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Parent training tailored for parents with ADHD: a randomized controlled trial

Therese Lindström^1,2, Sofia Buddgård³, Lena Westholm^3,4

¹Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet and Region Stockholm, Stockholm, Sweden. therese.lindstrom@ki.se.

|August 26, 2025

Abstract

Background:

Parents who themselves have Attention-Deficit/Hyperactivity Disorder (ADHD) tend to benefit less from conventional parent training (PT) interventions than parents without ADHD, reporting suboptimal effects on both parenting-related outcomes and child externalizing or oppositional behaviors. Therefore, we examined the efficacy of a PT protocol tailored to adults with ADHD called Improving Parenting Skills Adult ADHD (IPSA), using a randomized controlled trial design.

Methods:

N = 109 self-referred parents with ADHD who had a child with or without ADHD aged 3 to 11 years were randomized to receive IPSA in addition to their routine services (n = 55) or to a comparison group continuing their routine services only (n = 54). Parent-reports of parental self-efficacy (primary outcome), parental stress, home chaos, and externalizing child behaviors (secondary outcomes) were collected pre and post IPSA, as well as at follow-up one and a half to three months later. The primary analyses were conducted according to the intention-to-treat principle, using linear mixed-effects models.

Results:

There was a larger pre-to-post increase in parental self-efficacy following IPSA compared to routine services only (Cohen's d = 0.85, p < .001), which remained at follow-up (d = 0.84, p < .001). In addition, we observed a pattern of pre-to-post change in the expected direction across the study's secondary outcomes (post intervention d = -0.39 to -0.71), including reductions in parental ratings of child externalizing behaviors. Forty-seven (96%) of the 49 parents who started IPSA completed the program, without signs of unintended harm.

Conclusions:

The IPSA PT program effectively and safely supported parents with ADHD in improving their parental self-efficacy. However, the long-term stability of the program's effect requires further investigation, as does its effectiveness in a regular health care or social services context.

Trial Registration:

The study was retrospectively registered during data collection, before analyses (clinicaltrials.gov, ID NCT06040996, 28/08/2023).

Keywords:

ADHD adaptation Externalizing behaviors Parent training intervention Parental ADHD Parenting intervention efficacy

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