows.
My view is that going quiet under this much pressure is understandable, and I will not shame you for it. I help you see what the silence shields you from and how to break it in small, manageable steps. Often one short message, written together in a session, opens the door again.
A collapse can shake the story you tell about yourself. If you were the capable one who always pulled it off, a public failure can feel like the end of that person. You may wonder whether you have been fooling everyone. That fear shows how hard you have been working to hold things together, not that you are a fraud.
Once the most urgent steps are in hand, I help you look at what this crisis says about the way you have been living, and what it does not say. I will challenge harsh conclusions drawn in panic, and I will not impose a new story. The aim is a steadier sense of who you are when the dust settles.
If you are in the middle of this, request a call or book the first open session, and I will tell you plainly how soon we can meet.
You can also send me an email
Tell me briefly what kind of support you are looking for.
Include your country and time zone so we can discuss whether online work together is possible and find a suitable time.
You do not need to explain your whole story in your first message.
Your details are used to respond to your enquiry. Please leave detailed health information out of this form. Read the privacy policy for information about personal data, service providers and storage.
In an ADHD crisis, the sequence matters: steady yourself, shrink the list, then understand what led here.
Acute work with me will help you calm the immediate situation, see the pattern that brought you here and make practical changes before the next deadline arrives. Understanding why it happened is useful, but this week you also need to act differently.
In 22 years of practice I have learned that crisis work needs a clear, active therapist. I will structure our sessions, tell you what I think matters most and challenge plans driven by panic or shame. The 6 questions below describe what we work towards.
Related reading: Why does ADHD keep pulling us into the same fight?.
I help you separate the event from the noise around it. The warning, the debt or the argument is real, but it sits on top of other layers: sleep loss, months of hidden strain, and a belief that asking for help means admitting defeat.
I give you my honest reading of what needs attention first and which fears are inflating the danger. When you are ready, book a session with me and we will start with the one thing that cannot wait.
By learning to spot its first signs. In a crisis there is usually a pattern: a sudden thought that everything is ruined, a racing heart, then a burst of action, such as sending an email or booking a flight. Seeing the first step gives you a moment to pause.
I help you slow that sequence down and agree a simple rule for the coming days, such as waiting until morning before sending anything important. Noticing is not enough. We practise the pause until you can use it alone.
Settling does not mean pretending the crisis is not real. It means bringing your system down far enough that you can think, eat and sleep. With ADHD, a crisis often keeps the mind racing long after the body is exhausted.
I help you notice what keeps the engine running, such as late-night checking, and find small things that slow it, such as a fixed stopping time for crisis tasks. I will ask you to use them between sessions, because the nights are where much of the damage happens.
Clear communication begins with knowing what you need from each person. In a crisis you may want to explain every reason, apologise for everything or say nothing at all. Long explanations can sound like excuses, and silence can sound like indifference.
Together we work out short, honest messages for the people who matter: your manager, your partner, perhaps a landlord. I will challenge you when you take on all the blame, and also when you expect others to understand without being told.
Decisions get clearer once panic, shame and other people’s reactions are separated from what you actually want. In a crisis, quitting, moving or ending a relationship can feel like the only way to stop the pain.
I help you sort what truly must be decided now from what can wait a few weeks. You will hear my honest view, and I will say so if a choice looks driven by panic, but the decision stays yours.
Change has to go beyond surviving this week. Once things are calmer, you may need better support at work, clearer agreements at home, or ways of handling post and money that do not depend on panic.
I help you decide what needs to change so this does not repeat. Some people move on to online ADHD psychotherapy for steadier work, some take a pause, and some feel ready to stop. I help you choose deliberately.
You can also send me an email
You do not need to explain it all neatly or know what you want. You only need to show up.
When you begin, I listen to what has happened, check that you are safe and help you agree a plan for the coming days. I also tell you honestly whether acute sessions are the right format.
Once the crisis has eased, the work often continues as part of my online psychotherapy, structured individual work at a steadier pace. If the crisis is really in your relationship and your partner will join, online couples therapy offers long-term relational development and healing. When you expect several sessions close together, a therapy bundle gives you savings and one less thing to arrange.
In the first session I ask what has happened, what is at stake, what you have already tried and what scares you most. Then we separate this week’s tasks from everything else.
Before we finish, I share my first understanding and a short plan for the days until we meet again. You decide whether my approach feels useful. If you want to check first, book a free 30-minute call.
Individual work is right when the crisis sits mainly in your own life: your job, your finances, your health or your sense of yourself. We can talk about the people involved without them joining the call.
In acute sessions I give you direction, continuity and challenge while the pressure is high. Once things settle, online psychotherapy describes the structured individual work that can follow.
Choose couples therapy when the crisis is mainly between you: your partner feels they have become your manager, resentment is building on both sides, or trust has broken down. When both of you are willing, working together usually helps more.
In couples work I help you both see the cycle between you and build fairer ways of sharing the load. Online couples therapy is long-term relational development and healing, and online neurodiverse couples therapy focuses on relationships shaped by ADHD or autism.
