Videoconference-based cognitive behavioral therapy for children and adolescents with attention-deficit/hyperactivity disorder: a pilot randomized controlled trial

Access to evidence-based psychological treatments for children with attention-deficit/hyperactivity disorder (ADHD) remains limited by therapist shortages and geographical barriers. Videoconference-based cognitive behavioral therapy (vCBT) may provide an alternative to face-to-face CBT, but evidence in young populations is limited. This pilot randomized controlled trial (RCT) examined the feasibility and preliminary treatment outcomes of vCBT for children and adolescents with ADHD in Japan. Twenty-four participants with ADHD aged 11-17 years were randomized to a 12-week vCBT program (n = 11) or treatment-as-usual waitlist (n = 13). The primary outcome was change in ADHD symptoms on the Parent-Rated ADHD Rating Scale-IV (ADHD-RS-IV) from baseline to week 13. Secondary outcomes included depression, anxiety, quality of life, and self-esteem. The trial was registered at the UMIN Clinical Trials Registry (UMIN000048064). Completion and assessment rates were 100%. The adjusted between-group difference in ADHD-RS-IV total scores was 4.43 (95% CI [-2.02, 10.89], p = .17), non-significant, but with a moderate-to-large effect size favoring vCBT. This pilot RCT demonstrated good delivery feasibility of vCBT, although recruitment feasibility posed challenges, and provided preliminary evidence of treatment effects on ADHD symptoms. A definitive RCT is warranted to confirm efficacy.