The Importance of Therapeutic Processes in School-Based Psychosocial Treatment of Homework Problems in Adolescents With ADHD

Objective: To evaluate the importance of therapeutic processes in two brief school-based psychosocial treatments targeting homework problems in adolescents with attention-deficit/hyperactivity disorder (ADHD) as delivered by school mental health professionals. Method: A sample of 222 middle school s...

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Bibliographic Details
Published in:Journal of consulting and clinical psychology 2018-05, Vol.86 (5), p.427-438
Main Authors: Breaux, Rosanna P., Langberg, Joshua M., McLeod, Bryce D., Molitor, Stephen J., Smith, Zoe R., Bourchtein, Elizaveta, Green, Cathrin D.
Format: Article
Language:English
Subjects:
Adolescents
Attention Deficit Disorder with Hyperactivity
Attention deficit hyperactivity disorder
Contingency Management
Female
Homework
Human
Male
Mental health
Mental health professionals
Mental Health Services
Middle School Students
Parent participation
Parental Involvement
Psychosocial Factors
Psychosocial Interventions
Psychosocial therapy
School Based Intervention
Social psychology
Teachers
Teenagers
Test Construction
Therapeutic Alliance
Therapeutic alliances
Treatment methods
Working parents
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Summary:Objective: To evaluate the importance of therapeutic processes in two brief school-based psychosocial treatments targeting homework problems in adolescents with attention-deficit/hyperactivity disorder (ADHD) as delivered by school mental health professionals. Method: A sample of 222 middle school students (72% male; Mage = 12.00 years, SD = 1.02) diagnosed with ADHD was randomized to receive either a contingency-management or a skills-based treatment for homework problems. Both treatments included 16 individual sessions (20-min each) and 2 parent/family meetings. Adolescents and school mental health professionals reported on the working alliance in the middle of the treatment; professionals rated adolescent involvement at each of the 16 sessions, parent involvement during both parent meetings, and parent commitment to carry out the established homework plan. Attendance at parent meetings was also recorded. Results: Therapeutic processes predicted objective, parent-reported, and teacher-reported academic outcomes. Parent engagement was particularly important for the contingency-based treatment, whereas working alliance and adolescent involvement were most important for the skills-based treatment. Conclusions: Therapeutic processes such as developing a strong working alliance and engaging parents and students are key elements of treatment delivery and receipt in school-based mental health programming and should be explicitly trained and monitored. What is the public health significance of this article? This study demonstrates that several therapeutic processes are important in treatments focused on reducing the homework problems of adolescents with ADHD. School-based treatment protocols should include explicit training and guidance for school mental health professionals surrounding building a strong alliance and fostering parent and adolescent engagement.
ISSN:0022-006X
1939-2117
DOI:10.1037/ccp0000300