Development and Validation of a Solution-Focused Psychological Empowerment Package for Mothers of Children with ADHD

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate and persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning across multiple settings (American Psychiatric Association, 2022). Although the diagnostic criteria are child-centered, the clinical consequences of ADHD are distributed across the family system. Difficulties with task initiation, time management, emotional self-regulation, persistence, and behavioral inhibition can transform ordinary family routines—waking for school, homework, meals, play, and bedtime—into repeated episodes of negotiation and conflict. For caregivers, therefore, ADHD is not experienced only as a set of symptoms in the child; it is often lived as a chronic pattern of unpredictability, vigilance, repeated problem solving, and emotional labor.

Evidence consistently indicates that parents of children with ADHD experience elevated parenting stress and mental-health burden. Systematic evidence has linked child behavioral and sleep difficulties with poorer parental mental health and greater parenting stress (Martin et al., 2019), and broader syntheses have identified parenting stress, negative parenting practices, family disruption, and parental psychopathology as factors associated with ADHD symptom severity and family functioning (Jendreizik et al., 2023). These associations are likely bidirectional rather than unidirectional. Challenging child behavior increases parental fatigue and reactivity, whereas exhausted or distressed parents may find it harder to maintain consistent routines, calm limit-setting, or positive reinforcement. This reciprocal process is especially important when designing family interventions because symptom reduction in the child does not necessarily translate automatically into restoration of parental well-being.

Behavioral parent training is a well-established component of multimodal ADHD care. Meta-analytic and systematic-review evidence shows that parent training can improve parenting behavior, parental sense of competence, parent-child relationship quality, and child behavioral outcomes (Daley et al., 2014; Marquet-Doléac et al., 2024). Nevertheless, conventional parent-training formats usually prioritize techniques for managing child behavior. Such programs are clinically valuable, but their central question is commonly “What should the parent do differently with the child?” rather than “What psychological resources does the parent need in order to remain effective, hopeful, and emotionally regulated while living with a chronic developmental condition?” This distinction matters because a mother who knows the correct behavioral technique may still be too exhausted, ashamed, isolated, or dysregulated to implement it consistently.

The need to address the parent as a person, rather than solely as an agent of child behavior change, is increasingly recognized. Parenting stress has been associated with modifiable factors such as parental depression and social support, suggesting that family intervention should include protective resources as well as behavior-management skills (Fang et al., 2024). Likewise, mindfulness-based parent interventions have shown potential to reduce stress among parents of children with ADHD, although the evidence is heterogeneous and does not support a single universal model (Lee et al., 2022). These findings collectively suggest that parent-focused interventions may be strengthened when they explicitly target emotion regulation, perceived competence, self-blame, supportive relationships, and the capacity to notice progress.

Solution-focused practice offers a theoretically compatible framework for this purpose. Rather than organizing treatment around detailed analysis of deficits, solution-focused approaches emphasize preferred futures, exceptions to problems, existing strengths, scaling, small achievable changes, and collaborative identification of what is already working. This orientation may be particularly suitable for caregivers whose daily life has become dominated by failure narratives. A mother who repeatedly hears that her child is “difficult,” receives complaints from school, and judges herself against unrealistic standards can gradually develop a problem-saturated parenting identity. A solution-focused stance deliberately searches for exceptions: mornings that went slightly better, conflicts that stopped earlier, occasions when the child cooperated, or moments when the mother remained calm. These exceptions are not treated as accidental; they become evidence of resources that can be amplified.

Recent evidence lends support to systemic, solution-focused parent programs. An updated systematic review and meta-analysis of Parents Plus programs found beneficial effects on child behavior, parental stress, parental satisfaction, and therapeutic goal attainment across a range of family and clinical contexts, including ADHD (O'Dwyer et al., 2025). Importantly, this literature suggests that solution-focused parent work need not compete with evidence-based behavioral principles. Instead, it can provide a relational and motivational architecture within which behavioral, cognitive, and emotional skills are more likely to be used. In the present study, solution-focused principles were therefore integrated with psychological empowerment, emotion regulation, cognitive restructuring, and parent-child relational strengthening.

