Skip to main content

Advertisement

Log in

“If he doesn’t buy in, it’s a waste of time”: Perspectives from diverse parents and adolescents on engaging children in ADHD treatment

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

Engaging children and adolescents in ADHD care is critical for future independent disease management. However, there is a lack of evidence guiding health professionals and parents on how best to engage their children and adolescents in ADHD care. We recruited 41 diverse parents of children and adolescents with ADHD and 11 adolescents with ADHD from an urban, safety-net hospital to participate in in-depth, semi-structured qualitative interviews and then analyzed this data using thematic analysis. Children’s level of illness insight about ADHD and self-esteem emerged as two major contributors to engagement of children and adolescents in ADHD care, and their intersection created four styles of engagement: proactive (high insight, high self-esteem), anxious (high insight, low self-esteem), apathetic (low insight, high self-esteem), and resistant (low insight, low self-esteem). This framework can help health professionals engage children and adolescents in care for ADHD and guide development of interventions to improve engagement in care.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Alegría, M., Carson, N., Flores, M., Li, X., Shi, P., Lessios, A. S., Polo, A., Allen, M., Fierro, M., Interian, A., Jimenez, A., La Roche, M., Lee, C., Lewis-Fernández, R., Livas-Stein, G., Safar, L., Schuman, C., Storey, J., & Shrout, P. E. (2014). Activation, Self-management, Engagement, and Retention in Behavioral Health Care: A Randomized Clinical Trial of the DECIDE Intervention. JAMA Psychiatry, 71(5), 557–565. https://doi.org/10.1001/jamapsychiatry.2013.4519

  • Barber, B. K., Stolz, H. E., Olsen, J. A., Collins, W. A., & Burchinal, M. (2005). Parental Support, Psychological Control, and Behavioral Control: Assessing Relevance across Time, Culture, and Method. Monographs of the Society for Research in Child Development, 70(4), i–147.

  • Barnert, E., Kelly, M., Godoy, S., Abrams, L. S., & Bath, E. (2020). Behavioral health treatment “Buy-in” among adolescent females with histories of commercial sexual exploitation. Child Abuse & Neglect, 100, 104042. https://doi.org/10.1016/j.chiabu.2019.104042

  • Bench, R. C. (2019). A literature review evaluating parental tendencies in prior adolescent substance users. Children and Youth Services Review, 100, 480–484. https://doi.org/10.1016/j.childyouth.2019.01.021

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

  • Carter, N., Bryant-Lukosius, D., DiCenso, A., Blythe, J., & Neville, A. J. (2014). The Use of Triangulation in Qualitative Research. Oncology Nursing Forum, 41(5), 545–547. https://doi.org/10.1188/14.ONF.545-547

  • Corbin, J., & Strauss, A. (1990). Grounded theory research: Procedures, canons, and evaluative criteria. Qualitative Sociology, 13(1), 19.

  • Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, S. J. (2018). Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199–212. https://doi.org/10.1080/15374416.2017.1417860

  • Enns, J. E., Randall, J. R., Smith, M., Chateau, D., Taylor, C., Brownell, M., Bolton, J. M., Burland, E., Katz, A., Katz, L. Y., & Nickel, N. C. (2017). A Multimodal Intervention for Children with ADHD Reduces Inequity in Health and Education Outcomes. The Canadian Journal of Psychiatry, 62(6), 403–412. https://doi.org/10.1177/0706743717692301

  • Esping-Andersen, G. (2009). Incomplete Revolution: Adapting Welfare States to Women’s New Roles. Polity Press.

  • Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, A. R. (2018). Evidence-Based Psychosocial Treatments for Children and Adolescents With Attention Deficit/Hyperactivity Disorder. Journal of Clinical Child & Adolescent Psychology, 47(2), 157–198. https://doi.org/10.1080/15374416.2017.1390757

  • Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J. S., Tannock, R., & Franke, B. (2015). Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 1(1), Article 1. https://doi.org/10.1038/nrdp.2015.20

  • Gopalan, G., Goldstein, L., Klingenstein, K., Sicher, C., Blake, C., & McKay, M. M. (2010). Engaging Families into Child Mental Health Treatment: Updates and Special Considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(3), 182–196.

  • Grolnick, W. S., Ryan, R. M., & Deci, E. L. (1991). Inner resources for school achievement: Motivational mediators of children’s perceptions of their parents. Journal of Educational Psychology, 83(4), 508–517. http://dx.doi.org.proxy.cc.uic.edu/10.1037/0022-0663.83.4.508

  • Heary, C., Hennessy, E., Swords, L., & Corrigan, P. (2017). Stigma towards Mental Health Problems during Childhood and Adolescence: Theory, Research and Intervention Approaches. Journal of Child and Family Studies, 26(11), 2949–2959. https://doi.org/10.1007/s10826-017-0829-y

  • McWilliam, C. L. (2009). Patients, persons or partners? Involving those with chronic disease in their care. Chronic Illness, 5(4), 277–292. https://doi.org/10.1177/1742395309349315

