Skip to main content

Advertisement

SpringerLink
Log in

Psychoeducation Interventions for Parents and Teachers of Children and Adolescents with ADHD: a Systematic Review of the Literature

  • REVIEW ARTICLE
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is the most common neuropsychiatric condition in childhood and adolescence. Psychoeducation has been recommended by different guidelines as an initial treatment for ADHD, however the effects of the intervention for reducing symptoms and improving other outcomes still need to be established. This systematic review investigated the magnitude of impact that psychoeducation interventions have on various outcomes in children with ADHD. A systematic review of articles published between 1990 and 2018 was conducted of treatment outcome studies that investigated the effects of psychoeducation programs on youth with ADHD and their families. The outcomes of included studies consisted of ten constructs related to child and family functioning. Analyses used Hedges’ g formula to calculate individual study and summary effect sizes. Thirteen studies met our criteria. Among the effect sizes that were analyzed, significant findings include moderate to large effects on ADHD symptom improvement as reported by parents and teachers (g = 0. 787), parent/teacher and child knowledge about ADHD (g = 1.037 and g = 0. 721, respectively). Among the outcomes assessing child’s family and social functioning, effect sizes – as reported by parents, teachers, children/adolescents, and clinicians – were moderate to small. A few outcomes, including parenting stress and quality of life, were found to have small to no effects. Overall, this systematic review found the effects of psychoeducation as an intervention led to improvement in ADHD symptoms and behavioral problems, as reported by parents – potentially as a result of parents’ greater knowledge about how ADHD influences their child’s behavior, as well as potentially through an improvement in adherence to treatment following a psychoeducation course. Relatively few studies have looked at treatment adherence as an outcome, and this may be a future direction for researchers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

* = Studies included in the meta-analysis

  • Achenbach, T. M. (2009). The Achenbach system of empirically based assessment (ASEBA): Development, findings, theory, and applications. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

  • Achenbach, T. M., Krukowski, R. A., Dumenci, L., & Ivanova, M. Y. (2005). Assessment of adult psychopathology: Meta-analyses and implications of cross-informant correlations. Psychological Bulletin, 131, 361–382.

    PubMed  Google Scholar 

  • Acri, M., Gopalan, G., Chacko, A., & Mckay, M. (2017). Engaging families into treatment for child behavior disorders: A synthesis of the literature. In J. Lochman & W. Matthys (Eds.), The Wiley handbook for disruptive and impulse-control disorders. New York: Wiley.

    Google Scholar 

  • Adler, L. D., & Nierenberg, A. A. (2010). Review of medication adherence in children and adults with ADHD. Postgraduate Medicine, 122(1), 184–191.

    PubMed  Google Scholar 

  • Allan, C., & Chacko, A. (2018). Adverse events in behavioral parent training: An under-appreciated phenomena. The ADHD Report, 26(1), 4–9.

    Google Scholar 

  • American Academy of Pediatrics (AAP). (2011). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128(5), 1007–1022.

    Google Scholar 

  • American Psychiatric Association. (2013). Attention-deficit/hyperactivity disorder. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Google Scholar 

  • Anderson, C. M., Gerard, E., Hogarty, G. E., & Reiss, D. J. (1980). Family treatment of adult schizophrenic patients: A psycho-educational approach. Schizophrenia Bulletin, 6, 490–505.

    PubMed  Google Scholar 

  • *Bai, G. N., Wang, Y. F., Yang, L., & Niu, W. Y. (2015). Effectiveness of a focused, brief psychoeducation program for parents of ADHD children: Improvement of medication adherence and symptoms. Neuropsychiatric Disease and Treatment, 11, 2721.

  • Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry, 45(2), 192–202.

    PubMed  Google Scholar 

  • Barsevick, A. M., Sweeney, C., Haney, E., & Chung, E. (2002). A systematic qualitative analysis of psychoeducational interventions for depression in patients with cancer. Oncology Nursing Forum, 29(1), 73–86.

