Abstract

Adolescents with ADHD are at increased risk for myriad functional impairments and comorbidities and need accessible, acceptable, and effective treatment options. Stepped care treatment models employ a “light touch” initial intervention dose to meet lower needs and to reserve mental healthcare system capacity for more severe concerns. The current study employed a mixed methods approach to evaluate the First Approach Skills Training–Parenting Teens (FAST-P) program, a modular 4-session caregiver intervention implemented via telemedicine “tele-group.” The program workbook and 2-hour training video are available free online at www.seattlechildrens.org/FAST. Twenty-two adolescents ages 13–17 with ADHD plus a caregiver enrolled in the study and completed the idiographic Top Problems interview and ratings at baseline and posttest. Caregivers attended the 4-session program and completed acceptability measures and a semistructured qualitative interview.Group fidelity, attendance, and participant satisfaction were high. After the group, there was significant improvement in caregivers’ top problems. Themes from interviews included nearly all caregivers perceiving benefit from the program, especially to their parenting perspective, understanding of their teen, and communication. Most would have appreciated more sessions and additional topics, but the majority did not plan to seek additional treatments. Program delivery cost to the clinic was $76 per participating family.FAST-P is a feasible, acceptable, and affordable program for a first step in a “stepped care” model for adolescents with ADHD, with the goal of reducing the need for higher-intensity services. While the program supported caregivers and they perceived benefits, many families indicated they may need more intensive services.

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