Psychological empowerment in this context refers to strengthening the caregiver's sense of agency, competence, access to resources, decision-making capacity, and ability to act in accordance with personally meaningful goals. For mothers of children with ADHD, empowerment may involve several simultaneous shifts: from self-blame to a more accurate understanding of neurodevelopmental difference; from crisis-driven reacting to deliberate pauses; from global judgments of failure to recognition of specific effective responses; from social isolation to active support seeking; and from perfectionistic goals to small, observable improvements. These changes are clinically relevant because the caregiving environment for ADHD is characterized by high frequency rather than rare intensity: many burdens arise from small but repeated disruptions over days and years.

Cultural context is also central. Parenting expectations, family roles, school-family relationships, and stigma are shaped by local norms. Qualitative work has shown that parents of children with ADHD may encounter misunderstanding, blame, and practical barriers to support (Mesfin & Habtamu, 2024). In Iranian families, mothers frequently carry a substantial share of educational coordination, appointment management, emotional caregiving, and daily routine organization. A locally context-informed intervention should therefore be grounded not only in imported theoretical principles but also in mothers' own descriptions of where strain occurs, what support is absent, what they already do effectively, and what type of change feels realistic.

For these reasons, an intervention-development design was chosen rather than directly testing an externally developed protocol. The study first explored mothers' lived experiences and identified recurring needs, resources, and conflict patterns. These qualitative findings were then mapped onto solution-focused and empowerment principles to construct a brief intervention. Finally, an expert Delphi process was used to evaluate the relevance, necessity, clarity, structure, and feasibility of the proposed sessions. Figure 1 summarizes this developmental sequence. The aim of the study was therefore to develop and establish the content validity of a solution-focused psychological empowerment package specifically designed for mothers of children with ADHD. The study did not test clinical efficacy; rather, it sought to create a theoretically coherent, locally context-informed, and expert-reviewed intervention ready for subsequent controlled evaluation.

Methods

Study Design

An exploratory sequential mixed-methods design was used. The first phase was qualitative and focused on identifying needs, recurrent experiences, resources, and change targets from mothers' narratives. The second phase translated these findings into a structured intervention and evaluated the resulting package through expert judgment and Delphi-based content validation. This sequence was selected because intervention development requires both experiential relevance and theoretical coherence. The qualitative phase established what mattered in mothers' daily lives; the intervention-mapping phase linked those findings to solution-focused and empowerment mechanisms; and the expert phase examined whether the resulting content was necessary, clear, feasible, and appropriately sequenced.

Participants and Sampling

The qualitative sample consisted of 10 mothers of children reported as having an ADHD diagnosis. Purposeful sampling was conducted through clinics in District 5 of Tehran. Eligibility required the mother to have at least a high-school diploma and a child aged 6–12 years with an ADHD diagnosis. The available study records did not specify the diagnostic professional, diagnostic interview, DSM-based verification procedure, or medical-record confirmation used to establish the child’s ADHD diagnosis; this information should be added if it can be verified from the original recruitment records. Mothers were excluded if they had participated in another therapeutic program during the previous six months, were currently using psychiatric medication, reported substance use within the family, or had experienced a severe traumatic event during the previous year. Ten interviews were completed. During the final interviews, the research team judged that no substantively new thematic information was emerging; however, no prospective saturation grid or formal saturation index was documented. Accordingly, the sample is described as achieving thematic sufficiency within this relatively homogeneous clinical sample rather than as demonstrating saturation by a formal quantitative criterion. Participant characteristics are presented in Table 1.

The expert-validation panel comprised six professionals, including university faculty members and clinicians with substantial experience in psychology, counseling, and ADHD-related work. Their mean age was 47.19 years (SD = 4.84), and their mean professional experience was 19.7 years (SD = 6.51). Two experts were women and four were men. The panel was selected for methodological and clinical relevance rather than statistical representativeness, consistent with the purpose of expert content validation.

