Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation |
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| Authors: | Karen C. Wells William E. Pelham Jr. Ronald A. Kotkin Betsy Hoza Howard B. Abikoff Ann Abramowitz L. Eugene Arnold Dennis P. Cantwell C. Keith Conners Rebecca Del Carmen Glenn Elliott Laurence L. Greenhill Lily Hechtman Euthymia Hibbs Stephen P. Hinshaw Peter S. Jensen John S. March James M. Swanson Ellen Schiller |
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| Affiliation: | (1) Duke University Medical Center, P.O. Box 3320, Durham, North, Carolina, 2771;(2) State University of New York, Buffalo, New York;(3) University of California, Irvine, California;(4) Purdue University, Lafayette, Indiana;(5) New York University Medical Center, New York, New York;(6) Emory University School of Medicine, Atlanta, Georgia;(7) Ohio State University, Columbus, Ohio;(8) Duke University Medical Center, Durham, North Carolina;(9) National Institutes of Mental Health, Rockville, Maryland;(10) University of California, San Francisco, California;(11) New York State Psychiatric Institute, Columbia University, New York, New York;(12) Montreal Children's Hospital, Montreal, Quebec, Canada;(13) University of California, Berkeley, California;(14) U.S. Department of Education, Washington, DC |
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| Abstract: | The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased |
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| Keywords: | attention deficit/hyperactivity disorder psychosocial treatment parent training school intervention summer treatment program |
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