    PubMed  Google Scholar 

  • Bäuml, J., Froböse, T., Kraemer, S., Rentrop, M., & Pitschel-Walz, G. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, 32(Suppl 1), S1–S9.

    PubMed  PubMed Central  Google Scholar 

  • Bond, K., & Anderson, I. M. (2015). Psychoeducation for relapse prevention in bipolar disorder: A systematic review of efficacy in randomized controlled trials. Bipolar Disorders, 17(4), 349–362.

    PubMed  Google Scholar 

  • Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2005). CMA: Comprehensive meta-analysis (version 2.0) [computer software]. Englewood, NJ: Biostat.

    Google Scholar 

  • Bussing, R., Gary, F. A., Mason, D. M., Leon, C. E., Sinha, K., & Garvan, C. W. (2003). Child temperament, ADHD, and caregiver strain: Exploring relationships in an epidemiological sample. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 184–192.

    Google Scholar 

  • Canadian Attention Deficit Hyperactivity Disorder Resource Alliance. (2011). Canadian ADHD practice guidelines (3rd ed.). Toronto, Ontario, Canada: Author.

    Google Scholar 

  • Chacko, A., & Scavenius, C. (2018). Bending the curve: A community-based behavioral parent training model to address ADHD-related concerns in the voluntary sector in Denmark. Journal of Abnormal Child Psychology, 46(3), 505–517.

    PubMed  Google Scholar 

  • Chacko, A., Kofler, M., & Jarrett, M. (2014). Improving outcomes for youth with ADHD: A conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical Child and Family Psychology Review, 17(4), 368–384.

    PubMed  PubMed Central  Google Scholar 

  • Chacko, A. K., Feirsen, N., Rajwan, E., Zwilling, A., Pelham, W. E., & Kapalka, G. M. (2015). Attention-deficit hyperactivity disorder. In G. M. Kapalka (Ed.), Treating disruptive disorders (pp. 71–98). New York, NY: Routledge.

    Google Scholar 

  • Chacko, A., Isham, A., Cleek, A. F., & McKay, M. M. (2016a). Using mobile health technology to improve behavioral skill implementation through homework in evidence-based parenting intervention for disruptive behavior disorders in youth: Study protocol for intervention development and evaluation. Pilot and Feasibility Studies, 2(1), 57.

    PubMed  PubMed Central  Google Scholar 

  • Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimiklis, A., Chan, E., Lee, D., & Pulgarin, B. (2016b). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19, 204–215.

    PubMed  Google Scholar 

  • Chacko, A., Wymbs, B. T., Rajwan, E., Wymbs, F., & Feirsen, N. (2017). Characteristics of parents of children with ADHD who never attend, drop out, and complete behavioral parent training. Journal of Child and Family Studies, 26(3), 950–960.

    Google Scholar 

  • Chacko, A., Bedard, A. C., Marks, D., Gopalan, G., Feirsen, N., Uderman, J., et al. (2018a). Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children. Child Neuropsychology, 24(4), 427–450.

    PubMed  Google Scholar 

  • Chacko, A., Fabiano, G. A., Doctoroff, G. L., & Fortson, B. (2018b). Engaging fathers in effective parenting for preschool children using shared book reading: A randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 47(1), 79–93.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Colom, F., & Vieta, E. (2006). Psychoeducation manual for bipolar disorder. New York: Cambridge University Press.

    Google Scholar 

  • Corkum, P., Rimer, P., & Schachar, R. (1999). Parental knowledge of attention-deficit hyperactivity disorder and opinions of treatment options: Impact on enrolment and adherence to a 12-month treatment trial. Canadian Journal of Psychiatry, 44, 1043–1048.

    PubMed  Google Scholar 

  • Cummings, C. M., & Fristad, M. A. (2007). Medications prescribed for children with mood disorders: Effects of a family-based psychoeducation program. Experimental and Clinical Psychopharmacology, 15(6), 555–562.

