Positive parenting program for attention deficit hyperactivity disorder: maternal perspective shifts and child behavior problems reduction in a clinical trial

Abstract

Purpose: To evaluate the feasibility and effectiveness of the culturally adapted Triple P intervention in improving parenting competence and reducing behavioral symptoms among children with ADHD in Palestine. Methods: A randomized controlled trial was conducted with 64 Palestinian mothers of children aged 5–13 diagnosed with ADHD. Participants were randomly assigned to either the intervention group (Triple P) or a control group receiving standard care. Pre- and post-intervention assessments were conducted using the Parenting Sense of Competence (PSOC) scale, the Parenting Scale (PS), and the Strengths and Difficulties Questionnaire (SDQ). Feasibility was assessed through retention rates, session adherence, cultural congruence, and participant satisfaction. Results: Feasibility findings indicated high session attendance, strong participant engagement, and positive reception of the program, including its online adaptation. Post-intervention, the intervention group reported significantly higher parenting competence (PSOC) compared to the control group. There was also a significant reduction in lax parenting practices and an increase in children’s prosocial behavior. Hyperactivity symptoms showed marginal improvement. Conclusion: The culturally adapted Triple P intervention was both feasible and effective in enhancing parenting skills and improving child behavior among Palestinian families affected by ADHD. Findings support the integration of Triple P into national mental health services and highlight the importance of culturally responsive, evidence-based interventions in low-resource and conflict-affected settings. Trial Registration Submitted to (ClinicalTrials.gov) on 06/21/2025. Registration number pending.