Data Collection

Semi-structured interviews were conducted at the Nasim Counseling Center. Interview prompts were designed to elicit concrete descriptions of daily challenges, emotional responses, mother-child conflict, coping attempts, successful exceptions, available supports, unmet needs, and mothers' hopes for change. Questions were deliberately open enough to allow unanticipated themes to emerge. With participants' permission, interviews were audio-recorded and transcribed in full. Recruitment stopped after 10 interviews when the final interviews were judged not to add substantively new themes. Because a formal saturation-tracking matrix was not documented, this stopping decision is reported as a pragmatic judgment of thematic sufficiency.

Intervention Development

Intervention development proceeded through a structured mapping process. First, qualitative themes were organized into clinically meaningful domains. Second, each domain was linked to change processes derived from solution-focused practice and psychological empowerment. Third, exercises were selected only when they served an identified maternal need. For example, descriptions of repeated morning and homework conflicts informed routine mapping and micro-change planning; self-blame informed strengths-based identity work and cognitive restructuring; reciprocal escalation informed the “pause point” and co-regulation exercises; and isolation informed support-network mapping and assertive communication. This prevented the package from becoming a generic collection of techniques.

The resulting program contained six weekly sessions of approximately 90 minutes each. Sessions were deliberately sequenced from concrete daily routines toward emotional regulation, conflict interruption, parenting identity, cognitive and social empowerment, and finally maintenance and crisis planning. Homework assignments were brief and behaviorally specific to reduce burden and to preserve the solution-focused emphasis on small, observable changes.

Qualitative Analysis

Thematic analysis followed the phases described by Braun and Clarke (2021): familiarization with the data, coding, generation of candidate themes, review and refinement of themes, definition and naming of themes, and production of an analytic account. Coding was performed manually with spreadsheet support. The documented credibility procedures consisted of review of codes and themes with the academic supervisors and independent coding of one interview by an additional expert to challenge potentially idiosyncratic interpretations. These procedures were used as analytic checks rather than as a formal inter-rater reliability test. The available study records do not document formal member checking, a prospectively specified audit-trail protocol, or independent double-coding of the full dataset; these are therefore not claimed as trustworthiness procedures.

Content Validation and Delphi Procedure

The preliminary intervention was reviewed by six experts in an iterative expert content-validation process. Because the available study records do not specify the exact number of review rounds, a formal Delphi design is not claimed here. Experts rated the necessity of each session and scored five package-level dimensions—alignment with empowerment goals, session structure, adequacy of session time, content sufficiency, and overall package evaluation—on a 5-point scale. Session necessity was summarized using Lawshe's Content Validity Ratio (CVR) (Lawshe, 1975); with six experts, unanimous classification of a session as essential yields CVR = 1.00. For each package-level dimension, the normalized expert-rating proportion was calculated as the sum of the six expert scores divided by the maximum possible score (6 × 5 = 30). The overall expert-rating proportion was the arithmetic mean of the five normalized dimension scores. Item-level Content Validity Index (I-CVI/S-CVI) values were not retained in the available analytic dataset and are therefore not reported or used to support the conclusions. Expert comments were reviewed qualitatively and incorporated into the final package where appropriate. The development and validation pathway is shown in Figure 1.

Ethical Considerations

The study was approved by the Ethics Committee of the University of Tehran (IR.UT.PSYEDU.REC.1404.129). All participants received information about the study purpose, procedures, voluntary nature of participation, confidentiality, and their right to withdraw without penalty. Written informed consent was obtained before participation. Separate permission was obtained for audio recording. Identifying information was removed from analytic materials, and recordings were deleted after transcription in accordance with the approved protocol. Participants were informed that study findings could be made available to them on request. No deceptive procedures were used, and participation did not replace clinical care. Written consent for use of anonymized data in scientific publication was also obtained.

Results

Qualitative Findings

The analysis generated 264 initial codes, 43 subthemes, 15 main themes, and four core themes. The four core themes were: (1) challenges of managing everyday affairs; (2) emotion and conflict regulation; (3) adaptability and resilience; and (4) requirements for effective therapeutic support. Table 2 summarizes the thematic architecture and representative content. Although the themes are presented separately for clarity, mothers' narratives showed that they were strongly interconnected.