    PubMed  Google Scholar 

  • Daley, D., van der Oord, S., Ferrin, M., Danckaerts, M., Doepfner, M., Cortese, S., & Sonuga-Barke, E. (2014). Behavioral interventions in attention-deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials across multiple outcome domains. Journal of the American Academy of Child & Adolescent Psychiatry, 53(8), 835–847.

    Google Scholar 

  • *Dopfner, M., Breuer, D., Schurmann, S., Metternich, T. W., Rademacher, C., & Lehmkuhl, G. (2004). Effectiveness of an adaptive multimodal treatment in children with attention-deficit hyperactivity disorder – Global outcome. European Child & Adolescent Psychiatry, 13, 117–129.

  • DuPaul, G. J., & Langberg, J. M. (2015). Educational impairments in children with ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (pp. 169–190). New York, NY: Guilford Press.

    Google Scholar 

  • Durlack, J. A. (2009). How to select, calculate, and interpret effect sizes. Journal of Pediatric Psychology, 34(9), 917–928.

    Google Scholar 

  • Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O'Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder, 29(2), 129–140.

    Google Scholar 

  • *Ferrin, M., Moreno-Granados, J. M., Salcedo-Marin, M. D., Ruiz-Veguilla, M., Perez-Ayala, V., & Taylor, E. (2014). Evaluation of a psychoeducation programme for parents of children and adolescents with ADHD: Immediate and long-term effects using a blind randomized controlled trial. European Child and Adolescent Psychiatry, 23, 637–647.

  • *Ferrin, M., Prez-Ayala, V., El-Abd, S., Lax-Pericall, T., Jacobs, B., Bilbow, A., & Taylor, E. (2016). A randomized controlled trial evaluating the efficacy of a psychoeducation program for families of children and adolescents with ADHD in the United Kingdom: Results after a 6-month follow-up. Journal of Attention Disorders, 1-12.

  • Fristad, M. A. (2006). Psychoeducational treatment for school-aged children with bipolar disorder. Development and Psychopathology, 18(4), 1289–1306.

    PubMed  Google Scholar 

  • Ginsburg, G. S., Albano, A. M., Findling, R. L., Kratochvil, C., & Walkup, J. (2005). Integrating cognitive behavioral therapy and pharmacotherapy in the treatment of adolescent depression. Cognitive and Behavioral Practice, 12(2), 252–262.

    Google Scholar 

  • *Hantson, J., Wang, P. P., Grizenko-Vida, M., Ter-Stepanian, M., Harvey, W., Joober, R., & Grizenko, N. (2012). Effectiveness of a therapeutic summer camp for children with ADHD: Phase I clinical intervention trial. Journal of Attention Disorders, 16 (7), 610–617.

  • Harris, A. D., McGregor, J. C., Perencevich, E. N., Furuno, J. P., Zhu, J., Peterson, D. E., & Finkelstein, J. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Informatics Association : JAMIA, 13(1), 16–23.

    PubMed  Google Scholar 

  • Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. New York: Academic Press.

    Google Scholar 

  • Hoza, B. (2007). Peer functioning in children with ADHD. Journal of Pediatric Psychology, 32(6), 655–663.

    PubMed  Google Scholar 

  • Jensen, P. S. (2000). Current concepts and controversies in the diagnosis and treatment of attention deficit hyperactivity disorder. Current Psychiatry Reports, 2, 102–109.

    PubMed  Google Scholar 

  • Kanne, S. M., Abbacchi, A. M., & Constantino, J. N. (2009). Multi-informant ratings of psychiatric symptom severity in children with autism spectrum disorders: The importance of environmental context. Journal of Autism and Developmental Disorders, 39, 856–864.

    PubMed  PubMed Central  Google Scholar 

  • Kendall, J., Leo, M. C., Perrin, N., & Hatton, D. (2005). Modeling ADHD child and family relationships. Western Journal of Nursing Research, 27(4), 500–518.

