Dialectical Behavioral Therapy Skills Training for Adolescents with Attention Deficit Hyperactivity Disorder: A Pilot Study

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a commonly occurring neurodevelopmental disorder associated with impairments in numerous aspects of functioning and quality of life. There is a growing recognition that brief and effective psychosocial interventions are needed for youth with ADHD.

OBJECTIVE: The aim of this study was to assess the feasibility and preliminary effectiveness of a dialectical behavioral therapy-based skills training group for adolescents with ADHD in a routine clinical care setting.

METHODS: Ten adolescents with ADHD/ADD (Attention Deficite Disorder) commenced a 10-week training group including psychoeduction, mindfulness and other self-regulatory skills training. Primary outcomes were pre- to post-treatment changes in guardian-rated ADHD-symptoms and participant-rated quality of life. Secondary outcomes were pre- to post-treatment changes in participant-rated executive functioning, depression, anxiety, and treatment satisfaction, as well as parent/guardian-rated executive functioning. All symptom/functioning scales were administered at pre-treatment, post-treatment, and a 12-week follow-up.

RESULTS: Eight of the ten participants completed treatment, with > 80% attendance for treatment completers and high ratings for treatment satisfaction. Based on the intention-to-treat analyses, there were improvements from pre-treatment to follow-up in primary and secondary outcomes except quality of life. Based on the completer's analyses, there were improvements from pre-treatment to follow-up for guardian rated ADHD symptoms and executive functioning, depression, anxiety, and quality of life. Uncontrolled effect sizes for pre-treatment to 12-week follow-up for treatment completers were medium for inattention, executive functioning, and quality of life, and large for depression and anxiety.

CONCLUSIONS: The present study suggests that the DBT-based skills group training was feasible and, for treatment completers, yielded significant improvements across a range of symptom domains and quality of life assessed at the 12-week follow-up. However, this is only an exploratory finding and could be attributed to natural improvement or regression toward the mean. Therefore, further studies are warranted.