Addressing the complex homework and organization problems faced by students with attention-deficit/hyperactivity disorder (ADHD) must be balanced with ensuring that interventions are feasible to implement. The Homework, Organization, and Planning Skills (HOPS) intervention was developed to be a brief intervention implemented in typical school settings with minimal training/support required for school clinicians. Given this, it is critical to explore how clinician adherence and competency relate to student outcomes. Participants included 107 adolescents with ADHD (Mage = 11.95, SD = 1.04; 69% male; 57% on ADHD medication) who participated in the HOPS intervention. Path analyses examined the relation between clinician adherence (fidelity to session content, session length) and competency (e.g., empathic, enthusiastic, calm, collaborative), controlling for baseline scores of the outcome measure and other relevant therapeutic processes (parent and adolescent engagement, working alliance). Clinician fidelity and competency were inversely related, such that highly competent clinicians had lower fidelity to the HOPS content. Importantly, clinician competency was a significant predictor of fewer parent-reported adolescent organizational problems and a higher percentage of assignments turned in post-HOPS, whereas clinician fidelity was unrelated to treatment outcomes. Session length was inversely related to parent-reported homework performance, such that longer session length was associated with worse homework outcomes. Findings suggest that school clinician competency is an important factor in predicting positive treatment outcomes for youth who participate in school-based homework and organization interventions. Training to help school clinicians improve their competency including being more empathetic, calm, motivating, and collaborative with students, and to help them flexibly implement school-based interventions is warranted.

解决注意力不足/多动症（ADHD）学生面临的复杂的家庭作业和组织问题，必须在确保干预措施切实可行的前提下进行权衡。家庭作业，组织和计划技能（HOPS）干预措施的开发是在典型的学校环境中实施的一种简短干预措施，对学校临床医生的培训/支持最少。鉴于此，探索临床医生的依从性和能力与学生成绩之间的关系至关重要。参与者包括107名患有ADHD的青少年（M年龄= 11.95，  SD = 1.04; 69％男性；参与HOPS干预的ADHD药物占57％）。路径分析检查了临床医生的依从性（对会话内容的忠诚度，会话时长）和能力（例如，同理心，热情，镇定，协作）之间的关系，控制了结果测量的基线分数和其他相关治疗过程（父母和青少年的参与，工作联盟）。临床医生的保真度和能力成反比，因此，高素质的临床医生对HOPS含量的保真度较低。重要的是，临床医生的能力是父母报告的青少年组织问题较少，HOPS后转入作业的百分比更高的重要预测指标，而临床医生的忠诚度与治疗结果无关。上课时间与家长报告的作业成绩成反比，因此上课时间越长，作业结果越差。研究结果表明，学校临床医生的能力是预测参与学校家庭作业和组织干预的年轻人的积极治疗效果的重要因素。必须进行培训，以帮助学校临床医生提高他们的能力，包括变得更善解人意，更加镇静，激励和与学生合作，并帮助他们灵活地实施基于学校的干预措施。研究结果表明，学校临床医生的能力是预测参与学校家庭作业和组织干预的年轻人的积极治疗效果的重要因素。必须进行培训，以帮助学校临床医生提高他们的能力，包括变得更善解人意，更加镇静，激励和与学生合作，并帮助他们灵活地实施基于学校的干预措施。研究结果表明，学校临床医生的能力是预测参与学校家庭作业和组织干预的年轻人的积极治疗效果的重要因素。必须进行培训，以帮助学校临床医生提高他们的能力，包括变得更善解人意，更加镇静，激励和与学生合作，并帮助他们灵活地实施基于学校的干预措施。