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Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

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Abstract

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.

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  1. Duke University Medical Center, P.O. Box 3320, Durham, North, Carolina, 2771

    Karen C. Wells, C. Keith Conners & John S. March

  2. State University of New York, Buffalo, New York

    William E. Pelham Jr.

  3. University of California, Irvine, California

    Ronald A. Kotkin & James M. Swanson

  4. Purdue University, Lafayette, Indiana

    Betsy Hoza

  5. New York University Medical Center, New York, New York

    Howard B. Abikoff

  6. Emory University School of Medicine, Atlanta, Georgia

    Ann Abramowitz

  7. Ohio State University, Columbus, Ohio

    L. Eugene Arnold

  8. Duke University Medical Center, Durham, North Carolina

    Rebecca Del Carmen & Euthymia Hibbs

  9. National Institutes of Mental Health, Rockville, Maryland

    Glenn Elliott

  10. University of California, San Francisco, California

    Laurence L. Greenhill & Peter S. Jensen

  11. New York State Psychiatric Institute, Columbia University, New York, New York

    Lily Hechtman

  12. Montreal Children's Hospital, Montreal, Quebec, Canada

    Stephen P. Hinshaw

  13. University of California, Berkeley, California

    Ellen Schiller

Authors
  1. Karen C. Wells
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  2. William E. Pelham Jr.
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  3. Ronald A. Kotkin
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  4. Betsy Hoza
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  5. Howard B. Abikoff
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  6. Ann Abramowitz
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  7. L. Eugene Arnold
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  8. Dennis P. Cantwell
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  9. C. Keith Conners
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  10. Rebecca Del Carmen
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  11. Glenn Elliott
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  12. Laurence L. Greenhill
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  13. Lily Hechtman
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  14. Euthymia Hibbs
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  15. Stephen P. Hinshaw
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  16. Peter S. Jensen
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  17. John S. March
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  18. James M. Swanson
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  19. Ellen Schiller
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Corresponding author

Correspondence to Karen C. Wells.

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Deceased

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Wells, K.C., Pelham, W.E., Kotkin, R.A. et al. Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation. J Abnorm Child Psychol 28, 483–505 (2000). https://doi.org/10.1023/A:1005174913412

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