Kc. Wells et al., Psychosocial treatment strategies in the MTA study: Rationale, methods, and critical issues in design and implementation, J ABN C PSY, 28(6), 2000, pp. 483-505
The Collaborative Multimodal Treatment Study of Children with Attention Def
icit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooper
ative agreement treatment study of children, and the largest psychiatric/ps
ychological treatment trial ever conducted by the National Institute of Men
tal Health. It examines the effectiveness of Medication vs. Psychosocial tr
eatment vs. their combination for treatment of ADHD and compares these expe
rimental arms to each other and to routine community care. In a parallel gr
oup design, 579 (male and female) ADHD children, aged 7-9 years, Il months,
were randomly assigned to one of the four experimental arms, and then rece
ived 14 months of prescribed treatment (or community care) with periodic re
assessments. After delineating the theoretical and empirical rationales for
Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatme
nt strategy applied to all children in two of the four experimental arms (P
sychosocial treatment alone; Combined treatment). Psychosocial treatment co
nsisted of three major components: a Parent Training component, a two-part
School Intervention component, and a child treatment component anchored in
an intensive Summer Treatment Program. Components were selected based on ev
idence of treatment efficacy and because they address comprehensive symptom
targets, settings, comorbidities, and functional domains. We delineate key
conceptual and logistical issues faced by clinical researchers in design a
nd implementation of Psychosocial research with examples of how these issue
s were addressed in the MTA study.