Preliminary Analysis of the Effect of Adolescent Anxiety on Student-Teacher Relationships During Behavioral Consultation

Abstract

Background: The impact of ADHD on the formation of relationships with adults has been noted for several decades. Anxiety has been mentioned as a potentially enhancing factor in the treatment of ADHD and there is emerging evidence in support of this position. Working alliance between therapist and patient is well documented in both adult and child research as a critical component to treatment outcomes. Current research evidence indicates student outcomes are impacted by the relationship between teachers and students. Purpose: The present study is a preliminary investigation probing for anxiety as a possible moderator of the relationship between severity of ADHD and working alliance in behavioral consultation delivered via videoconferencing. Methods: Two cohorts of students (n = 18) were recruited from two rural underserved middle schools to participate in a pilot study investigating the efficacy of school-based behavior consultation delivered via videoconferencing technology. 44% of the total sample were African-American, 22% white, Hispanic, 22% white, non-Hispanic, and 11% Biracial. Participants came primarily from low-income households (M = 24.3 , SD =12.1) and the average mother educational was grade 11.7. Consultation was delivered to teacher mentors using an established model of face-to-face behavior consultation. Results: Parent-reported anxiety had no meaningful impact on the relationship between the severity of ADHD and the working alliance between student and teacher/mentor. There were no significant findings in terms of how the degree of anxiety (i.e., high or low) might moderate this relationship. Discussion: Findings were reviewed in the context of research and clinical implications of comorbidities and the potential impact of research methodologies incorporating analysis of individual components, mediators and moderators.