  • 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: The Journal of the Association of European Psychiatrists, 26(3), 166–175. https://doi.org/10.1016/j.eurpsy.2010.10.005

  • Nigg, J. T. (2013). Attention-deficit/hyperactivity disorder and adverse health outcomes. Clinical Psychology Review, 33(2), 215–228. https://doi.org/10.1016/j.cpr.2012.11.005

  • NVivo 12 (Version 12). (2018). [Computer software]. QSR International. https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/support-services/nvivo-downloads

  • O’Donnell, E. H., Moreau, M., Cardemil, E. V., & Pollastri, A. (2010). Interparental Conflict, Parenting, and Childhood Depression in a Diverse Urban Population: The Role of General Cognitive Style. Journal of Youth and Adolescence, 39(1), 12–22. http://dx.doi.org/10.1007/s10964-008-9357-9

  • O’Donohue, W., Snipes, C., & James, L. (2017). Treatment Engagement: An Introduction. In W. O’Donohue, L. James, & C. Snipes (Eds.), Practical Strategies and Tools to Promote Treatment Engagement (pp. 3–8). Springer International Publishing. https://doi.org/10.1007/978-3-319-49206-3_1

  • Sibley, M. H., Link, K., Torres Antunez, G., & Greenwood, L. (2022). Engagement Barriers to Behavior Therapy for Adolescent ADHD. Journal of Clinical Child & Adolescent Psychology, 1–16. https://doi.org/10.1080/15374416.2022.2025597

  • Spencer, A. E., Sikov, J., Loubeau, J. K., Zolli, N., Baul, T., Rabin, M., Hasan, S., Rosen, K., Buonocore, O., Lejeune, J., Dayal, R., Fortuna, L., Borba, C., & Silverstein, M. (2021). Six Stages of Engagement in ADHD Treatment Described by Diverse, Urban Parents. Pediatrics, 148(4), e2021051261. https://doi.org/10.1542/peds.2021-051261

  • Swift, K. D., Hall, C. L., Marimuttu, V., Redstone, L., Sayal, K., & Hollis, C. (2013). Transition to adult mental health services for young people with Attention Deficit/Hyperactivity Disorder (ADHD): A qualitative analysis of their experiences. BMC Psychiatry, 13(1), 74. https://doi.org/10.1186/1471-244X-13-74

  • Thomas, K. C., Stein, G. L., Williams, C. S., Jolles, M. P., Sleath, B. L., Martinez, M., García, S. J., Guzman, L. E., Williams, C. E., & Morrissey, J. P. (2017). Fostering Activation Among Latino Parents of Children With Mental Health Needs: An RCT. Psychiatric Services, 68(10), 1068–1075. https://doi.org/10.1176/appi.ps.201600366

  • Walker-Noack, L., Corkum, P., Elik, N., & Fearon, I. (2013). Youth Perceptions of Attention-Deficit/Hyperactivity Disorder and Barriers to Treatment. Canadian Journal of School Psychology, 28(2), 193–218. https://doi.org/10.1177/0829573513491232

  • Ying, L., Zhou, H., Yu, S., Chen, C., Jia, X., Wang, Y., & Lin, C. (2018). Parent–child communication and self-esteem mediate the relationship between interparental conflict and children’s depressive symptoms. Child: Care, Health and Development, 44(6), 908–915. https://doi.org/10.1111/cch.12610

Download references

Funding

No honorarium, grant, or other forms of payment were given to anyone to produce this manuscript. The sponsors who provided the funding necessary to complete this research, the Gordon and Betty Moore Foundation (Grant #: 5300) and the National Institute of Mental Health (Grant #: K23 MH118478), had no involvement in study design, data collection, data analysis or interpretation, preparation of, or decision to submit this manuscript.

Author information

Authors and Affiliations

Authors

Contributions

A.S., J.S., and K.L. obtained funding and outlined the protocols for this project. A.S., N.Z., J.S., K.L., S.H., K.R., O.B., and M.R. participated in the recruitment of subjects and collection of data. A.S., N.Z., J.S., and K.L., in collaboration with the research team, conducted the qualitative analysis. N.Z. wrote the main manuscript text and prepared the figure. T.B. ensured a rigorous analytic process using her expertise in research methods; ran all quantitative analyses for the project; and prepared the tables. A.D., L.F., C.B., and M.S. all periodically reviewed and provided their expertise throughout the process of crafting this report. All authors reviewed the manuscript.

Corresponding author

Correspondence to Andrea E. Spencer.

Ethics declarations

Conflict of interest

The authors have no competing interests as defined by Springer, or other interests that might be perceived to influence the results and/or discussion reported in this paper.

Additional information

Publisher’s Note

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

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zolli, N., Loubeau, J.K., Sikov, J. et al. “If he doesn’t buy in, it’s a waste of time”: Perspectives from diverse parents and adolescents on engaging children in ADHD treatment. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01473-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10578-022-01473-x

Keywords

Navigation