The first core theme, challenges of managing everyday affairs, captured the cumulative burden of ordinary routines. Mothers described feeling alone in educational follow-up and caregiving, particularly when spouses worked long hours or schools responded primarily with complaints. Routines were often carefully planned yet fragile; a small disruption could derail the entire morning or evening. Homework, bedtime, preparation for school, and transitions between activities were recurrent tension points. Mothers also described an emotional cycle following diagnosis that moved through shock, anger, self-blame, and, for some, partial relief once they understood ADHD as a neurodevelopmental condition rather than evidence of parental failure.

Parenting responses were described as inconsistent under pressure. Mothers could identify effective strategies such as immediate praise, small rewards, simplifying tasks, and choosing short, active games. Yet the same mothers also reported shouting, threats, or harsh reactions when tired, hungry, rushed, or repeatedly opposed. This contrast was clinically important. It indicated that the problem was not simply lack of parenting knowledge; implementation depended on the mother's emotional state and available energy. Successful moments were more likely when both mother and child were calmer and when expectations were narrower and more realistic.

The second core theme, emotion and conflict regulation, reflected reciprocal escalation. Mothers described anger, helplessness, sadness, shame, anxiety, and fatigue. Children under pressure were described as restless, irritable, tearful, loud, or aggressive. Mothers frequently recognized a cycle in which time pressure or school demands triggered child resistance, which increased maternal arousal, which then intensified the child's dysregulation. Importantly, mothers also described naturally occurring de-escalation strategies: reducing stimulation, pausing demands, waiting for arousal to subside, physical affection when welcomed, naming emotions, apologizing after conflict, and returning to discussion only after calm had been restored. These naturally occurring exceptions became direct targets for amplification in the intervention.

The third core theme, adaptability and resilience, captured mothers' attempts to revise expectations and build competence. Mothers reported learning to lower unrealistic standards, seek professional help, use peer support, and recognize moments when they had remained calm or completed a task without conflict. These moments were psychologically significant because they challenged an identity organized around failure. At the same time, resilience was constrained by chronic fatigue, loneliness, social judgment, limited school support, and the ongoing nature of ADHD-related demands. Thus, resilience was not conceptualized as an individual trait that mothers simply possessed or lacked; it was understood as a dynamic process affected by resources, context, and repeated opportunities for successful coping.

The fourth core theme, requirements for effective therapeutic support, concerned what mothers believed would make help usable. They wanted better understanding of the child's needs, practical ways to regulate the environment, support in tolerating long-term psychological pressure, more effective advocacy in school contexts, and recognition of their own emotional needs. Hope was linked to concrete signs of change—fewer explosive episodes, less shouting, smoother mornings, greater cooperation—rather than to complete symptom elimination. Mothers also emphasized the value of family support and the importance of being seen as people with legitimate needs rather than as caregivers expected to remain indefinitely strong.

Intervention Package

The qualitative themes were converted into six intervention sessions. Session 1 establishes a collaborative therapeutic foundation and maps a typical day to identify high-tension periods, exceptions, and a small “5–10% better” change. Session 2 focuses on maternal emotion regulation and understanding the child's emotional world, including primary and secondary emotions, scaling, co-regulation, and reframing behavior in terms of underlying needs. Session 3 reconstructs the mother-child conflict cycle and introduces a “pause point” before escalation. Session 4 targets parenting identity, shame, and self-blame through a strengths-based narrative and identification of internal and external resources. Session 5 integrates cognitive restructuring with social empowerment, including assertive communication and support-network activation. Session 6 consolidates gains, identifies relapse risks, and creates maintenance and crisis plans. The final structure is presented in Table 4.

