Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study

Abstract

Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and treatment gains are often not maintained. Nonviolent resistance parent training (NVR) focuses on helping parents resist the child's negative behaviors without escalating the problem. NVR helps parents to fulfill an anchoring function, supporting the child through presence, self-regulation, structure, and support network. This study is a randomized controlled trial designed to assess the efficacy of NVR in the treatment of childhood ADHD. Participants were Israeli parents of children with primary ADHD diagnosis (N = 101; 5–13 years old; 79% male participants) randomly assigned to either 12-session NVR (N = 50) or waiting list (N = 51). Measures were administered before and after treatment and at a 4-month follow-up. ADHD outcomes included the Conners and Child Behavior Checklist. Parenting outcomes included parental helplessness, emotional regulation, anchoring function, and family chaos. Participants in the NVR condition reported significant improvements in the child’s internalizing, externalizing, and ADHD symptoms, as well as improvement in paternal and maternal helplessness and anchoring. Participants in the control condition did not report changes in the child’s symptoms or the parents’ condition. The results at follow-up revealed maintenance of change in the child’s externalizing and internalizing symptoms, but failure to maintain gains in ADHD core symptoms. Maternal helplessness and anchoring, as well as family chaos continued to improve at follow-up. Dropout rates in the treatment group were low (5%), and fathers’ engagement was close to 100%. NVR is an efficient treatment for childhood ADHD, with benefits extending beyond the child’s symptoms to the entire family. NVR’s special focus on parental distress may have contributed to low dropout, high paternal engagement, and maintenance of change.

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author, ISS. The data are not publicly available in order not to compromise the privacy of the research participants.

Notes

  1. 1.

    The study was conducted at the ADHD Clinic at the Schneider Children's Medical Center, Petah Tikvah, Israel.

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Correspondence to Irit Schorr-Sapir.

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Schorr-Sapir, I., Gershy, N., Apter, A. et al. Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study. Eur Child Adolesc Psychiatry (2021). https://doi.org/10.1007/s00787-021-01723-8

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Keywords

  • ADHD
  • Parent training
  • Nonviolent resistance
  • Externalizing symptoms
  • Parental helplessness