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. 2025 Jun 6.
doi: 10.1007/s10578-025-01868-6. Online ahead of print.

A Randomized Clinical Trial Comparing the Effectiveness of Emotion-Focused and Behavioral Parent Training in Families of School-aged Children with Attention-Deficit/Hyperactivity Disorder

Ghazaleh Zargarinejad  1 , Joann Wu Shortt  2 , J Mark Eddy  3 , Saeed Ebadi Zare  4 , Banafsheh Gharraee  4 , Hojjatollah Farahani  5 , Asma Aghebati  4 , Elham Shirazi  6
Affiliations

A Randomized Clinical Trial Comparing the Effectiveness of Emotion-Focused and Behavioral Parent Training in Families of School-aged Children with Attention-Deficit/Hyperactivity Disorder

Ghazaleh Zargarinejad et al. Child Psychiatry Hum Dev. .

Abstract

Behavioral Parent Training (BPT) is a well-established intervention for Attention-Deficit/Hyperactivity Disorder; however, it has been criticized for its limited focus on enhancing parental emotion regulation (ER) skills, which are crucial for supporting children's emotional development. This gap underscores the need to examine the effectiveness of ER-focused parental interventions in comparison to BPT. The present study aimed to compare the effectiveness of an EF parenting and a BPT intervention on various child- and mother-related outcomes in families of school-aged children with ADHD. Fifty-nine participants were randomly assigned to an EF intervention (The Emotions Program), a BPT intervention (Triple P Positive Parenting Program), or a waitlist control group, with data from forty-seven participants (mean child age = 8.00; SD = 1.38; 72.3% boys) included in the final analyses. The treatment groups received structured, manual-based interventions, while the waitlist group received the BPT intervention after the final assessment. Assessments were conducted at pre-intervention, post-intervention, and a two-month follow-up. Results from repeated-measures ANOVAs and post-hoc analyses indicated that both EF and BPT led to significant improvements compared to the control group, though each approach had distinct effects. Both interventions significantly reduced child conduct problem scores; however, EF was particularly effective in decreasing non-supportive maternal reactions, alleviating parenting stress, and improving parental emotion regulation, while BPT showed greater effectiveness in reducing ADHD symptoms and child emotion dysregulation. These findings highlight the importance of tailoring interventions to address specific parental and child needs, suggesting that integrating EF and BPT approaches may provide a more comprehensive framework for supporting families of children with ADHD.

Keywords: Attention Deficit Disorder with Hyperactivity; Dialectical Behavior Therapy; Emotion-focused; Emotional Regulation; Parenting.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests. Ethical Approval: All participants signed a written informed consent form. The trial was conducted according to the principles of the Declaration of Helsinki, and Ethical approval was obtained from the Research Ethics Committee of the Iran University of Medical Sciences (Approval ID: IR.IUMS.REC.1398.701). The Iran University of Medical Sciences registered the project on www.irct.ir (IRCT Code: IRCT20190915044776 N1).

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