At the start, sessions are usually closer together than in ordinary therapy, often twice in the first week, so the crisis does not run away between meetings. The pace depends on how serious things are and how much capacity you have.
I recommend a rhythm based on what you tell me and on how the first session goes. As things calm, we space sessions out, and I will tell you honestly when we can safely meet less often.
A bundle makes sense when you already expect several sessions in a short time. It removes the need to decide after each session whether to book again, which helps when your mind is already overloaded.
A bundle lowers the cost per session and gives you a structure to lean on. I will tell you if I think you need one. Bundle sizes for a crisis sit under therapy discounts and bundles, and the cards follow below.
The acute phase is over when you are sleeping again, the most urgent tasks are handled and you can think about next month rather than only tonight. You understand better how the crisis built up.
I review this with you openly at each session. You may stop, continue with regular sessions or return later if something new happens. Coming back does not mean the earlier work failed.
Not sure acute sessions are the right starting point? Here is how they compare with the nearest options.
| Option | Choose it when | Pace |
|---|---|---|
| Acute online ADHD psychotherapy (this page) | Something linked to ADHD has just gone badly wrong, and you need help this week. | Video sessions soon and close together |
| Online ADHD psychotherapy | There is no immediate crisis, but a long pattern of struggle. | Weekly 1-hour video sessions |
| Acute online neurodiverse psychotherapy | You are neurodivergent and in crisis, without one clear label. | Video sessions within days |
| Acute online AuDHD psychotherapy | Both ADHD and autism are part of the collapse. | Short, frequent video sessions at first |
Acute online ADHD psychotherapy with me is short-term, structured individual psychotherapy by video, in English, for adults with ADHD whose life has just gone into crisis. It focuses first on steadying you and limiting further damage, then on understanding what happened.
I work quickly but not superficially, keeping the whole person in view. If there is no immediate crisis, online ADHD psychotherapy is the broader place to start.
It is a crisis when something important is at stake, such as your job, your relationship, your money or your health, and your usual ways of coping have stopped working. If you are not sleeping and cannot think straight, take that seriously.
I look at what has happened, how fast things are moving and what support you have around you. If you are asking the question, it is worth a conversation.
I can help you think clearly, plan your response and talk to your employer without panic or self-sabotage. I cannot promise the outcome, and I do not act as a workplace adviser or advocate.
In my clinical experience, people in this position often make things worse by over-promising or going silent. I would focus with you on a calm, honest response and on the support you may need, such as written instructions or clearer priorities.
Often, yes. A partner reaching their limit is sometimes a final decision and sometimes a desperate request for change. Acute sessions help you understand what you can change and what you need to say.
I would help you respond without collapsing into apology or defensiveness. If you both want to work on it together, online neurodiverse couples therapy is the right next step.
Both are ways of trying to stop the fear. One floods you with action, the other with avoidance. Neither is a character flaw. They are habits that once helped you survive.
I help you notice which way you move under pressure and what it costs. Then we practise a middle path: a few deliberate steps and honest messages, at a pace you can keep up.
That is fine. Most people in crisis arrive scattered. I will ask questions, help you put events in order and pick out what matters most. By the end you will have a short plan for the coming days.
You do not need notes or a timeline. Book the first open session, or start with a free 30-minute call if you want to talk first.
Most people steady things within a few sessions over 2 to 4 weeks. If the crisis has uncovered longer-standing patterns, the work usually continues at a steadier pace.
In 22 years of practice I have found that clear, close support at the start, reviewed after each session, works far better than waiting to see. We decide together when to step back.
Yes. Video lets us meet quickly, wherever you are, without travel. You can sit somewhere private and familiar, which helps when your nervous system is already overloaded.
Bring headphones, a laptop or tablet, a steady connection and a door you can close. The calendar shows times in your own time zone. I am not an emergency service, so if you are in immediate danger, contact the emergency services where you live. For anything else, ask on a free call.
Acute sessions are booked as 1-hour online individual psychotherapy sessions, each with 50 minutes of therapy. The current fees, in US dollars, are listed on my prices page.
Because a crisis often needs several sessions in a short time, a therapy bundle can make sense: it saves 10 per cent and gives you a clear plan. See therapy discounts and bundles.
Book the first available session now, or request a free 30-minute call if you want to talk first. Times appear in your local time zone.
If none of the times are soon enough, write to me with a short description of what has happened. I hold some room for acute cases and usually find a time within days. Send that message today.
You can also send me an email
I want therapy to help you understand your experience and make choices you can use in everyday life. We pay attention to feelings, needs and the responses that happen before you have time to think.
Our online room should offer enough trust and honesty to explore what is difficult. I bring attention and professional judgement. You bring your experience, questions and the right to say when something does not fit.
Sign up for my occasional writing on feelings, relationships and life between cultures. No spam, and you can unsubscribe whenever you like.
Please fill in your details and I’ll contact you soon. I use your details to reply to your enquiry, talk through practicalities and, if you wish, arrange an online session. Requesting a call also adds your email address to my mailing list. Please do not write sensitive information in the message field.
Clicking the button adds your email address to my mailing list. Please read the Privacy Policy for more information.
P.S. I’ll call you in a bit!
