One year follow-up of participants in a randomised controlled trial of a CBT-based group therapy programme for adolescents diagnosed with ADHD

Abstract

Background

Adolescents with ADHD often struggle on many areas of their lives and have a high risk of adverse outcomes and negative life trajectories. Multimodal treatment including psychosocial interventions is recommended but evidence regarding effect of such interventions is still limited.

Materials and methods

This study was a follow-up study of adolescents participating in a randomised controlled trial (RCT) of a group intervention based on cognitive behavioural therapy (CBT). Participants were adolescents diagnosed with ADHD and still impaired by their symptoms after standard treatment including psychoeducation and medication. All participants were interviewed by telephone one year after inclusion, and outcome measures included both quantitative and qualitative measures.

Results

There were 100 adolescents included in the study. We found no significant differences between treatment and control group on measures of ADHD-symptoms, self-efficacy, overall problems, global psychosocial functioning, or symptom severity at one-year follow-up. Still, participants in the intervention group reported on positive gains and that they learned a lot about ADHD and themselves.

Conclusions

The intervention delivered in this trial failed to show a treatment effect on symptom level when added to standard care. Participants did however report on positive gains and felt they learned a lot. More research is needed to explore how the programme and delivery of treatment might be improved, and which patients might benefit the most from this type of interventions.

Keywords:

• ADHD
• CBT
• adolescence
• group therapy

Acknowledgements

The authors wish to thank the adolescents and families participating in the study.

Disclosure statement

AMS has received travel support and congress fee from MEDICE in the last 3 years. PHT has received speaker’s fee from MEDICE and Takeda in the last 3 years. SY has received honoraria for consultation and/or educational talks in the last 5 years from Takeda and MEDICE. She is the author of ‘ADHD Child Evaluation (ACE) and ACE+ (for adults), and lead author of ‘R&R2 for ADHD Youths and Adults’. TSN has received travel support from MEDICE in the last 3 years. ACA and SL report no conflicts of interest.

Additional information

Funding

The first author received a PhD grant from the Central Norway Regional Health Authority in 2018. The trial received additional funding from the St. Olav’s University Hospital; Norwegian University of Science and Technology (NTNU); Regional Network for Autism, ADHD, and Tourette syndrome, Mid-Norway Health Trust; The National Research Network for ADHD, Ullevål University Hospital and Johanne and Einar Eilertsens research foundation.

Notes on contributors

Ann Christin Andersen

Ann Christin Andersen, MD, PhD, is a Child and Adolescent Psychiatrist. She is a trained cognitive behavioral therapist and supervisor. Main research interests include neurodevelopmental disorders and psychosocial treatment of mental health problems in adolescence.

Anne Mari Sund

Anne Mari Sund, MD, PhD, is a Child and Adolescent Psychiatrist and Professor Emeritus. Her research interests are spanning from large epidemiological studies to preventive and clinical studies. She is also a CBT therapist and certified CBT Supervisor.

Per Hove Thomsen

Per Hove Thomsen, MD, PhD, is a Consultant Child and Adolescent Psychiatrist and appointed Professor and head of the research unit. His main research areas are OCD, ADHD, eating disorders and autism.

Stian Lydersen

Stian Lydersen, PhD, is professor of medical statistics. He is one of the authors of the books “Medical Statistics in Clinical and Epidemiological Research” (2012) and “Statistical Analysis of Contingency Tables” (2017).

Susan Young

Susan Young, BSc (Hons), DClinPsy, PhD, CSi, AFBPS is a clinical and forensic psychologist, and a practitioner neuropsychologist. She is the director of Psychology Services Limited and an Honorary Professor.

Torunn Stene Nøvik

Torunn Stene Nøvik, MD, PhD, is a Consultant Child and Adolescent Psychiatrist and Associate Professor Emeritus. Her current clinical and research interests include the assessment and treatment of children and adolescents with mood disorders and neurodevelopmental disorders.