Psychoeducational group therapy within a pediatric residency clinic: A novel treatment approach for children with ADHD GC Mooneyham¹ MD MS, D Szczepaniak¹ MD, P Sullivan¹ PhD, A Pottenger¹,²BA, N Bauer¹,²MD MPH 1Indiana University School of Medicine, Dept of Pediatrics, 2Section of Children’s Health Services Research, Indianapolis, Indiana GROUP VISIT CURRICULUM BACKGROUND GROUP VISITS RESULTS (con’t) Children in intervention had fewer parent reported ADHD symptoms on Vanderbilt at 1 year compared to controls (3 vs. 8) Themes from audiotaped participant feedback Children reported: group enjoyment application of skills learned improved ability to make friends increased organization identified emotions & how to control Parents reported: increased knowledge about parenting & educational advocacy acquired social support improved family interactions & communication gained time to discuss common issues with other parents & providers improved communication with their child and positive impact on their children’s self esteem Clinic follow up improved in intervention group average 5.3 ADHD visits vs. 3.4 ADHD visits for usual care 7 out of 9 families assigned to intervention arm attended all group visits Primary care providers face numerous challenges around management of patients with Attention Deficit Hyperactivity Disorder (ADHD): Short visits limit time to effectively educate families High volume of patients Medication titration requires frequent visits Psychoeducational group therapy - underutilized resource in primary care that can be used to address barriers: focuses on education group members with shared diagnosis central message can be shared with participants simultaneously learning as a community decrease stigma & normalize experiences Study Purpose: Provide more meaningful opportunities for families with children diagnosed with ADHD in our clinic Engage families in the medical home Resource for teaching & support Fostering collaborative partnerships Parent-child dyads participated in 5 separate group therapy visits once every 3 months Groups lasted 60 minutes followed by 15 minute individual physical exam and medication review Child curriculum written by child psychologist implemented by resident physician Parent curriculum written by behavioral pediatrician implemented by general pediatrician PARENT GROUP CHILD GROUP Understanding ADHD & your child Build comfort & normalize experiences: share parenting challenges & child strengths What is ADHD all about? Build comfort & normalize experiences: share challenges & self-identified strengths Understanding treatment options & partnership to reach goals Review common medications & understand how to monitor positive & negative effects Feelings: Identification, handling and use of feeling charts Enhance ability to respond appropriately to emotions including anger management Advocating for Child’s Educational Success Understand parental educational rights, how to collaborate with teacher & become an advocate for child Friendships, Hobbies, Empathy & Handling Rejection Foster positive relationships with family members, friends & classmates Managing Children’s Behavior with Positive Parenting Techniques Learn ABCs of behavior, review of strategies for time-in, praise, effective commands & transition warnings School: Classroom Etiquette, Learning Difficulties, and Homework Help Reinforce organizational strategies & positive classroom behavior for academic success Techniques to Defuse Common Parenting Challenges & Wrap Up Review of ignore, natural & logical consequences & time-out & how to manage parental stress Wrap Up Review of covered topics & celebration with group Significant difference in adaptive functioning Intervention mean baseline 5.5 vs. 12 month score: 3.7, p=0.0036 Usual care control mean baseline score 4.7 vs. 12 month score 4.4, p=0.8003 RESULTS Recruitment of children (ages 6-18) with ADHD receiving care in general pediatric resident clinic along with their parent Randomized to intervention or usual care Exclusion criteria: Conduct disorder, Autism, moderate to severe intellectual impairment Length of study = 1 Year Inclusion of ADHD inattentive & combined types Stable on medications x 3 months Data collection included: Home Situations Questionnaire (HSQ) for adaptive functioning Vanderbilt checklist for ADHD symptoms Informal feedback from parent-child dyads # of routine ADHD follow up visits attended METHODS CONCLUSIONS Psychoeducational group therapy can be applied to teaching families about the diagnosis & management of ADHD Group visits are feasible even within a busy pediatric clinic & led to improved follow up Participation in group therapy led to significant parent-reported improvements for our patients scheduled & maintained 3 month medication management visits (seen by resident & attending MD) Families encouraged to call between visits for acute concerns USUAL CARE Special thanks to Dr. Stephen M Downs & the IUSOM Pediatric Research Network (PResNet) as well as the staff, faculty, & resident physicians at Riley MSA 1 General Pediatrics clinic. Authors have no conflict of interest or financial disclosures to report.