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Objective: We conducted a large (N = 216) multisite clinical trial of the Challenging Horizons Program (CHP)--a yearlong afterschool program that provides academic and interpersonal skills training for adolescents with attention-deficit/hyperactivity disorder. Intent-to-treat analyses suggest that, as predicted, the CHP resulted in significant reductions in problem behaviors and academic impairment when compared to community care. However, attendance in the CHP ranged from zero to 60 sessions, raising questions about optimal dosing. Method: To evaluate the impact of treatment compliance, compiler average causal effect modeling was used to compare participants who attended 80% or more of sessions to an estimate of outcomes for comparable control participants. Results: Treatment compilers exhibited medium to large benefits (ds = 0.56 to 2.00) in organization, disruptive behaviors, homework performance, and grades relative to comparable control estimates, with results persisting 6 months after treatment ended. However, compliance had little impact on social skills. Conclusions: Students most in need of treatment were most likely to comply, resulting in significant benefits in relation to comparable control participants who experienced deteriorating outcomes over time. Difficulties relating to doseresponse estimation and the potentially confounding influence of treatment acceptability, accessibility, and client motivation are discussed. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent among adolescent clinical populations and associated with myriad deficits in school functioning. Yet, behavior therapists have few developmentally appropriate tools for addressing school problems in this group. This article introduces a behavioral protocol designed to fill the gap: Changing Academic Support in the Home for Adolescents With ADHD (CASH-AA). CASH-AA is a family-based intervention that targets home environment, adolescent skills, and family-school partnership characteristics in order to improve school performance. Protocol components are derived from three evidence-based approaches for adolescent behavior problems: family psychoeducation, clinical family interventions to heighten adolescent and caregiver motivation to change, and training interventions for homework planning and organization skills. CASH-AA contains four treatment modules: (1) Psychoeducation: ADHD and Academic Functioning; (2) Motivation and Preparation: Home Academic Environment; (3) Behavior Change: School Attendance and Homework Plan; (4) Collaboration: Therapist-Family-School Partnership. The protocol can be implemented as a stand-alone intervention for ADHD or an adjunct to other behavioral interventions for co-occurring disorders. Two case examples with markedly different treatment profiles are presented to illustrate the utility and flexibility of the protocol. [ABSTRACT FROM AUTHOR]