Study Design
There were two studies testing CBGT effectiveness on children with ADHD
both in 2020 and 2021. The first study involved 9 children with ADHD and
one child dropped out halfway because of a young age combined with low
cognition; the second study involved 13 children with ADHD and one
dropped out due to lack of persistence. Among these 20 children with
ADHD, 19 appeared to exhibit moderate to severe attention deficits,
while 15 showed severe attention deficits. There were 11 children with
moderate hyperactivity and impulsivity symptoms and 7 with severe
hyperactivity symptoms. There were 18 cases with moderate or above
oppositional defiant disorder symptoms and 10 cases with severe
oppositional defiant disorder symptoms. Nevertheless, even though there
were only 2 children with ADHD did not show symptoms of ODD and
impulsivity, they also displayed emotional problems, hostility, and
interpersonal difficulties with peers, teachers and parents.
Furthermore, these children only received methylphenidate from the
hospital, which is the most commonly used medication for reducing core
symptoms of hyperactivity, impulsivity and inattention in children and
adolescents with ADHD (Storebø, 2018). Even though 17 of 20 children
received medication, the reduction rate of drug therapy alone was less
than 30% and no adjustment of drug therapy regimen was made during
psychotherapy in the last three months. Because these children’s
condition only improved slightly with the help of medication in the
early stages of ADHD, the limited effects of drugs on children three
months before the intervention can be neglected. To achieve a full
remission from ADHD, we aimed to apply CBGT intervention to remedy it
with its comorbidity in a non-pharmaceutic way.
The basic structure and content were practically the same in both
studies. The reason why we conducted the study twice is to make sure the
class size is small each time to verify its effectiveness that the group
leader would be able to pay attention to each child and at the same time
to repeatedly prove the benefits of CBGT on parents and children. Each
study was composed of 3-month sessions concerning parental stress
problems and preadolescent children with ADHD, while four parent classes
and ten children’s classes were included. Further, sessions for parents
were conducted in the form of teaching and discussion, while sessions
for preadolescents were structured with closed youth groups of
participants once a week for 120 minutes each time. We sampled both
studies in the same way, by selecting children with ADHD aged 9-14 who
meet the requirement and voluntarily attend the group therapy from the
Fuzhou Children’s Hospital of Fujian Province.
Before we started the intervention, all children participants agreed and
signed the informed consent (see Appendix A). We also obtained general
demographic data as supplemental information as part of the
investigation of the medical records, including parent socioeconomic
status (SES), whether or not the family has one child, family type,
parental relationship, parenting style, primary caregiver, and child’s
personality, as listed in Table A.1.
At the beginning and the end of the study, we provided questionnaires
and collected Parenting-Stress Index-Short Form (PSI-SF), SNAP-IV,
Conners Scale, Barratt impulsivity Scale to analyze the effectiveness of
the therapy by statistics and graphs. After gathering adequate data for
the experiment, these children with ADHD and their parents would begin
their CBGT intervention classes led by the Director of the Department of
Psychiatry.