A Case Study of Multisystem Therapy for Improving Classroom Disruption Behavior and Parental Interaction in Adolescents with ADHD

Purpose: This study is a single-case study of multisystemic therapy focusing on the problems of classroom disruptive behavior, peer bullying, disobedience to teachers, and negative interactions with mother in a middle-school boy with attention deficit hyperactivity disorder (ADHD). Methods: Treatment was conducted over a seven-month period with a team of two counselors and one supervisor. Home visits were conducted weekly and included parenting coaching for the mother, social skills training for the child, and monitoring of the reward system. The evaluation included behavioral observation (counselor, teacher), K-CBCL (Korean-Child Behavior Checklist), TRF (Teacher's Report Form), and Parenting Stress Index (PSI). The intervention focused on a behavioral therapeutic approach to identify and improve environmental factors that contribute to problem behaviors, and weekly supervision meetings were held. Results: First, classroom disruptive behavior, peer bullying, disobedience to teacher, and negative interactions with mother decreased. Second, compliance behaviors such as returning home before 10 p.m., going to bed at 12 p.m., waking up at 7 a.m., and speaking without anger increased. Third, there were positive changes in K-CBCL, TRF, and PSI. Conclusion: The effectiveness of multisystemic treatment for ADHD children with externalizing problem behaviors was confirmed. It is suggested that multisystemic therapy can be proposed as an alternative to individual counseling which has limited effects on externalizing problem behaviors.