Background: Attention-Deficit/Hyperactivity Disorder (ADHD) exists in 20 to 50 percent of the 3 million adolescents annually enrolled in outpatient counseling services. Adolescents with ADHD have problems with attention, self-regulation, and social competence that affect school performance and general development. Currently, there are only two proven treatment options for this age group: academic training and stimulant medications. Unfortunately, most adolescents with ADHD do not receive either treatment.
Objective: The primary objective is to compare the effectiveness, in outpatient behavioral services, of academic interventions only versus integrated (academic plus medication) interventions for adolescents with ADHD. The study will compare the effects of these two treatment options on counseling attendance, medication use, behavioral problems, and quality of life.
Methods: This study will randomly assign 140 primarily Hispanic and African- American adolescents with ADHD to academic-only or integrated treatment in community mental health clinics. Half of the study participants will have substance use problems as well as ADHD. Parents and adolescents will complete research interviews at the beginning of the study and then 3, 6, and 12 months later.
Patient Outcomes: Statistical analyses will test for effects on treatment attendance, decrease in behavior problems, and improvement in quality of life that are primary reasons for seeking counseling. Post-treatment interviews will ask families about their decisions regarding starting medication and their suggestions for improving services. Note that families will retain the option of starting ADHD medication if they choose, and no family will be required to start medication at any time.
Patient and Stakeholder Engagement: To guide the study, we will regularly consult researchers, youth, family advocates (including school officials), therapists and supervisors from counseling centers, and families who have an adolescent with ADHD.
Anticipated Impact: If proven efficacious, the academic-only and integrated treatment protocols could be rapidly shared with therapists, treatment programs, and school mental health counselors. With minimal additional training, clinicians working with adolescents in all kinds of settings could use the protocols to treat ADHD and related problems.
Other Clinical Interventions
Other Health Services Interventions
Shared Decision Making
Training and Education Interventions