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Smit, Sophie Christina

University of British Columbia

Many parents of children with attention-deficit/hyperactivity disorder (ADHD) have their own ADHD or depressive symptoms. Literature suggests that parent mental health concerns may hinder the efficacy of treatments that target parents to improve child ADHD symptoms and impairments. These parent-focused approaches typically provide psychoeducation about ADHD and/or teach specific parenting strategies. The focus of this dissertation was to better understand how parent mental health may impact parent engagement in treatment (parent participation in and connection with treatment) and treatment outcomes. This dissertation examines Parental Friendship Coaching, a behavioural parent training program that teaches parenting strategies and skills to support child friendships. In Study 1, I conducted a secondary data analysis of a completed randomized clinical trial of this program relative to a parent psychoeducation program, with 172 families of children with ADHD. I examined whether parent ADHD or depressive symptoms were associated with parent engagement and outcomes, and tested engagement as a mediator between mental health and outcomes. Although no evidence for mediation was found, findings suggested that parent ADHD, depression, and engagement are associated with treatment outcomes in both the behavioural parent training and the psychoeducation programs. In Study 2, I modified the Parental Friendship Coaching program and piloted it with 33 parents with mental health concerns who had a child with elevated symptoms of ADHD. The modifications were meant to enhance parent engagement in treatment. The program was compared to a waitlist condition. Parents had good participation (attendance, home practice completion) and they felt connected to the program (therapeutic alliance, enjoyment, social support). After completing the program, parents self-reported feeling more competent in their parenting and there was some indication that they also perceived an increase in their positive parenting behaviours. However, reports from a co-parent and the child did not suggest improvements in parenting behaviour. This dissertation is an important addition to the literature examining parent mental health, parent engagement in treatment, and treatment outcomes, among families of children with ADHD. It emphasizes that in addition to promoting treatment outcomes, programs and research would benefit from careful consideration of how to improve the treatment experience for families.

Text

2024-08-12

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88924

Psychology

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/