    PubMed  Google Scholar 

  • Klaus, N., & Fristad, M. A. (2005). Family Psychoeducation as a valuable adjunctive intervention for children with bipolar disorder. Directions in Psychiatry, 25(3), 217–230.

    Google Scholar 

  • Kooij, S. J. J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugué, M., Carpentier, P. J., et al. (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European network adult ADHD. BMC, 10(67), 1–24.

    Google Scholar 

  • Krain, A. L., Kendall, P. C., & Power, T. J. (2005). The role of treatment acceptability in the initiation of treatment for ADHD. Journal of Attention Disorders, 9(2), 425–434.

    PubMed  Google Scholar 

  • Loe, I. M., & Feldman, H. M. (2007). Academic and educational outcomes of children with ADHD. Journal of Pediatric Psychology, 32(6), 643–654.

    PubMed  Google Scholar 

  • Lopez, M. A., Toprac, M. G., Crismon, M. L., Boemer, C., & Baumgartner, J. (2005). A psychoeducational program for children with ADHD or depression and their families: Results from the CMAP feasibility study. Community Mental Health Journal, 41(1), 51–66.

    PubMed  Google Scholar 

  • *MacKay, L., & Corkum, P. (2006). Evaluation of a demystification workshop for children with ADHD. Journal of Developmental and Physical Disabilities, 18(3), 319–332.

  • *McCleary, L., & Ridley, T. (1999). Parenting adolescents with ADHD: Evaluation of a psychoeducation group. Patient Education and Counseling, 38(1), 3–10.

  • *Miranda, A., Presentación, M. J., & Soriano, M. (2002). Effectiveness of a school-based multicomponent program for the treatment of children with ADHD. Journal of Learning Disabilities, 35(6), 547–563.

  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), 1–6.

    Google Scholar 

  • *Monastra, V. J. (2005). Overcoming the barriers to effective treatment for attention-deficit/hyperactivity disorder: A neuro-educational approach. International Journal of Psychophysiology, 58, 71–80.

    PubMed  Google Scholar 

  • Montoya, A., Colom, F., & Ferrin, M. (2011). Is psychoeducation for parents and teachers of children and adolescents with ADHD efficacious? A systematic literature review. European Psychiatry, 26(3), 166–175.

    PubMed  Google Scholar 

  • *Montoya, A., Hervás, A., Fuentes, J., Cardo, E., Polavieja, P., Quintero, J., & Tannock, R. (2014). Cluster-randomized, controlled 12-month trial to evaluate the effect of a parental psychoeducation program on medication persistence in children with attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 10, 1081.

  • MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086.

    Google Scholar 

  • *Myers, K., Stoep, A. V., Thompson, K., Zhou, C., & Unützer, J. (2010). Collaborative care for the treatment of Hispanic children diagnosed with attention-deficit hyperactivity disorder. General Hospital Psychiatry, 32, 612–614.

  • National Institute for Health and Care Excellence (NICE). (March 2018). Attention deficit hyperactivity disorder: Diagnosis and management. https://www.nice.org.uk/guidance/ng87/chapter/Recommendations# managing-adhd. Accessed February 2019.

  • Öksüz, E., Karaca, S., Özaltın, G., & Ateş, M. A. (2017). The effects of Psychoeducation on the expressed emotion and family functioning of the family members in first-episode schizophrenia. Community Mental Health Journal, 1-10.

  • Oruche, U. M., Robb, S. L., Draucker, C. B., Aalsma, M., Pescosolido, B., Chacko, A., Ofner, S., Bakoyannis, G., & Brown-Podgorski, B. (2018). Pilot randomized trial of a family management efficacy intervention for caregivers of African American adolescents with disruptive behaviors. Child & Youth Care Forum, 47(6), 803–827.

    Google Scholar 

  • Owens, E. B., Cardoos, S. L., & Hinshaw, S. P. (2015). Developmental progression and gender differences among individuals with ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (pp. 223–255). New York, NY: Guilford.

