Reach the root, not the band-aid

Ezawa & Hollon. In-session cognitive restructuring (identifying and revising the underlying belief rather than surface reframing) correlated with better psychotherapy outcomes at r=.35 (95% CI .24-.44; ~d=0.85). Supports the mechanism of 'reach the root belief,' but is a general therapy-process meta-analysis, not a test of self-directed root-tracing in ADHD/autism.

Jennissen et al., Am J Psychiatry. Aggregating 23 effect sizes, patient insight showed a moderate positive association with psychotherapy outcome (r=0.31), consistent across CBT, experiential, and psychodynamic orientations. The method is fundamentally an insight-generating technique ('trace why this jab lands -> the root insecurity'), so this is the closest process-level support — but it is a correlational cross-diagnostic proxy, not a controlled test of the technique.

Narrative review. Adults with ADHD show elevated early maladaptive schemas — most prominently 'Failure', 'Defectiveness/Shame', 'Subjugation', 'Emotional Deprivation' — which standard CBT does not substantially address. Schema/core-belief work is proposed as promising for secondary problems like impaired self-perception, but the authors state explicitly that NO pilot studies or RCTs of schema therapy in ADHD have been conducted.

Frontiers in Psychology review. Autistic/ADHD individuals carry higher rates of early maladaptive schemas (notably defectiveness/shame), and greater schema severity tracks poorer mental health — directly mapping onto 'I feel broken and worthless' and rejection sensitivity. Concludes schema/root-belief therapy is a 'promising avenue' but reports NO original trial: literature on schema therapy for ADHD is 'markedly sparse' and only ~3 studies exist for autistic adults.