An Intensive Summer Treatment Program for ADHD Reduces Parent–Adolescent Conflict Margaret H. Sibley & J. Megan Ross & Elizabeth M. Gnagy & Laura J. Dixon & Bradfield Conn & William E. Pelham Jr. Published online: 16 August 2012 # Springer Science+Business Media, LLC 2012 Abstract There are currently almost no treatment efforts to reduce parent –adolescent conflict in adolescents with ADHD. As such, this study investigated the effect of an intensive Summer Treatment Program for Adolescents with ADHD (STP-A) on parent–adolescent conflict. Twenty ado- lescents and their parents completed the 8 week behavioral treatment program, which included 320 hours of adolescent- directed treatment, 15 hours of parent behavior management training, and daily feedback from staff on parent implemen- tation of a home-based behavioral contract. Results indicat- ed that 70–85 % of adolescents who attended the STP-A demonstrated reliable improvement in parent–adolescent conflict from baseline to post-treatment. Treatment response was associated with higher levels of conflict at baseline, but not adolescent ODD severity or parent ADHD severity. Several patterns of treatment non-response were detected through visual examination of weekly conflict scores during the STP-A. Discussion suggests that intensive, parent- involved treatment programs may be necessary to improve home-conflict in adolescents with ADHD. Keywords ADHD . Family conflict . Behavioral treatment For typically developing youth, adolescence represents a time of increased parent–child conflict as teens strive to increase autonomy in the face of parental limits (Larson et al. 1996; Laurensen et al. 1998; Steinberg and Morris 2001). Compared to same-aged dyads, adolescents with Attention Deficit/Hyperactivity Disorder (ADHD; American Psychi- atric Association 2000) and their parents engage in further elevated conflict, exhibiting more intense arguments, less effective communication skills, and fewer positive state- ments during discussions (Barkley et al. 1992a; Pelham et al. 2012). Increased parent–adolescent conflict is not unex- pected in youth with ADHD. These adolescents display low frustration tolerance, poor interpersonal and conflict resolu- tion skills, and a high incidence of comorbid Oppositional Defiant Disorder (ODD; Anderson et al. 1987; Cantwell 1986; Fletcher et al. 1996; Sobanski et al. 2010; Wehmeier et al. 2010) and these factors exacerbate strained relation- ships between adolescents and adult family members (Evans et al. 2009). Accordingly, dysfunctional parent–adolescent relationships are one of the most impaired domains for adolescents with ADHD (Barkley et al. 1992a; Edwards et al. 2001; Montemayor and Hanson 1985). Parent–adolescent relationship quality may be a particularly meaningful domain of intervention for adolescents with ADHD. For example, a distressed parent–adolescent relation- ship increases risk for adolescent substance use (Farrell and White 1998), delinquency (Moffitt and Caspi 2001), academic problems (Shek 1997) and poor psychological well-being (Steinberg 2001). Longitudinal follow-up studies of children with ADHD suggest that in adolescence, these youth display higher rates of risk behaviors, academic problems, and comor- bid disorders than peers (Barkley et al. 1990; Mannuzza et al. 1993; Mikami et al. 2010; Molina et al. 2007). Consequently, reducing parent–adolescent conflict may improve a range of outcomes for adolescents with ADHD. Unfortunately, treatments to reduce family conflict in adolescents with ADHD report limited success. Stimulant This study was supported in part by the Elizabeth Munsterberg Koppitz Fellowship from the American Psychological Foundation. M. H. Sibley (*) : J. M. Ross : E. M. Gnagy : W. E. Pelham Jr. FIU Center for Children and Families, AHC-1 Room 146, 11200 SW 8th Street, Miami, FL 33199, USA e-mail: msibley@fiu.edu L. J. Dixon University of Wyoming, Laramie, WY, USA B. Conn Alliant International University, San Diego, CA, USA J Psychopathol Behav Assess (2013) 35:10–19 DOI 10.1007/s10862-012-9314-5