Engagement barriers are barriers that prevent individuals from participating in Attention Deficit Hyperactivity Disorder (ADHD) therapy. Kazdin et al. (1997) found that having fewer engagement barriers serves as a protective factor to prevent treatment dropout. Despite knowledge behind the importance of having few engagement barriers, who experiences what barriers is largely unexplored. By understanding what engagement barriers can arise during behavioral therapy, and who experiences them, therapists can generate tools to overcome these barriers, thus improving the treatment of adolescent ADHD. Our purpose of this study was to ascertain and understand any relationships between engagement barriers in behavioral therapy and clinical characteristics/sociodemographic factors. Participants were 121 adolescents with ADHD (which came from an ethnically diverse sample) and their parents. Twenty-five different barriers were sorted across three subtypes (cognitive/attitudinal, behavioral, and logistical), three sources (parent, teen, or dyadic) and three treatment phases (engagement, skills, and planning). Minority status, gender, ADHD medication status, family adversity, Oppositional Defiant Disorder (ODD) comorbidity, and parental ADHD served as independent variables. I used multiple regression models to analyze relationships between each independent variable and barrier subtype, source, and treatment phase. ODD comorbidity and parental ADHD each significantly predicted a primary outcome of an overall increase in barrier frequency. Significant secondary outcomes included ODD comorbidity and parental ADHD each significantly predicting greater cognitive barriers, teen barriers, engagement phase, and skills phase barriers frequencies. ODD also predicted significant increases in planning phase barriers frequencies, while minority status significantly predicted lower planning phase barriers frequencies. These results demonstrate that populations of adolescents diagnosed with ADHD and comorbid ODD or who have parents that are also diagnosed with ADHD are at risk to experiencing more engagement barriers. Additional research is required to develop therapeutic tools. These tools will help therapists better serve adolescents with comorbid ADHD/ODD, and parents with ADHD.

One year prior to the 1968 presidential election, CBS News hosted a town hall debate between rising political stars Robert Kennedy and Ronald Reagan that captured their opposing beliefs and styles as partisan leaders, especially on racial issues. In post-civil rights America, no tool shaped race relations as effectively as the two types of populistic rhetoric distinctly epitomized by Reagan and Kennedy. The reactionary style and colorblind rhetoric of the former was used by the Right to promote white backlash and racial hierarchy. Conversely, Kennedy’s inclusive style and rhetoric was used by the Left to break down hierarchy and expand political representation. This research explores the rhetoric and policy proposals in the campaigns of Reagan in 1966 and Kennedy in 1968 on the issues of government size, welfare, and law and order. In a macroscopic view, it also looks at partisan trends that followed the loss of the inclusive style, with Kennedy's death, and the adoption of the reactionary style throughout the Republican Party. I argue it was these compounding processes in the mid to late 1960s that made white backlash mainstream and pushed the country to the Right where it has largely remained since. This research utilizes primary source material that reflects Reagan’s and Kennedy’s campaigns, identities, and beliefs, namely newspaper reports, opinion pieces, and contemporary political analyses. This body of material is supplemented with secondary biographies that have shaped understandings of the campaigns in historical scholarship. Altogether, the chosen sources enable analysis of the populist messages Reagan and Kennedy promoted in their campaigns and brings to light refined explanations of the twentieth century party realignment, race’s primary role in the process, and America’s current conservative tendencies and beliefs.

STAND (Supporting Teens Autonomy Daily) is an evidence-based practice modular therapy that helps ADHD (Attention deficit hyperactivity disorder) teens build academic and interpersonal skills. STAND has been shown to be cost-effective in promoting evidence-based practices compared to the usual-care psychological services and medication for ADHD. The purpose of this study is to assess the utilization and efficacy of online resources and training tools for therapists and supervisors implementing STAND. Six therapists and four supervisors administered STAND with the use of LYSSN, an AI (Artificial Intelligence) based tool that provides feedback on therapy audio tapes, and Care4, a dashboard that provides supervisors with a library of resources. I analyze 49 therapist sessions and 3 supervision sessions to determine the attitudes and engagement of the therapists and clients with STAND activities by calculating the average of scores provided by therapists and supervisors from Care4. Therapists login onto the Care4 system after a therapy session and answer questions about feedback they received from LYSSN and the preparation for their session. Supervisors used the data collected from the therapist’s LYSSN score and formulate their feedback for therapists. Therapists spent an average time of 11 to 30 minutes reading through the STAND session description and preparing client worksheets and an average of 1 to 10 minutes reviewing LYSSN feedback, watching STAND demonstration videos, seeking consultation from the STAND research team, and reviewing feedback from their supervisor. Therapists found LYSSN to be “occasionally” accurate and credible. Collection of this research will provide insight about the implementation of STAND through an online format and about the general appeal of the use of AI, the workload of supervisors and therapists could be reduced and give feedback more efficiently to them with regards to STAND treatment and other evidence-based treatments.

The adolescent age is ideal for Attention-Deficit/Hyperactivity Disorder (ADHD) treatments, such as Supporting Teen's Autonomy Daily (STAND) which was developed to make therapy accessible to disadvantaged youth with ADHD, since these treatments may be carried from the teenage years into adulthood. To increase the quality of care for these adolescents and improve their outcomes, six therapists and four supervisors have received STAND training. This training uses technology, such as the Artificial Intelligence (AI) tool that gives them feedback: Lyssn, is used to enhance provider engagement and delivery. The purpose of this study is to examine whether this STAND training and its technology are effective in improving therapists' STAND delivery methods to patients. Through 64 previously coded audio recordings of provider sessions that took place in Spring and Summer 2021, I assess the effectiveness of this AI training for therapists and their supervisors on their performance and delivery of STAND treatments. To do this, I analyze the Motivational Interviewing Treatment Integrity (MITI) coding system scores that the therapists received as feedback from Lyssn, when the therapy sessions occured, when those sessions were uploaded, and when therapists received feedback. I also examine questionnaires given to therapists regarding their thoughts on Lyssn before and after their sessions. Though data is preliminary and lacks a control group, results could inform us of therapists' positive engagement with Lyssn. Using AI feedback to train therapists on new practices or more efficient ways to deliver ADHD therapy sessions could potentially produce significant benefits to disadvantaged adolescents with ADHD so that they receive optimal care and see positive outcomes.