Telehealth Delivery of the RELAX Intervention for Families of Adolescents Diagnosed with ADHD: Preliminary Treatment Outcomes and Evidence of Acceptability and Feasibility

ABSTRACT

Regulating Emotions Like An eXpert (RELAX) is a group-based intervention that targets emotion dysregulation (ED) and interpersonal conflict among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). This study is a preliminary evaluation of the feasibility, acceptability, and efficacy of RELAX across in-person and telehealth groups, examining differences in treatment outcomes and feedback based on format. Participants included 32 families (18 in-person, 14 telehealth) with adolescents diagnosed with ADHD, ages 11–16. Caregiver-, clinician- and adolescent-report of adolescent ED, adolescent communication, and caregiver-adolescent/family conflict, as well as caregiver self-report of ED and emotion socialization were collected pre- and post-RELAX; caregivers and adolescents completed a feedback survey post-RELAX. Attendance was higher for telehealth (95% vs. 87%), but homework completion was higher for in-person (85% vs. 70%). Caregiver and adolescent feedback indicated very high rates of satisfaction with RELAX, with no significant differences in caregiver satisfaction and minimal differences in adolescent satisfaction between the in-person and telehealth groups. Large improvements were found for caregiver and clinician ratings of adolescent ED (η² = .18−.48) and family conflict (η² = .26 and .43), moderate decreases in non-supportive emotion socialization were found (η² = .11), and small improvements were found for caregiver ED (η² = .03). Treatment outcomes were similar for in-person and telehealth groups, with some evidence for larger improvement of adolescent ED for telehealth, whereas larger improvement in family conflict emerged for in-person. RELAX was successfully adapted to be administered via telehealth with similar feasibility, acceptability, and efficacy to the in-person intervention. Efforts to continue disseminating and evaluating ED-focused interventions are warranted and imperative.

Acknowledgments

We would like to thank Katie Behrhorst, Natalie Buchen, Caroline Cusick, Elizabeth DeLucia, Katelyn Garcia, Cathrin Green, Kelly O’Connor, Kelcie Willis, and Sandra Yankah for their help with running the RELAX intervention and focus groups. We would also like to thank the community clinicians who provided feedback to help improve the RELAX intervention, and the families who kindly agreed to participate in this pilot study. Finally, we would like to extend our sincerest gratitude to the Clark-Hill Institute for Positive Youth Development at Virginia Commonwealth University for their financial support for the in-person pilot study and the Virginia Tech, Department of Psychology for their financial support for the telehealth pilot study.

Disclosure statement

The authors of this study, nor any members of their immediate family, have any conflicts of interest to disclose.