The association between parenting stress, parenting self-efficacy, and the clinical significance of child ADHD symptom change following behavior therapy.

We examined parenting stress (PST) and self-efficacy (PSE) following participation in behavioral parent training (BPT) with regard to child treatment response. Forty-three families of children diagnosed with ADHD participated in a modified BPT program. Change in PST and PSE was evaluated using a single group, within-subjects design. Parenting outcomes based on child treatment response were evaluated based upon (1) magnitude and (2) clinical significance of change in child symptom impairment. Parents reported significant improvements in stress and self-efficacy. Parents of children who demonstrated clinically significant reduction in ADHD symptoms reported lower stress and higher self-efficacy than those of children with continued impairments. Magnitude of child impairment was not associated with parent outcomes. Clinical implications for these results include extending treatment duration to provide more time for symptom amelioration and parent-focused objectives to improve coping and stress management.