Department of Applied Psychology, Steinhardt School of Culture, Education and Human Development, New York University, 246 Greene Street, Room 702, New York, NY, 10003, USA.
SFI-The Danish National Centre for Social Research, Herluf Trollesgade 11, DK-1052, Copenhagen, Denmark.
J Abnorm Child Psychol. 2018 Apr;46(3):505-517. doi: 10.1007/s10802-017-0310-9.
Limited access to evidence-based behavioral parent training (BPT) for addressing attention deficit/hyperactivity disorder (ADHD) has been a growing concern internationally. Models to improve access to BPT are needed, particularly those that can be readily implemented in community settings and that leverage the potential workforce to increase capacity to deliver BPT. The purpose of this study was to evaluate a BPT model which included oft-used content, methods, processes of BPT (common-elements), non-professionally delivered (task-shifted/shared) BPT intervention, and an efficient ancillary support system (training, fidelity, and supervision methods) for families of youth with parental concerns about ADHD. In a randomized controlled trial of 161 families of children (79% male; mean age 7.04 [1.55]), the Caring in Chaos (CiC) BPT model, delivered by community volunteers across 12 community-based sites in Denmark, was compared to a wait-list control condition on key child and parent outcomes at immediate post-treatment and 4-month follow-up assessment points. Results suggested that the CiC model led to significantly greater improvement in parenting behavior, parenting sense of competence, child functional impairment, parental stress and parental depressive symptoms compared to the wait list condition at immediate post-treatment, with maintenance of gains in most of these areas at follow-up assessment. No effect of intervention was found on ADHD symptoms. The results of this study suggest that developing efficient BPT intervention models, such as the CiC model, can result in readily implemented interventions by a variety of individuals in community settings. Such models are necessary to bend the curve on addressing unmet needs of families of youth with concerns about ADHD.
国际上越来越关注获取基于证据的行为家长培训（BPT）来解决注意力缺陷/多动障碍（ADHD）的机会有限。需要建立改善 BPT 机会的模式，特别是那些可以在社区环境中轻松实施并利用潜在劳动力来提高提供 BPT 能力的模式。本研究的目的是评估一种 BPT 模式，该模式包括 BPT 常用的内容、方法和过程（共同要素）、非专业提供（任务转移/共享）的 BPT 干预措施，以及针对有 ADHD 父母担忧的青少年家庭的高效辅助支持系统（培训、保真度和监督方法）。在一项针对 161 个有儿童家庭（79%为男性；平均年龄为 7.04[1.55]）的随机对照试验中，丹麦 12 个社区基地的社区志愿者实施了 Caring in Chaos（CiC）BPT 模式，与等待名单对照组相比，在即时治疗后和 4 个月随访评估点的关键儿童和家长结果上，CiC 模式显著提高了父母养育行为、父母效能感、儿童功能障碍、父母压力和父母抑郁症状，与等待名单组相比，在随访评估时大多数这些领域的收益都得到了维持。干预对 ADHD 症状没有影响。本研究结果表明，开发高效的 BPT 干预模式，如 CiC 模式，可以使各种社区环境中的个人轻松实施干预措施。这种模式对于解决有 ADHD 担忧的青少年家庭的未满足需求至关重要。
