Self-directed or therapist-led parent training for children with attention deficit hyperactivity disorder? A randomized controlled non-inferiority pilot trial

Abstract

Background and objectives Therapist-led behavioral parent training is a well-established treatment for behavior problems in children with attention-deficit/hyperactivity disorder (ADHD). However, parental attrition is high; self-directed forms of parent training may be a promising alternative. To date, no studies have compared these two forms of parent training in referred children with ADHD. The objectives of this pilot study were to examine the non-inferiority of a blended parent training (i.e. online program + supportive therapist contact) in comparison to its therapist-led equivalent (i.e. face-to-face parent training) regarding effects on behavioral problems, and to compare attrition rates, parental satisfaction, and therapist-time between both treatments. Methods 21 school-aged children with ADHD and behavioral problems, who had been referred to an outpatient mental health clinic, were randomized to blended (n\u202f=\u202f11) or face-to-face (n\u202f=\u202f10) parent training. Behavior problems were measured with the Child Behavior Checklist. Treatment completers and dropouts were included in the analyses. Results and conclusions Blended parent training was not found to be non-inferior to face-to-face parent training in the reduction of behavior problems. Parents in the blended condition dropped out of treatment significantly earlier than parents in the face-to-face condition and were less satisfied. Therapists in the blended condition spent significantly less time on parent training than therapists in the face-to-face condition.