Treatment effects of combined cognitive behavioral therapy with parent training in hyperkinetic syndrome

In the past cognitive behavioral treatment concepts failed to demonstrate their clinical effectiveness in the treatment of ADHD children. We combined a cognitive treatment package (CBT) with a special focus on self-instructional and self-management skills with a subsequent parent management training (PMT) in order to reduce academic problems and oppositional/aggressive behavior. 18 children with a diagnosis of ADHD combined type and Oppositional Defiant Disorder participated in the study. In an A-B study design the effects of a 12 weeks treatment phase (6 weeks CBT; 6 weeks PMT) were compared with a preceding 4 weeks baseline. Core symptoms of ADHD, conduct and homework problems were assessed by weekly administration of parent and teacher questionnaires. CBT was effective in reducing the core symptoms of ADHD at home, in school and concerning homework problems. Moreover conduct problems at home and in school were reduced. PMT resulted in a further amelioration of the cited symptoms. We conclude that CBT is an important component in the treatment of ADHD provided that aspects of generalization are considered. PMT is a useful adjunct to CBT due to its effectiveness in situations where children still have problems of self guidance.