Effects of a Brief Online Mindful Parenting Program on Parenting Stress and Parent-Reported Child Symptoms in Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Abstract

This randomized controlled trial evaluated the efficacy and feasibility of a brief, 4-week Online Mindful Parenting Program on parenting stress, parental mindfulness, and parent-reported child symptoms among parents of children with attention-deficit/hyperactivity disorder (ADHD). Following diagnostic confirmation via the Thai Diagnostic Interview for Children and Adolescents-Revised, 98 eligible parents were randomized to an intervention ( n  = 49) or control group receiving standard medical care ( n  = 49). The intervention consisted of four weekly 90-min videoconferencing sessions, 5-min daily home practices, and four daily mobile messaging reminders. Feasibility was measured via session attendance. The primary endpoint was parenting stress (evaluated by the Parental Stress Scale) at immediate post-intervention. Secondary outcomes included the Philadelphia Mindfulness Scale, and the parent-reported Swanson, Nolan, and Pelham Rating Scales were assessed at baseline, immediately after, and 2-month follow-up. The intervention proved feasible, with 96.0% of participants completing at least three sessions, home practice averaging 4–5 days per week among those who submitted practice logs, and no adverse events or harms reported. Compared to controls, the intervention group demonstrated significantly reduced parenting stress at both immediate post-intervention ( p  < 0.001, d  = 0.85) and 2-month follow-up ( p  < 0.001, d  = 0.73). After adjusting for baseline parenting stress, significant between-group improvements were also observed in parent-reported child Inattention ( p  = 0.01, d  = 0.57) and parent-reported child Hyperactivity ( p  = 0.02, d  = 0.47) at immediate post-intervention. However, these between-group differences in ADHD symptoms were no longer statistically significant at the 2-month follow-up. No significant between-group differences were observed for parent-reported child oppositional defiant symptoms or general parental mindfulness. This highly feasible and brief online program effectively reduced parental stress and yielded short-term reductions in parent-reported child core ADHD symptoms. By combining a condensed format with daily digital prompts to encourage consistent home practice, it offered an accessible and scalable support model for families managing ADHD. This study was preregistered with the Thai Clinical Trials Registry under the identification number TCTR20250801008. The full trial protocol is available upon request from the corresponding author.