Parent training based on cognitive-behavioural principles in ADHD: a narrative review of recent evidence
DOI:
https://doi.org/10.25118/2763-9037.2026.v16.1599Keywords:
ADHD, parent training, CBT, attention deficit hyperactivity disorder, cognitive behavioral therapy, psychoeducation, quality of lifeAbstract
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neuropsychiatric conditions in childhood, with significant impact on family functioning. Parent training (PT) based on cognitive-behavioural principles emerges as a central non-pharmacological strategy; however, its effectiveness on broader outcomes (including quality of life, parental stress, and cognitive indicators), warrants updated synthesis. Objective: To critically synthesize recent evidence on parent training based on cognitive-behavioural principles in the management of ADHD in children and adolescents, with emphasis on behavioural, parental, and quality-of-life outcomes. Methods: A structured narrative review, conducted in accordance with the principles of the SANRA (Scale for the Assessment of Narrative Review Articles), with an oriented search in PubMed/MEDLINE, covering publications from January 2020 to July 2026 (search run in July 2026), in English, Portuguese, and Spanish. Primary studies of structured parent training based on cognitive-behavioural principles for caregivers of children and adolescents with ADHD were prioritized. Reviews, editorials, and case reports were excluded. Studies were analyzed critically and descriptively regarding study design, sample characteristics, outcomes, and methodological limitations. Results: The search retrieved 161 records; after excluding 44 by publication type, 117 primary studies were screened, of which 41 were randomized controlled trials, and eight were purposively selected for critical synthesis. The majority demonstrated statistically significant reductions in ADHD symptoms or externalising behaviours. In some of the studies, improvements were also observed in parental competence or self-efficacy, caregiver stress, parenting practices, inhibitory control, and quality of life. Triple P, behavioural parent training programmes, and national adaptations were the most frequently evaluated. Conclusion: Overall, findings indicate favourable evidence for parent training based on cognitive-behavioural principles, with more consistent benefits on externalising behaviours and parenting practices, and less uniform findings for family stress and other parental outcomes. Heterogeneity of designs and outcomes, as well as the purposive selection of studies, warrants caution in generalising. Its use should be integrated into multimodal care.
Downloads
Metrics
References
1. Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2015;44(2):377-88. https://doi.org/10.1093/ije/dyv005
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: APA; 2013.
3. Johnston C, Mash EJ. Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev. 2001;4(3):183-207. https://doi.org/10.1023/a:1017592030434
4. Miranda A, Presentacion MJ, Soriano M. Effectiveness of a school-based multicomponent program for the treatment of children with ADHD. J Learn Disabil. 2002;35(6):546-62. https://doi.org/10.1177/00222194020350060601
5. Coghill D, Cortese S, Daley D, Dittmann R, Ferrin M, Holtmann M, et al. Evidence-based management of ADHD: new questions and renewed controversies. Lancet Psychiatry. 2023;10(8):658-72. https://doi.org/10.1016/S2215-0366(22)00388-3
6. Storebø OJ, Storm MR, Pereira Ribeiro J, Skoog M, Groth C, Callesen HE, Schaug JP, Darling Rasmussen P, Huus C-ML, Zwi M, Kirubakaran R, Simonsen E, Gluud C. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database Syst Rev. 2023;3(3):CD009885. https://doi.org/10.1002/14651858.CD009885.pub3 PMid:36971690 PMCid:PMC10042435
7. Fabiano GA, Schatz NK, Aloe AM, Chacko A, Chronis-Tuscano A. A systematic review of meta-analyses of psychosocial treatment for attention-deficit/hyperactivity disorder. Clin Child Fam Psychol Rev. 2015;18(1):77-97. https://doi.org/10.1007/s10567-015-0178-6
8. Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. 4th ed. New York: Guilford Press; 2015.
9. Kazdin AE. Parent management training: treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. New York: Oxford University Press; 2008.
10. Webster-Stratton C, Reid MJ. The Incredible Years parents, teachers, and children training series: a multifaceted treatment approach for young children with conduct problems. In: Weisz JR, Kazdin AE, editors. Evidence-based psychotherapies for children and adolescents. 3rd ed. New York: Guilford; 2017. p. 122-41.
