This trial compared STAND with usual care for teens with ADHD, then followed them for about three years. STAND is a parent and teen behavior therapy blended with motivational interviewing. It was given as 10 weekly sessions. Each session lasted 60 minutes. The trial randomized 278 adolescents aged 11 to 17 at four US community agencies. The authors describe the group as mostly Latinx and mostly on Medicaid, state-subsidized insurance or free care. Most of the original group took part in the follow-up (81.3%).
Across everyone, STAND made no difference to ADHD symptoms at three years. Nor did it change whether ADHD persisted, medication use, other treatment use or school enrollment. An early advantage on medication use had faded. Many still met ADHD criteria (about 45%). Most were still enrolled in school (90.3%).
A secondary analysis looked only at teens who started treatment. Few therapists were licensed (22.0%). When licensed therapists delivered STAND, parents reported fewer hyperactive and impulsive behaviors than with usual care. Parents also reported better organization, time management and planning skills. Teens reported less conflict with their parents. These gains were small to medium. Inattention and parent-reported conflict showed no difference between groups.
Some teens never started care, with 19.1% dropping out before the first session. Teacher ratings were not collected at follow-up. The authors note it is unclear how the results apply to middle-class White teens.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Sibley, 2025: average time from the start of the trial to follow-up, 2.99 years (SD = 0.99).
- Sibley, 2025: parent-rated hyperactivity and impulsivity, licensed STAND versus licensed usual care, d = 0.39 (small effect).
- Sibley, 2025: parent-rated hyperactivity and impulsivity, licensed STAND versus unlicensed STAND, d = 0.36 (small effect).
- Sibley, 2025: teen-reported parent and teen conflict, licensed STAND versus licensed usual care, d = 0.27 (small effect).
- Sibley, 2025: teen-reported parent and teen conflict, licensed STAND versus unlicensed STAND, d = 0.12 (negligible effect).
- Sibley, 2025: parent-rated organization, time management and planning skills, licensed STAND versus licensed usual care, d = 0.79 (medium effect).
- Sibley, 2025: parent-rated organization, time management and planning skills, licensed STAND versus unlicensed STAND, d = 0.42 (small effect).
- Sibley, 2025: the authors' summary of the size of the lasting gains, d = 0.27 to 0.79. What the terms mean:
- d shows how big the difference between 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.
- SD (standard deviation) shows how spread out the values were around the average.
Source: Sibley M, Graziano P, Coxe S, et al.. Three-Year Effects of Motivational Interviewing–Enhanced Behavior Therapy for Adolescents With Attention-Deficit/Hyperactivity Disorder: A Randomized Community-Based Trial. Journal of the American Academy of Child & Adolescent Psychiatry (2025). doi:10.1016/j.jaac.2024.10.009