CBT, parent training, and combined approaches for children with ADHD: A randomized study.

Abstract

Objective: This study aimed to evaluate the effectiveness of cognitive behavioural therapy (CBT), parent training programm (PTPs), and their combination as adjunctive interventions to medication in reducing core ADHD symptoms and functional difficulties in children aged 7-11 who had been receiving pharmacological treatment. The goal was to examine whether these psychosocial approaches could enhance treatment outcomes beyond medication alone.

Method: Forty-two mother-child dyads were randomly assigned to one of four groups: (1) medication (M) plus cognitive behavioural therapy (CBT), (2) M plus parent training programme (PTP), (3) M plus both CBT and PTP (combined), and (4) M only (control). Families completed the sociodemographic data form, the Turgay DSM-IV ADHD Assessment Scale, and the Strengths and Difficulties Questionnaire (SDQ) before and after the intervention period. Data were analysed using Kruskal-Wallis H, Mann-Whitney U, Bonferroni correction, Wilcoxon signed-rank, and Chi-square tests, with a significance level set at p < .05.

Results: Significant reductions in attention deficit, hyperactivity, and impulsivity were observed in the M + CBT, M + PTP, and combined groups, as measured by the Turgay DSM-IV ADHD Assessment Scale. According to the SDQ, all three groups also showed significant decreases in SDQ impact scores, suggesting improved functional outcomes. In contrast, the control group showed improvement only in attention deficit, despite a notable increase in SDQ impact scores, indicating worsened overall functioning.

Conclusion: Adjunctive CBT, parent training, and their combination were more effective than medication alone in reducing core ADHD symptoms and improving children's functioning. These findings support the integration of psychosocial interventions into routine ADHD treatment, especially in school and family settings where behavioural support is essential. However, the small sample size limits generalizability, and further research with larger samples, extended follow-up, and placebo-controlled designs is needed to confirm these results and guide evidence-based policy and practice.