Where Do I Even Begin? Navigating the First Steps of Adult ADHD Assessment

This post was authored by Kate Hardiman, Educational and Developmental Psychologist, BA (Psych)(Hons), MPsych (Ed & Dev). The content used AI-assistance for editing and readability.

For some people, it’s a low, persistent thrum beneath the surface of everything they do. It’s a constant sense of pushing a boulder uphill while everyone else seems to be strolling by on level ground. There’s a point where the effort of pretending to have it all together becomes heavier than the fear of asking for help.

At the start of the assessment process some people describe a two-part dialogue running in their head. Maybe you recognize it, too. Thoughts such as "Trying harder isn’t really helping the way I thought it would." Or, "What might my life might have looked like had I known sooner." But then, the other voice crashes in: It says, "You’ve just researched this too much, you’re going to fool the assessor."

It’s uncomfortable, that internal conflict. But for whatever reason—whether it's the exhaustion, the hope, or just a small, stubborn spark of authenticity demanding to be seen—you’ve landed here. 

The decision to invest in an assessment is huge. It means dedicating your time, your money, and, most importantly, your emotional energy to something that often feels like navigating a dense fog without a map. There are no clear,

signposted pathways, and for a neurotype that already struggles with task initiation, that ambiguity is a real roadblock.

Do I see a psychologist? Or a psychiatrist? Do I need a GP referral? Is there a rebate?

It’s a lot. Let’s try to illuminate the path a little, moving from the personal, messy starting point to the practical steps of choosing the right professional for your unique needs.

Two Doors to Walk Through: Psychiatrist vs. Psychologist

When considering an adult ADHD assessment, your choice of professional comes down to what you ultimately hope to gain from the process. It’s about more than just a diagnosis; it’s about choosing the kind of support that will nourish you moving forward.

The Psychiatrist: The Medical Path

A psychiatrist is a registered medical professional. They are equipped to assess, diagnose, and manage psychiatric conditions, including ADHD.

Pros

Can prescribe and manage ADHD medication, which many people find helpful.

A GP referral allows you to access Medicare rebates for the assessment.

Can manage your entire medical and medication pathway.

If you know, right now, that exploring medication is a critical and necessary component of your post-diagnosis plan, a psychiatrist is your clearest starting point. You will require a GP referral to access the Medicare rebate for your appointment.

The Psychologist: The Identity Path

A psychologist is a post-graduate qualified health professional. They assess and diagnose ADHD using interviews and questionnaires, but their professional lens often offers a different kind of depth.

I think of the psychologist’s assessment process as an invitation to sit with your own identity and life story. It’s less about understanding your neurotype in the context of your whole life.

Their approach often frames difficulty through a lens of environmental mismatch—the idea that it's not a personal failing, but rather a clash between your unique brain (hello, spoons theory!) and an environment designed for another neurotype. This mismatch is often what fuels the secondary struggles like anxiety and depression.

Pros

Focus on identity, self-compassion, and understanding your neurotype.

Provides therapeutic support to explore behavioural and environmental strategies.

Often engages with concepts of neurodiversity and how your brain works.

If your primary interest is in a broad, gentle understanding of your whole self—your relationship to your thoughts, your emotions, and developing skills like self-compassion—then a psychologist can be an incredibly appropriate option for assessment and therapy. Keep in mind that a psychologist cannot prescribe medication. A GP referral is not required for assessment, but for ongoing therapy a GP referral is required to access Medicare rebates.

What Working with a Psychologist is Like in Therapy 

A psychologist's role is often to help clients gently address the relationship they have with their own thoughts and emotions. People spend years unconsciously internalising the idea that their struggles are moral failings. The internal advisor says, "I’m lazy. I’m inconsiderate. I don’t try hard enough." Therapy is about shifting that narrative. It’s about looking at those feelings of failure and asking, "What if that wasn't true?

The aim is not to minimise the difficulty. The struggles with executive function are real, heavy, and frustrating. But in a therapeutic space, we can explore them with gentleness. We ask questions like:

• What does productivity look like for a brain that works like yours?

• How can we re-design your space to support, rather than fight, your flow?

• Where did you learn that your inherent value was tied to your output?

  
  

The core value here is fairness. It’s about being given a fair chance, armed with accurate information about how your brain functions, and then being supported to develop a different kind of relationship with that internal advisor.