Telephone-Assisted Self-Help for Caregivers of Adolescents with Attention-Deficit/Hyperactivity Disorder: An Observational Proof-of-Concept Study

Abstract

Studies on the treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescence indicate small to moderate treatment effects (e.g., of parent training). Self-help interventions might overcome structural and personal barriers to treatment utilization. The present proof-of-concept study examined the feasibility and effectiveness of a twelve-month, telephone-assisted self-help (TASH) intervention for caregivers of adolescents with ADHD. This intervention comprised 8 booklets on the management of ADHD-related problems and 14 telephone counseling sessions. Sixty-six caregivers participated in the study with a one-group pretest-posttest design (intention-to-treat sample). Of these, forty-three families completed the intervention in accordance with the study protocol (per-protocol sample). Compared to families with early discontinuation (n = 23, drop-out sample), adolescents in the per-protocol sample demonstrated a higher level of caregiver-rated emotional problems and a lower level of quality of life at pre-assessment. Caregivers in the per-protocol sample showed high adherence and reported high satisfaction with the intervention. Analyses of the per-protocol sample yielded significant, moderate to large pre-to-post improvements in caregiver-rated ADHD symptoms (primary outcome; d = 0.81, 95% confidence interval [0.51, 1.11]), oppositional, emotional and behavioral problems and quality of life of the adolescents, and caregiver self-efficacy during the intervention. In intention-to-treat analyses, which considered data of all 66 participants who had originally participated in the study, the pre-post differences in ADHD symptoms, emotional and behavioral problems, and quality of life remained at their significant level. These results provide initial support for the feasibility and effectiveness of the TASH intervention. Its efficacy compared to control conditions remains to be examined.