The Effectiveness of Metacognitive Therapy on Parenting Stress and Self-Compassion of Mothers of 6-8 years Old Children With Attention-Deficit/Hyperactivity Disorder

Attention–Deficit/Hyperactivity Disorder (ADHD) is a significant public and clinical health problem because of its many consequences, such as financial costs, family stress, academic and occupational challenges, and low self–esteem. A child with ADHD increases the parents' stress and psychological problems in the family. Because the mothers interact more with these children, they are likely to be most affected by the situation and are particularly at risk of psychological harm. Therefore, in addition to targeting the disorder's symptoms in the child, therapeutic interventions are needed for parents' problems, especially mothers. Considering the importance of reducing stress in mothers of children with ADHD, empowering them to face the challenges of parenting, and improving self–compassion as a preventive factor against psychological problems, this research aimed to study the efficacy of metacognitive therapy on parenting stress and self–compassion in mothers with ADHD.

This research is a quasi–experimental study with a pretest–posttest and follow–up design with a control group. The study population consisted of all mothers of children aged 6–8 years with ADHD living in Falavarjan City, Isfahan Province, Iran. The study setting was Falavarjan education counseling and psychological centers and was conducted in 2019. A total of 30 mothers were selected through a convenience sampling method. Then, they were randomly assigned to two groups (experimental=15, control=15). The inclusion criteria were having children diagnosed with ADHD by at least one clinical psychologist and a child psychiatrist. The mother's unwillingness to cooperate was the exclusion criterion. The study tools used in the pretest, posttest, and follow–up were the Parenting Stress Index (Abidin, 1990) and Self–Compassion Scale (Neff, 2003). The experimental group received eight 90–min sessions of metacognitive therapy, whereas the control group received no intervention. The collected data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and Bonferroni post hoc test) in SPSS software version 22. To compare demographic information, the independent two–sample t test and Mann–Whitney U test were used. The significance level of the tests was set at 0.05.

The results showed the significant effect of the group on parenting stress (p=0.028) and self–compassion (p=0.021). The effect of time on parenting stress (p<0.001) and self–compassion (p<0.001) was significant, too. Also, the effect of time and group interaction on parenting stress (p<0.001) and self–compassion (p<0.001) was significant. There was a significant difference in the parenting stress variable between the pretest with posttest and follow–up stages (p<0.001). Regarding the self–compassion variable, a significant difference was observed between the pretest, posttest (p=0.028), and follow–up (p=0.005) results. There was a significant difference between the posttest and follow–up stages regarding the parenting stress (p<0.001), but no significant difference was observed between the posttest and follow–up (p=0.175) regarding the self–compassion variable, indicating the persistence of the intervention in the follow–up stage.

The results showed that metacognitive therapy reduces parenting stress and increases self–compassion in mothers with ADHD children. This treatment can be used as an effective intervention to improve psychological competencies in these parents.