ADHD Treatment at home through E-health? A Non-inferiority pilot trial and Examination of costs and consumer satisfaction of blended versus face to face parent training for children with ADHD and behavioral problems

Parent training is a well-established intervention for children with ADHD and behavior problems. Due to the growing need to enhance the cost-effectiveness of treatments in mental health care, a blended parent training program has been developed, providing parent training partially online and partially face-to-face. The blended program aims to reduce costs by diminishing therapist time and to enhance the availability, accessibility, and user-friendliness of the intervention, without reducing its effectiveness. The current pilot study will explore (1) whether the effect of blended parent training is noninferior to the effect of face to face parent training in children with ADHD and behavioral problems, (2) whether therapist time can be reduced by offering the intervention partially online, (3) whether parents are satisfied with the blended parent training program, and (4) the opinion of parents regarding the feasibility of the blended program. We will conduct a randomized controlled trial, with two conditions: (1) individual face to face parent training (n=10), and (2) individual blended parent training (n=10).

Our primary outcome will be the severity of parent reported behavior problems, as measured with the Externalizing scale of the Child Behavior Checklist (CBCL). Secondary outcome measures include parental satisfaction with the training, parenting competence and stress, the amount of therapist time, and children’s comorbid problems.

Children with attention–deficit/hyperactivity disorder (ADHD) often show behavior problems (e.g., temper tantrums, disobedience, aggressive behaviors) that can severely influence their daily life and development. Parent training is a well-established intervention for children with ADHD and behavior problems; its effectiveness has been shown particularly with respect to the reduction of behavioral problems. Due to the growing need to enhance the cost-effectiveness of treatments in mental health care, a blended parent training program has been developed, providing parent training partially online and partially face-to-face. The blended program aims to reduce costs by diminishing therapist time and to enhance the availability, accessibility, and user-friendliness of the intervention, without reducing its effectiveness.

Objective: The current pilot study will explore (1) whether the effect of blended parent training is noninferior to the effect of face to face parent training, (2) whether therapist time can be reduced by offering the intervention partially online, (3) whether parents are satisfied with the blended parent training program, and (4) the opinion of parents regarding the feasibility of the blended program.

There are two time-points: assessments will take place before randomization and immediately after the BPTG.

Face to face parent training consists of 10-17 manualized face to face contacts with homework to practice learned skills.

In the blended parent training, parents participate in a training with the same content, but delivered largely online, with an additional minimum of four face to face contacts. The duration of both treatments is approximately twenty weeks.