Strategy intervention (STRATEGI-programmet)
Summary
Introduction
The Strategy intervention is a psychosocial support intervention aimed at supporting the parents or guardians of children and adolescents diagnosed with ADHD. The intervention aims to reduce the child’s ADHD symptoms by strengthening parenting skills and improving the executive function of the parents and the child. The objective of the Strategy intervention is to increase the parents’ understanding and knowledge of ADHD so that they recognise the limitations to executive function caused by the symptom profile and their impacts on the family. The intervention also supports the parents’ adaptation to their child’s ADHD diagnosis.
Objective and research question
This systematic literature review assesses the effectiveness of the Strategy intervention on the basis of research literature. The review answers the following questions: In how much detail is the Strategy intervention described? Does the Strategy intervention have evidence-based effectiveness, applicable to Finland, in increasing the ADHD knowledge of the parent, strengthening parenting skills and improving the executive function of the child and the parent?
Data and research methods
This study used the Population, Concept and Context (PCC) strategy to search for literature, which is a typical strategy in exploratory literature reviews. The search targeted the following question: What research has been done on the Strategy intervention? The following keywords were used: P = children, adolescents, parents, C = Strategy intervention, Strategi-programmet. Context was omitted to avoid an excessive restriction of the results of the search. The primary area of interest in the search was effectiveness studies carried out on the method, although studies carried out by using different frameworks were also included. A systematic search was carried out for the following six reference databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus. In addition, a search for publications in Finnish was performed on the Finna.fi service, and the search was supplemented by a manual search.
Results
Based on the literature search, only one effectiveness study was selected for a systematic review. In addition, one Swedish peer-reviewed study and one Swedish non-peer-reviewed report were reported at the end of this review and did not affect the methodology evaluation of the intervention. The selected Swedish study was conducted without a control group using a pre-post design, where the effectiveness of the Strategy intervention was examined in terms of the parents’ increased knowledge of ADHD. The secondary response variables examined were the intervention’s effect on the child’s behavioural symptoms and characteristics (Strengths and Difficulties Questionnaire (SDQ)), parental stress (The Parental Stress Scale (PSS)) and parenting attributions (modified Written Analog Questionnaire). Parents (n=549) were divided into three groups based on the severity of their ADHD symptoms. The severity of the parents’ ADHD symptoms had no effect on the response variables: the parents’ knowledge of ADHD increased in allof the groups.
Methodology evaluation
As the Strategy intervention is well-described and there is promising evidence of its effectiveness, it receives a methodology evaluation score of 3/5. There is research evidence of increased knowledge of ADHD among parents of children diagnosed with ADHD. More research is needed to support the intervention’s strengthening of parenting skills and the improvement of the child’s and parent’s executive function.