    Google Scholar 

  • Pardini, D. A., & Fite, P. J. (2010). Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: Advancing an evidence base for DSM-V. Journal of the American Academy of Child & Adolescent Psychiatry, 49(11), 1134–1144.

    Google Scholar 

  • Schachar, R. (2009). Attention deficit hyperactivity disorder in children, adolescents, and adults. Continuum, 15, 78–97.

    Google Scholar 

  • *Schoenfelder, E., McCabe, C., Fife, A., Herzig, L., Ahrens, K. (2017). Research brief: The teen ADHD workshop to improve adolescent ADHD treatment engagement. Journal of Attention Disorders https://doi.org/10.1177/1087054716686184, 108705471668618.

  • Skounti, M., Philalithis, A., & Galanakis, E. (2007). Variations in prevalence of attention deficit hyperactivity disorder worldwide. European Journal of Pediatrics, 166(2), 117–123.

    PubMed  Google Scholar 

  • Sonuga-Barke, E. J. S., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., … Sergeant, J. (2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275–289.

    PubMed  Google Scholar 

  • Sterne, J. A., Higgins, J. P., & Reeves, B. C. (2014). A Cochrane risk of bias assessment tool: For non-randomized studies of interventions (ACROBAT-NRSI), version 1.0.0.

  • *Svanborg, P., Thernlund, G., Gustafsson, P. A., Hägglöf, B., Poole, L., & Kadesjö, B. (2009a). Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder. European Child and Adolescent Psychiatry, 18, 240–249.

  • *Svanborg, P., Thernlund, G., Gustafsson, P. A., Hägglöf, B., Schacht, A., & Kadesjö, B. (2009b). Atomoxetine improves patient and family coping in attention deficit/hyperactivity disorder: A randomized, double-blind, placebo-controlled study in Swedish children and adolescents. European Child and Adolescent Psychiatry, 18, 725–735.

  • Taylor, E., Döpfner, M., Sergeant, J., Asherson, P., Banaschewski, T., Buitelaar, J., ... Zuddas, A. (2004). European clinical guidelines for hyperkinetic disorder - First upgrade. European Child and Adolescent Psychiatry, 13(Suppl 1), 17–30.

  • The Cochrane Collaboration. (2011). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). J. P. T. Higgins & S. Green (eds.). http://handbook.cochrane.org. Accessed June 2017.

  • Xiao, W., Chow, K. M., So, W. K., Leung, D. Y., & Chan, C. W. (2016). The effectiveness of Psychoeducational Intervention on Managing Symptom Clusters in Patients With Cancer: A Systematic Review of Randomized Controlled Trials. Cancer Nursing, 39(4), 279–291.

Download references

Acknowledgements

The authors would like to thank Maite Ferrin, PhD for sharing her expertise on psychoeducation-based interventions and for her contributions to, and her assistance in, editing the manuscript.

Author information

Authors and Affiliations

  1. Department of Applied Psychology, FACES Lab, New York University - Steinhardt School of Culture, Education, and Human Development, 246 Greene Street, 8th Floor Kimball Hall, New York, NY, 10003, USA

    Victoria Dahl, Amrita Ramakrishnan, Angela Page Spears, Annlady Jorge, Janice Lu, Nina Abraham Bigio & Anil Chacko

Authors
  1. Victoria Dahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amrita Ramakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angela Page Spears
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Annlady Jorge
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Janice Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nina Abraham Bigio
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anil Chacko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Victoria Dahl.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this study is a systematic review of already completed and published studies, we did not need to seek approval from our university’s institutional review board or seek informed consent from any study subjects.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dahl, V., Ramakrishnan, A., Spears, A.P. et al. Psychoeducation Interventions for Parents and Teachers of Children and Adolescents with ADHD: a Systematic Review of the Literature. J Dev Phys Disabil 32, 257–292 (2020). https://doi.org/10.1007/s10882-019-09691-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10882-019-09691-3

Keywords

Search

Navigation