Cognitive behavioural group therapy for adolescents with ADHD: a study of satisfaction and feasibility

Abstract

Background

Adolescents with ADHD are at increased risk of adverse outcomes and a negative life trajectory into adulthood. Evidence regarding treatment specifically tailored for the needs of this age group are still limited. High dropout rates, discontinuation of medication and treatment resistance are common issues in this population, and the patient perspective on new treatment options is therefore important. In this study, we aimed to investigate treatment satisfaction and feasibility of a group CBT program for adolescents with ADHD. We further aimed to identify any baseline characteristics predicting satisfaction.

Materials and methods

This study was part of a larger RCT of group CBT as add-on treatment for adolescents aged 14–18 years (Mean age 15.9 years, SD 1.3) with ADHD in Norway. Satisfaction and feasibility in the treatment group (n = 48) were measured by completion of an evaluation questionnaire, attendance of group sessions and a group-leaders checklist. Predictors of satisfaction were analysed using linear regression.

Results

Overall satisfaction was very high with a significant age effect, the eldest participants being most satisfied. Attendance rate was high with few dropouts and medical adherence during the treatment period was good. Group-leaders generally self-evaluated adherence to treatment manual positively but addressing resistance towards homework as challenging.

Conclusions

The participants were very satisfied with the group CBT treatment. Treatment options that are accepted and well-liked by the targeted population have the potential of reducing resistance towards treatment, improving future health and adherence to medication. The program is considered suitable for a clinical setting and may represent a feasible treatment supplement for adolescent ADHD.

Keywords:

• ADHD
• group therapy
• CBT
• adolescence
• treatment satisfaction

Acknowledgements

The authors wish to thank adolescents and their families for participating in this 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 Shire in the last 3 years. SY has received honoraria for consultation and/or educational talks in the last 5 years from Janssen, HB Pharma and/or Shire. 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 a speaker’s fee from MEDICE in the last 3 years.

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 CAP Clinic, St. Olav’s Hospital; the Regional Competence Centre for Child and Youth Mental Health and Child Welfare (RKBU), Norwegian University of Science and Technology (NTNU); Regional Network for Autism, ADHD, and Tourette syndrome, Mid-Norway Health Trust and The National Research Network for ADHD, Ullevål University Hospital, Oslo.

Notes on contributors

Ann Christin Andersen

Ann Christin Andersen, MD, is a Consultant Child and Adolescent Psychiatrist and a PhD-candidate. She is also a trained CBT therapist and certified CBT supervisor.

Anne Mari Sund

Anne Mari Sund, MD, PhD, is a Child and Adolescent Psychiatrist and Professor. Her research interests are spanning from large epidemiological studies to preventive and clinical RCT 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 is an Honorary Professor in the Department of Psychology at Reykjavik University.

Torunn Stene Nøvik

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