This study tested STAND, a therapy that pairs parent-teen skills training with motivational interviewing. The trial included 128 adolescents with ADHD, aged 11 to 15, in a large, ethnically diverse eastern U.S. city. Most were Hispanic (78.5%). By random assignment, 67 received STAND and 61 received usual care.
Right after treatment, parents reported large gains at home. Teens had fewer problems with organization, time management and planning. Their ADHD symptoms were less severe. Parents used home privileges as rewards more often. Parenting stress dropped by a medium amount. Smaller gains showed up for behavior problems at home, parent-teen contracts and writing down homework at school.
Six months later, the gains in organization, ADHD symptoms and parenting stress held up. The other gains did not last. Teachers and teens reported no clear change, and grades did not improve by a reliable amount. Most families (85.1%) finished all sessions.
The study had limits. The teens were 11 to 15, so results may not apply to older teens. Most parents held bachelor's degrees. Clinicians were mostly supervised trainees with small caseloads. There was no attention control group. The groups differed in ADHD type and IQ. The sample was too small to detect smaller effects.
The authors suggest STAND worked in the short term at home for these adolescents, with some effects lasting six months and limited change at school, and they note more work is needed on long-term effects.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Sibley, 2016: organization, time-management and planning problems at home, right after treatment, d=1.12.
- Sibley, 2016: ADHD symptom severity at home, right after treatment, d=.81.
- Sibley, 2016: parent use of home privileges as rewards, right after treatment, d=1.07.
- Sibley, 2016: parenting stress, right after treatment, d=.60.
- Sibley, 2016: behavior problems at home, right after treatment, d=.40.
- Sibley, 2016: parent-teen contracting, right after treatment, d=.49.
- Sibley, 2016: recording daily homework at school, right after treatment, d=.45.
- Sibley, 2016: grade point average, right after treatment (not significant), d=.33.
- Sibley, 2016: organization, time-management and planning problems at home, six months later, d=1.01.
- Sibley, 2016: ADHD symptoms at home, six months later, d=.63.
- Sibley, 2016: parenting stress, six months later, d=.52.
- Sibley, 2016: smallest effect the sample could reliably detect, d=.40.
What the terms mean:
- d is a measure of how big the difference between the two groups was. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
Source: Margaret H. Sibley, Paulo A. Graziano, Aparajita B. Kuriyan, et al.. Parent–teen behavior therapy + motivational interviewing for adolescents with ADHD.. Journal of Consulting and Clinical Psychology (2016). doi:10.1037/ccp0000106