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.