Family intervention for home-based problems of adolescents with attention-deficit/hyperactivity disorder

Adolescents with ADHD frequently argue with their parents about a variety of issues, especially when they also have Oppositional Defiant Disorder or Conduct Disorder. Family interventions have proven effective for ameliorating such conflicts in two independent investigations. After a comprehensive assessment including family interviews and self-report inventories, the therapist first teaches the parents contingency management techniques and then teaches the parents and adolescent problem solving communication skills. Contingency management techniques include one-on-one time, effective commands, positive incentive systems, and punishment systems. Problem solving involves discussing a specific dispute by defining the problem, generating a list of solutions, evaluating the solutions, and reaching a compromise. Communication training involves identifying specific negative communication skills and replacing them with positive communication skills. This article reviews research and provides practitioners with specific guidelines for implementing these family interventions.