title: Outcomes for adolescents who comply with long-term psychosocial treatment for ADHD.
abstract: OBJECTIVE
  We conducted a large (N = 216) multisite clinical trial of the Challenging Horizons Program (CHP)-a yearlong afterschool program that provides academic and interpersonal skills training for adolescents with attention-deficit/hyperactivity disorder. Intent-to-treat analyses suggest that, as predicted, the CHP resulted in significant reductions in problem behaviors and academic impairment when compared to community care. However, attendance in the CHP ranged from zero to 60 sessions, raising questions about optimal dosing.
  
  
  METHODS
  To evaluate the impact of treatment compliance, complier average causal effect modeling was used to compare participants who attended 80% or more of sessions to an estimate of outcomes for comparable control participants.
  
  
  RESULTS
  Treatment compliers exhibited medium to large benefits (ds = 0.56 to 2.00) in organization, disruptive behaviors, homework performance, and grades relative to comparable control estimates, with results persisting 6 months after treatment ended. However, compliance had little impact on social skills.
  
  
  CONCLUSIONS
  Students most in need of treatment were most likely to comply, resulting in significant benefits in relation to comparable control participants who experienced deteriorating outcomes over time. Difficulties relating to dose-response estimation and the potentially confounding influence of treatment acceptability, accessibility, and client motivation are discussed. (PsycINFO Database Record
authors.affiliation: Department of Psychology, East Carolina University.
authors.forename: Brandon K
authors.identifier: 0000-0001-9130-6723
authors.initials: BK
authors.lastname: Schultz
authors.affiliation: Department of Psychology, Ohio University.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Evans
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Langberg
authors.affiliation: Department of Psychology, East Carolina University.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Schoemann
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D066107:Social Skills; D016896:Treatment Outcome