Content Validity and Expert Agreement

All six experts rated each of the six sessions as essential, producing a session-level CVR of 1.00 for every session. This finding should be interpreted as evidence of expert endorsement of the necessity of the sessions as whole units; it does not establish the necessity or validity of every technique, exercise, or homework component within each session. Package-level ratings were normalized to the maximum possible score on the 5-point scale. The resulting proportions were 0.90 for alignment with empowerment goals, 0.93 for session structure, 0.97 for adequacy of session time, 0.93 for content sufficiency, and 0.87 for overall package evaluation. The arithmetic mean of these five normalized proportions was 0.92. These values are presented descriptively rather than against an unreported consensus threshold. The results are summarized in Table 3.

Expert feedback was not used merely as a numeric endorsement. Qualitative comments were incorporated into revisions of session sequencing, wording, homework burden, and the balance between solution-focused and cognitive-emotional content. This iterative process helped preserve a coherent intervention logic: the package begins with mothers' daily lived experience, introduces regulation before expecting complex behavior change, addresses identity and social context after initial stabilization, and concludes with maintenance rather than assuming that a brief intervention eliminates ongoing ADHD-related demands.

Discussion

The present study developed and established the content validity of a six-session solution-focused psychological empowerment package for mothers of children with ADHD. Its main contribution is not the introduction of another isolated parenting technique, but the integration of mothers' lived experiences with a coherent set of psychological change processes. Four domains—daily management challenges, emotion and conflict regulation, adaptability and resilience, and requirements for effective therapeutic support—formed the empirical foundation of the intervention. Expert validation then supported the necessity, structure, and practical appropriateness of the resulting package.

The first major finding concerns the density of everyday burden. Mothers did not describe stress primarily in terms of rare crises; rather, stress accumulated through repeated routine failures, school complaints, transitions, homework, and bedtime conflict. This is consistent with research showing that parenting stress in ADHD is linked to child behavioral difficulties and broader family functioning (Martin et al., 2019; Fang et al., 2024). The intervention therefore begins with a full-day map rather than with abstract psychoeducation. This choice is clinically important. Mapping the day makes the problem observable, separates high-risk periods from more manageable periods, and creates opportunities to identify exceptions. It also allows mothers to select a small change that is proportionate to their available energy.

A second important finding was the reciprocal nature of mother-child dysregulation. Participants could often describe what effective parenting looked like, yet those strategies became difficult to use when maternal arousal was high. This observation supports models in which parent and child behavior form feedback loops rather than simple one-way causal chains. Meta-analytic research has found associations between parenting stress, negative parenting practices, and ADHD-related outcomes, while behavioral parent training produces benefits not only for child behavior but also for parental outcomes (Marquet-Doléac et al., 2024). The current package addresses this reciprocal process by placing emotion regulation and conflict interruption early in treatment. The “pause point” is deliberately simple: its function is to create a short interval between trigger and response so that the mother can shift from automatic escalation to intentional action.

The qualitative findings also showed that self-blame is not a peripheral issue. Mothers described guilt about being a “bad mother,” perceived responsibility for the child's difficulties, and shame generated by social judgment. Such beliefs can reduce self-efficacy and make ordinary setbacks feel like evidence of global failure. The intervention therefore treats parenting identity as a direct therapeutic target. Rather than offering reassurance alone, session 4 asks mothers to identify evidence of competence, examine the social origins of unrealistic standards, and construct a more accurate strengths-based account of themselves as caregivers. This is aligned with psychological empowerment because agency requires a believable sense that one's actions can produce meaningful change.

Solution-focused methods are particularly relevant to this identity shift. Scaling questions, preferred-future descriptions, exception finding, and micro-goals help move the conversation from “Why does this keep going wrong?” to “When is it slightly better, and what is different then?” This does not deny the chronic nature of ADHD. Instead, it distinguishes acceptance of the condition from resignation about family functioning. The updated meta-analysis of systemic solution-focused Parents Plus programs reported improvements in parental stress, satisfaction, therapeutic goal attainment, and child behavior, providing convergent support for using solution-focused principles in parent work (O'Dwyer et al., 2025). The current package extends that logic by centering maternal empowerment and stressors identified in this local clinical context.

