# The effects of cognitive behavioral therapy-based psychoeducation on quality of life, anxiety, and depression in children with attention deficit hyperactivity disorder

## TL;DR

A psychoeducational program based on cognitive behavioral therapy improved quality of life and reduced anxiety and depression in children with ADHD.

## Contribution

This study is the first to evaluate a family-involved CBT-based psychoeducational program for children with ADHD.

## Key findings

- Children in the intervention group showed significant improvements in quality of life.
- The program led to significant reductions in anxiety and depressive symptoms.
- No significant changes were observed in the control group.

## Abstract

Attention deficit hyperactivity disorder is a prevalent neurodevelopmental condition in childhood, associated not only with difficulties in attention and impulsivity but also with increased internalizing symptoms, such as anxiety and depression, and a marked reduction in quality of life. Although pharmacological treatments play a central role in the management of attention deficit hyperactivity disorder, there is a growing need for psychosocial interventions that target these emotional difficulties and quality of life outcomes while actively involving families. This study is novel in its evaluation of the effectiveness of a structured cognitive behavioral therapy based psychoeducational program involving both children and their parents in reducing anxiety and depressive symptoms and improving quality of life in children diagnosed with attention deficit hyperactivity disorder.

A quasi-experimental controlled pretest–posttest design was employed. The intervention group comprised thirty-seven children aged eight to twelve years diagnosed with attention deficit hyperactivity disorder and their parents, while the control group included thirty-six age- and gender-matched children with the same diagnosis and their parents. The intervention consisted of an eight-session cognitive behavioral therapy based psychoeducational program integrating emotional regulation, adaptive coping strategies, and parent-focused guidance. Data were collected at baseline and after the intervention using a sociodemographic information form, the Quality of Life Inventory, and the Revised Children’s Anxiety and Depression Scale.

The intervention and control groups were similar in terms of demographic characteristics. The mean age of children in the intervention group was 10.35 ± 1.40 years, while the mean age of children in the control group was 10.47 ± 1.28 years (p = 0.751). Regarding gender distribution, the intervention group consisted of 11 girls (29.7%) and 26 boys (70.3%), while the control group consisted of 18 girls (50.0%) and 18 boys (50.0%) (p = 0.077). Children participating in the cognitive behavioral therapy -based psycho-educational program showed a statistically significant improvement in quality of life and a significant decrease in anxiety and depressive symptoms between the pre-test and post-test. No significant changes were observed in the same outcome measures in the control group.

These findings provide robust evidence that cognitive behavioral therapy based psychoeducational interventions incorporating family participation are effective in improving psychological well-being and quality of life in children with attention deficit hyperactivity disorder. From both psychiatric and nursing perspectives, such programs represent a valuable, non-pharmacological adjunct to standard care, supporting holistic and family-centered approaches in the multidisciplinary management of childhood attention deficit hyperactivity disorder.

This study was registered under Clinical Trial Number: NCT06624527 on September 25, 2023. URL: https://clinicaltrials.gov/study/NCT06624527?term=NCT06624527&rank=1.

The online version contains supplementary material available at 10.1186/s40359-026-04110-7.