11. Daley D, Jones K, Hutchings J, Thompson M. Attention deficit hyperactivity disorder in pre-school children: current findings, recommended interventions and future directions. Child Care Health Dev. 2009;35(6):754-66. https://doi.org/10.1111/j.1365-2214.2009.00938.x
12. Daley D, Leahy A, Doyle C. Online parent training programs for ADHD: a systematic review of evidence. JCPP Adv. 2023;3(1):e12143. https://doi.org/10.1002/jcv2.12143
13. Mautone JA, Marcotte AM, Pfiffner LJ. Digital health approaches to parent training for ADHD. Curr Psychiatry Rep. 2022;24(12):789-98. https://doi.org/10.1007/s11920-022-01381-4
14. Mah JWT, Murray C, Locke J, Carbert N. Mindfulness-enhanced behavioral parent training for clinic-referred families of children with ADHD: a randomized controlled trial. J Atten Disord. 2021;25(12):1765-77. https://doi.org/10.1177/1087054720925882
15. Nobel E, Gustafsson P, Kadesjoe B, Westerlund M, Ghaderi A. Parent training tailored for parents with ADHD: a randomized controlled trial. BMC Psychiatry. 2025;25:344. https://doi.org/10.1186/s12888-025-07166-8
16. Amro N, Dardas LA. Positive parenting program for attention deficit hyperactivity disorder: maternal perspective shifts and child behavior problems reduction in a clinical trial. Child Adolesc Psychiatry Ment Health. 2025;19:38. https://doi.org/10.1186/s13034-025-00960-y
17. Lund HN, Ma Y, Li X, Wang Y, Xiang Y, Liu X. Internet-based behavioural parent training intervention for children with attention-deficit/hyperactivity disorder: a randomized clinical trial. Int J Psychiatry Clin Pract. 2025;29(1):44-52. https://doi.org/10.1080/13651501.2025.2469847
18. Hornstra R, van der Oord S, Staff AI, Hoekstra PJ, Oosterlaan J, van der Veen-Mulders L, et al. Which techniques work in behavioral parent training for children with ADHD? A randomized controlled microtrial. J Clin Child Adolesc Psychol. 2021;50(6):888-903. https://doi.org/10.1080/15374416.2021.1955368
19. Yao A, Shimada K, Kasaba R, Tomoda A. Beneficial effects of behavioral parent training on inhibitory control in children with attention-deficit/hyperactivity disorder: a small-scale randomized controlled trial. Front Psychiatry. 2022;13:859249. https://doi.org/10.3389/fpsyt.2022.859249
20. Chequer de Castro Paiva A, Pianetti Machado ME, Moreira de Sousa LF, Rodrigues de Figueiredo T, Sato JR, Romano-Silva MA, et al. Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial. Front Psychol. 2024;15:1293244. https://doi.org/10.3389/fpsyg.2024.1293244
21. Turan B, Esin IS, Dursun OB. The effect of parenting programme on the symptoms and the family functioning of children with attention deficit and hyperactivity disorder who have residual symptoms despite medical treatment. Behaviour Change. 2022;39(1):14-24. https://doi.org/10.1017/bec.2021.13
22. Sanders MR, Turner KMT, Markie-Dadds C. The development and dissemination of the Triple P-Positive Parenting Program: a multilevel, evidence-based system of parenting and family support. Prev Sci. 2002;3(3):173-89. https://doi.org/10.1023/A:1019902312544
23. Marquet-Doleac J, Biotteau M, Chaix Y. Behavioral parent training for school-aged children with ADHD: a systematic review of randomized control trials. J Atten Disord. 2024;28(3):377-93. https://doi.org/10.1177/10870547231211595
24. Dekkers TJ, van Rentergem JAA, Koopman-Verhoeff ME, Hornstra R, Luman M, van den Hoofdakker BJ, et al. Sustained improvements by behavioural parent training for children with ADHD: a meta-analytic review of longer-term child and parental outcomes. JCPP Adv. 2023;3(3):e12144. https://doi.org/10.1002/jcv2.12144
25. Patterson GR. Coercive family process. Eugene: Castalia; 1982.
26. Hutchings J, Lane E, Ellis C, Roberts-Tyler E, Webster-Stratton C. The incredible years CBT-based parent programme in the United Kingdom: a systematic review and meta-analysis. Child Care Health Dev. 2021;47(3):341-52. https://doi.org/10.1111/cch.12851
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Danilo Bastos Bispo Ferreira, Railma Coutinho de Oliveira, Thaís Carreiro de Morais, Fernanda Bastos Bispo Ferreira, Ciro Sousa de Moura Fé, Allan Maia Andrade de Souza, Ana Christina Mageste Castelar Campos
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