The intervention also deliberately incorporates selected cognitive and behavioral elements. Solution-focused practice alone may not fully address rigid expectations, catastrophic interpretations, or recurrent self-critical thoughts. Likewise, cognitive restructuring without attention to lived exceptions can become overly didactic. Combining these elements allows the intervention to remain pragmatic: mothers learn to identify a recurring thought, test whether it is useful and accurate, generate a more workable interpretation, and then connect that interpretation to a concrete behavioral step. The intention is not to create a comprehensive cognitive-behavioral protocol, but to use cognitive techniques in service of empowerment.

Social support emerged as another central mechanism. Mothers described difficulty obtaining help from schools, spouses, and extended family, and some reported feeling that they had to solve educational problems alone. This finding is consistent with evidence that social support is associated with parenting stress and may represent a modifiable protective factor (Fang et al., 2024). Accordingly, the package includes support-network mapping and assertive communication rather than defining coping as an exclusively intrapersonal skill. This is particularly important in contexts where mothers carry a disproportionate share of care coordination. Empowerment that ignores structural and relational barriers risks implying that the individual should simply become more resilient to inadequate support.

The design also reflects a deliberate effort to minimize treatment burden. Mothers in the qualitative phase repeatedly described fatigue, limited time, and competing responsibilities. A long protocol with extensive daily homework could therefore reproduce the very demands it intends to reduce. The six-session format and brief between-session tasks were selected to maximize feasibility. Homework focuses on observing one calm moment, implementing one micro-change, using one pause, or initiating one support-seeking conversation. These assignments are consistent with the solution-focused principle that small successful actions can create momentum and increase perceived competence.

The unanimous session-level CVR values and the package-level normalized expert ratings provide evidence of expert endorsement, but their scope should be interpreted narrowly. The CVR was calculated for whole sessions rather than for each intervention component, and item-level I-CVI/S-CVI values were not available. Expert consensus therefore supports the coherence and perceived necessity of the package at the session level; it does not demonstrate that every technique is essential, nor does it establish clinical efficacy. Statements about efficacy would require an experimental or quasi-experimental evaluation with validated outcome measures, adequate sample size, preregistered analyses, and follow-up. The present study therefore represents an intervention-development stage rather than a clinical-effectiveness trial.

Future evaluation should ideally use a randomized controlled design comparing the package with an active control, treatment as usual, or a recognized parent-training program. Primary maternal outcomes could include parenting stress, psychological empowerment, self-efficacy, emotion regulation, and depressive/anxiety symptoms. Secondary outcomes could include parenting practices, parent-child relationship quality, child behavioral functioning, school-related conflict, and family quality of life. Multi-informant assessment would strengthen inference because reliance on the participating mother alone creates common-method bias. Where feasible, teacher reports and observational coding of parent-child interaction could be included.

Treatment fidelity also deserves explicit attention in subsequent trials. Because the package integrates solution-focused, cognitive, emotional, and relational components, therapist drift could alter its mechanism. A session checklist, training manual, and independent fidelity ratings would help determine whether the protocol was delivered as intended. At the same time, fidelity should not eliminate responsiveness. Solution-focused practice depends on individualized goals and client language; therefore, fidelity criteria should focus on core processes rather than scripted wording.

Several limitations of the current study must be acknowledged. First, the qualitative sample was small and drawn from urban clinical settings in one district of Tehran. Purposeful sampling is appropriate for intervention development, but the findings should be regarded as locally context-informed rather than representative of Iranian mothers broadly. Experiences may differ in rural settings, smaller cities, different socioeconomic groups, or families with limited access to specialist care. Second, only mothers participated. This focus was intentional because the intervention was designed around mothers' experiences, yet fathers, grandparents, and other caregivers may influence family dynamics and could identify different needs. Third, qualitative findings relied on self-report and may be affected by recall, social desirability, and willingness to disclose harsh parenting or family conflict. Fourth, recruitment stopped after 10 interviews based on a pragmatic judgment that the final interviews were not generating substantively new themes; a formal saturation grid was not documented. Fifth, the documented trustworthiness procedures were limited to supervisor review of codes/themes and independent coding of one interview; the available records do not document formal member checking, a prospective audit trail, or full-dataset double coding.

