Universität zu Köln

Döpfner, Manfred ORCID: 0000-0002-7929-0463, Plück, Julia ORCID: 0000-0003-3425-5995, Rosenberger, Kerstin Daniela ORCID: 0000-0003-3459-3812, Klemp, Marie‐Theres ORCID: 0000-0002-1394-5818, Mühlenmeister, Judith ORCID: 0009-0007-3946-5402, Wähnke, Laura ORCID: 0000-0002-7960-5090, Hellmich, Martin ORCID: 0000-0001-5174-928X, Schürmann, Stephanie and Dose, Christina ORCID: 0000-0001-5405-4934 (2025). Efficacy of guided and unguided web‐assisted self‐help for parents of children with attention‐deficit/hyperactivity disorder and oppositional defiant disorder: A three‐arm randomized controlled trial. Journal of Child Psychology and Psychiatry, 66 (9). pp. 1320-1332. Wiley. ISSN 0021-9630

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Abstract

Background: Empirical evidence supports the efficacy of behavioral online parent training. However, further large trials in school-age children with externalizing behavior problems and analyses on the impact of additional therapist support are needed. This three-arm randomized controlled trial examined the efficacy of guided and unguided web-assisted self-help (WASH) for parents of children with externalizing behavior problems.Methods: Parents of 431 children (6–12 years) with elevated externalizing symptoms were randomly assigned to either treatment as usual (TAU), a 6-month behavioral WASH intervention (WASH+TAU), or WASH plus telephone-based support (WASH+ S+TAU). Assessments took place at baseline and at 3, 6, and 12 months. The primary outcome was child externalizing symptoms as rated by a clinician blinded to condition; secondary outcomes were parent-rated child externalizing symptoms, internalizing symptoms, functional impairment, quality of life, parenting practices, and parental internalizing symptoms. (German Clinical Trials Register (DRKS): DRKS00013456; URL: https://drks.de/ search/de/trial/DRKS00013456; registered on January 3rd 2018). Results: Linear mixed models for repeated measures revealed a significant overall intervention effect on blinded clinician-rated externalizing symptoms at 6 months in both the intention-to-treat sample and per-protocol samples, with at least 25% (PP25) or 40% treatment utilization (PP40), respectively (intention-to-treat: p = .017). Subsequent pairwise comparisons revealed a greater symptom reduction in WASH+S+TAU than in the other conditions (intention-to-treat: WASH+S+TAU vs. WASH+TAU: p = .029, d = −0.28, 95% CI [−0.54, −0.03]; WASH+S+TAU vs. TAU: p = .009, d = 0.34 [−0.59, −0.09]). At 12 months, a significant overall effect on blinded clinician-rated externalizing symptoms only emerged in the PP40 sample (p = .035). Secondary analyses revealed an overall effect on child functional impairment at 12 months (intention-to-treat and per-protocol analyses) and on negative parenting behaviors at 6 months in the PP40 sample. For both variables, pairwise comparisons demonstrated significant differences between WASH+S+TAU and TAU. Conclusions: Parent-directed WASH is effective in reducing blinded clinician-rated externalizing symptoms, but only when combined with additional support. Keywords: ADHD; oppositional defiant disorder; school children; parent training; e-health

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Döpfner, Manfred UNSPECIFIED https://orcid.org/0000-0002-7929-0463 UNSPECIFIED Plück, Julia UNSPECIFIED https://orcid.org/0000-0003-3425-5995 UNSPECIFIED Rosenberger, Kerstin Daniela UNSPECIFIED https://orcid.org/0000-0003-3459-3812 UNSPECIFIED Klemp, Marie‐Theres UNSPECIFIED https://orcid.org/0000-0002-1394-5818 UNSPECIFIED Mühlenmeister, Judith UNSPECIFIED https://orcid.org/0009-0007-3946-5402 UNSPECIFIED Wähnke, Laura UNSPECIFIED https://orcid.org/0000-0002-7960-5090 UNSPECIFIED Hellmich, Martin UNSPECIFIED https://orcid.org/0000-0001-5174-928X UNSPECIFIED Schürmann, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Dose, Christina UNSPECIFIED https://orcid.org/0000-0001-5405-4934 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-794452
Identification Number:	10.1111/jcpp.14153
Journal or Publication Title:	Journal of Child Psychology and Psychiatry
Volume:	66
Number:	9
Page Range:	pp. 1320-1332
Number of Pages:	13
Date:	10 September 2025
Publisher:	Wiley
ISSN:	0021-9630
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Medizinische Statistik und Bioinformatik > Institut für Medizinische Statistik und Bioinformatik – IMSB Faculty of Medicine > Psychiatrie und Psychotherapie > Psychiatrie und Psychotherapie des Kindes- und Jugendalters
Subjects:	Life sciences Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79445