Non-randomized Controlled Pilot Study of a Health Promotion Program for Mothers of Children in the Ultra-orthodox Community: Examining Feasibility
Phase: NA
Conditions: Attention Deficit Disorder With Hyperactivity (ADHD)
Sponsor: Adina Maeir

Pilot Study on a Health Promotion Intervention for Ultra-Orthodox Mothers of Children With ADHD 
NCT06703242 
 
Date: January 30, 2024 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
Intervention protocol content outline 
Unit 
Session Objective(s) 
Target behavior 
Method 
Developing 
awareness/ 
knowledge 
of ADHD 
and it’s 
biological 
origins 
1 
Create a safe 
emotional 
environment to 
reduce 
shame/stigma 
Member shares 
thoughts and 
experiences to the 
group. 
1) Setting: safe and attractive place in the school building 
 
2) Group contract:  
a) Therapist brings prepared contract which includes 
establishing boundaries, confidentiality, communication, 
norms of behavior, expectations from the group, 
overarching goals. 
b) Members modify and agree through group discussion.  
 
3) Activity: Members complete the ADHD stigma 
questionnaire and then have a follow up discussion 
 
4) Introduction to client diary: A place for each 
member to write down their takeaways and mini goals 
during each session  
2 
Reduce ambiguity 
of diagnosis and 
behavioral 
manifestations 
Members will use 
biological attribution 
and research-based 
descriptions/language 
when discussing their 
child’s ADHD 
manifestations. 
1) Short presentation: provide background information 
on ADHD 
 
2) Group Activity:  
a) Analyze prepared ADHD script of behavioral 
manifestations 
b) Members write a script together describing ADHD 
along with examples of ADHD behavioral manifestations 
(from personal experiences).  
 

3) Goal: Have a real or imagined conversation with a 
person of their choice and describe their child’s ADHD 
utilizing labelling/language from this session 
3 
Identify reliable 
resources 
regarding optimal 
and recommended 
treatment for 
child’s ADHD 
 
Identify resources 
available to 
support mothering 
a child with ADHD 
Members identify 1-2 
appropriate resources 
for their child’s 
ADHD challenges 
and/or parenting 
skills. 
1) Short presentation:  
a) Recommended ADHD treatment, clinical guidelines, 
examples of behavioral ADHD treatment options 
 
2) Reflective group activity: 
a) Identify reliable sources of ADHD and health 
information 
b) Recall successful past experiences finding reliable 
sources 
 
3) Establish the group as a resource: 
a) Follow up norms of communication with the group 
during and post intervention 
 
4) Goal: each member creates an action plan to identify 1 
resource for managing their child’s ADHD. 
4 
Modify negative 
beliefs about 
mothering and its 
relationship to 
child behavior  
 
Promote positive 
identity regarding 
their mothering 
role  
Members are able to 
verbally de-couple 
their child’s ADHD 
behaviors from their 
mothering identity 
1) Group Activity:  
a) Members are presented with statements/depictions that 
reflect the cognitive bias (i.e., mothers are to blame for 
child’s behavior) in various social contexts. 
b) Members generate personal examples of scenarios  
c) Members create alternate scenarios- role play positive 
reframing of belief in response to child’s behavioral 
challenges (e.g. child is not responding to parenting 
attempts at routinizing bedtime as opposed to self-blame, 
‘I’m not a good enough mother to this child’- mother 
recognizes need for additional/knowledge/skills) 
 
2) Goal: To notice cognitive bias(es) in their 
surroundings.  

Developing 
strategies to 
manage 
child ADHD 
in the school  
5 
Understand the gap 
between the 
school’s 
capabilities to meet 
their child’s needs  
 
Increase mother 
advocacy skills 
Members will 
identify a person of 
interest in their 
child’s education and 
be able to advocate 
for 1 of their child’s 
needs.  
1) Short presentation given along with key school staff 
member: Brief education about effective self-advocacy 
 
2) Role playing:  
a) Members identify a need of their child with ADHD 
b) Practice the skill of self-advocacy (multiple scenarios, 
different contexts) 
 
3) Goal: Each member identifies in own life:  
a) Where they want to apply this  
b) Create a plan 
Healthy 
mother-
healthy 
child: 
Legitimacy 
and 
importance 
of self-care 
6 
Promote 
engagement in 
health promoting 
activities in 
response to their 
caregiver role 
Members will 
increase engagement 
in 1 health promoting 
activity (subjectively 
or objectively) 
1) Short presentation:  
a) The parenting occupations and purposes framework 
b) Knowledge on link between healthy lifestyle behaviors 
and health outcomes 
 
2) Group activity: Adapted Occupational Questionnaire 
to build awareness of personal profile regarding 
engagement in health promoting activities and discussion 
 
3) Goal:  
a) Each member chooses a goal* to promote their 
engagement in a health promoting activity 
b) Action plan: setting + visualize implementation, 
identify barriers, identify resources  
 
*Therapist provides a bank of goals to choose from. 
Notes. The parenting occupations and purposes framework (Lim et al., 2021)