Sixth, the expert panel consisted of six members. Unanimous necessity ratings produce CVR = 1.00, but with a small panel a single rating change would materially alter the index. Seventh, validation was conducted at the session level rather than at the level of each technique, exercise, and homework item, and item-level I-CVI/S-CVI values were not available. Future revisions should use a larger multidisciplinary panel and retain item-level validity ratings. Eighth, the current validation addresses expert-rated content and face-related dimensions rather than construct validity or clinical efficacy. Finally, the package integrates multiple mechanisms, which may make it difficult to identify active ingredients without dismantling or mediation analyses.

Despite these limitations, the study has several strengths. Intervention content was derived from mothers' narratives rather than imposed solely from theory. The package translates qualitative findings into specific session components, making the link between need and intervention visible. It combines individual and relational targets, acknowledges social context, and treats hope as a practical process rather than a vague positive attitude. Expert review was iterative, and ethical procedures included informed consent, confidentiality, withdrawal rights, and protection of recorded data.

The clinical implication is that support for mothers of children with ADHD may be improved when treatment goes beyond instructing parents how to manage symptoms. Mothers may benefit from a structured space in which their own exhaustion, guilt, conflict patterns, and support needs are legitimate treatment targets. By helping mothers identify exceptions, regulate arousal, revise unrealistic expectations, mobilize support, and build a maintenance plan, the intervention aims to increase the conditions under which evidence-based parenting strategies can actually be implemented. In this sense, psychological empowerment is not an alternative to behavior management; it is a potential facilitator of sustainable parenting behavior.

In conclusion, the study produced a six-session, solution-focused psychological empowerment package with strong expert-rated content validity for mothers of children with ADHD. The package is grounded in four empirically derived domains and integrates daily-routine reconstruction, emotion regulation, conflict interruption, strengths-based parenting identity, cognitive and social empowerment, and maintenance planning. The next scientific step is not further assertion of benefit but rigorous efficacy testing. A well-designed randomized trial should determine whether the intervention produces measurable and durable improvements in maternal well-being, empowerment, parenting, and family functioning, and whether those changes contribute to improved outcomes for children with ADHD.

Conclusion

The present study developed a brief, locally context-informed, solution-focused psychological empowerment package for mothers of children with ADHD and obtained strong session-level expert endorsement. The intervention is grounded in the lived experiences of mothers recruited from urban clinics in one district of Tehran and organizes change around realistic daily routines, maternal regulation, interruption of reciprocal conflict, reconstruction of parenting identity, cognitive and social empowerment, and maintenance planning. Because this was an intervention-development and expert-validation study, no claim of clinical efficacy or broad cultural generalizability is warranted. The package should now be evaluated in a preregistered randomized controlled trial with adequate power, validated maternal and family outcomes, item-level content validation, fidelity monitoring, multi-informant assessment, and follow-up sufficient to test durability.

Declarations

Ethics approval and consent to participate: The study was approved by the Ethics Committee of the University of Tehran (IR.UT.PSYEDU.REC.1404.129). Written informed consent was obtained from all participants. Participation was voluntary, confidentiality was protected, and participants could withdraw at any stage without penalty. Audio recordings were deleted after transcription.

Consent for publication: Written consent for publication of anonymized findings was obtained from all participants.

Funding: This research received no financial support from any funding agency, institution, or organization.

Competing interests: The authors declare that they have no competing interests.

Availability of data and materials: De-identified data may be available from the corresponding author upon reasonable request and subject to ethical and institutional requirements.

Authors’ contributions: M.H. designed the study, collected and analyzed the data, developed the intervention, and drafted the manuscript. Y.M. and M.S.K. contributed methodological and academic supervision and critically revised the manuscript. All authors reviewed and approved the final manuscript.

Acknowledgements: The authors thank the participating mothers and the expert panel for their time and contributions.