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

Simone Breider, Annelies de Bildt, Maaike H Nauta, Pieter J Hoekstra, Barbara J van den Hoofdakker, Simone Breider, Annelies de Bildt, Maaike H Nauta, Pieter J Hoekstra, Barbara J van den Hoofdakker

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 = 11) or face-to-face (n = 10) 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.

Keywords: Attrition; Behavior problems; Blended; Face-to-face; Non-inferiority; Online.

Conflict of interest statement

Van den Hoofdakker receives royalties as one of the editors of “Sociaal Onhandig” (published by Van Gorcum), a Dutch book for parents that is being used in the face-to-face behavioral parent training. Non-financial: developed and evaluates several Dutch behavioral training programs for parents, teachers and staff, without financial interests. All other authors have no competing interests.

© 2019 The Authors.

Figures

Fig. 1
Fig. 1
Study's flow chart. *Not included in analyses.

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