(PS14-78) Pilot Study of an Act-enhanced PMT Program for ADHD: Preliminary Caregiver Outcomes Data

Parent management training (PMT) is an empirically supported treatment with well-documented positive effects on reducing problem behaviors in children with disruptive behaviors, including attention-deficit/hyperactivity disorder (ADHD; Evans et al., 2014). Despite PMT’s strong efficacy, caregiver’s lack of engagement can hinder treatment gains. It is estimated that 50% of families terminate treatment prematurely which may contribute to poor outcomes (Chacko et al., 2016). Furthermore, the chronicity of ADHD may leave parents vulnerable to persistent emotional distress and ineffective parenting practices which, in turn, can result in maintenance of problem behaviors (Burke et al., 2008). Acceptance and Commitment Therapy (ACT) is a third-wave behavioral intervention that emphasizes accepting unwanted or unchangeable experiences, which may be particularly well-suited for families of children with ADHD (Hayes et al., 2012). In the parenting context, ACT could promote acceptance of the on-going difficulties of managing ADHD symptoms, increase engagement in examination of parenting values, reduce parenting stress, and increase implementation of effective parenting strategies. The current pilot study examined preliminary parent outcomes of an adapted PMT program for families of children with ADHD in a single-case experimental design. The intervention was modified to include an ACT theoretical foundation and was delivered via a telehealth platform. The final sample included five families (six caregivers) of children ages 7-12 diagnosed with ADHD as a primary disorder. Time series data were collected using a daily diary via automated survey to provide preliminary information regarding changes in parenting stress, parenting strategy implementation, and experiential acceptance across baseline and treatment phases. Sequencing of these three variables was also examined utilizing cross-correlational analyses to identify a potential mechanism of change. Results indicated a reduction in parenting stress and an increase in strategy implementation. Conversely, there was no support for experiential acceptance as a potential mediator of change in parenting stress or strategy implementation. Nonetheless, these findings contributed to emerging literature supporting ACT-based PMT for reducing stress and increasing utilization of PMT skills for caregivers of children with ADHD. Additionally, these findings serve as an initial first step in mechanism of change studies that are lacking in the ACT parenting literature.