Stepped Care Treatment for ADHD and Disruptive Behaviors

EXPERT: Erin Schoenfelder Gonzalez, PhD, associate professor in the Department of Psychiatry and Behavioral Sciences and the Department of Pediatrics at the University of Washington School of Medicine

Evidence-based behavioral treatments such as parent Behavior Management Training (BMT) are found to be effective for treating ADHD and disruptive behaviors, but also burdensome and difficult to access. Stepped care treatment models tailor intervention “doses” to family-level factors and clinical acuity while increasing family engagement and treatment capacity. In this lecture, we will explore a stepped care approach to delivering BMT for ADHD and disruptive behaviors. This includes low-dose treatment for primary care, flexible sessions, and high-intensity outpatient programs. We will also discuss strategies for integrating health behavior changes into BMT models, including the improvement of sleep and screen-time limits.

• Discuss access and retention barriers for ADHD and disruptive behavior psychosocial treatments.
• Explore a brief, modular disruptive behavior treatment model as an initial “step” of treatment in primary care and other settings.
• Discuss a multi-level stepped care approach for treating disruptive behavior from low to high acuity, and for addressing health behaviors that contribute to a child’s symptoms and impairment.

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