# Practise friendship without pressure

Published by Pawel Jozefiak. [About this project](https://adhd100.jock.pl/about/), [How we check sources](https://adhd100.jock.pl/methodology/)

- Canonical: https://adhd100.jock.pl/practise-friendship-without-promises/
- Language: en
- First published: 2026-09-29
- Evidence checked: 2026-09-29, using AI-assisted source verification
- Clinical review: Not clinically reviewed
- Number 100 of 100 in the list: https://adhd100.jock.pl/#practise-friendship-without-promises

Pick one social situation your child wants help with, and keep expectations realistic.

**The number:** Very low certainty: small short-term gain in social skills from full programmes (SMD 0.253) ([Gosling et al., BMJ accompanying open data, 2025](https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv))

## The evidence

- How sure: Certainty of evidence: Very low certainty. Measured in people with ADHD.
- See this comparison on the evidence map: https://adhd100.jock.pl/evidence/#r-social-skill-training-youth-social-communication-skills-na-short
- Evidence grade: C. Grade C: small or mixed studies, expert consensus or clinical practice. Worth knowing, not worth betting on.
- Basis: EBI re-estimation of youth social skills trials; practical rehearsal is an extrapolation, not a tested substitute for a programme.
- Outcome: youth social-communication skills after full social skills programmes
- Comparison: vs passive controls, including waitlist
- Benefit: 32/100. The benefit score is an editorial prioritization for the general list, weighted by certainty. It is not a prediction of what will happen for you.

## Why it matters

NHS guidance suggests rehearsing conversations through role-play and supporting friendships. EBI found only a small short-term effect on social communication from social skills training near 12 weeks, SMD 0.253, with very low certainty. The medium-term estimate came from 2 small trials and was too uncertain to show an effect. A brief rehearsal at home has not been shown to deliver what the programme did.

## How to do it

1. Ask your child which social situation they'd like help with.
2. Rehearse one simple exchange together, like joining a game or asking a question.
3. Look for enjoyment and your child's own goals, not a change of personality.

## Talk to a clinician first

Do not promise that social skills training will reliably improve ADHD or friendships; the evidence is very uncertain.

## Putting it into practice

### Start now

- 1 minute: Try one gentle question: 'Is there a friendship situation you want help with?'
- 5 minutes: Rehearse one short exchange with your child, if they want to.
- 15 minutes: Discuss a recent social situation, practise one option and ask whether it feels useful to your child.

### What it looks like

- Practise asking, 'Can I join the next round?' if your child wants to.
- Take turns asking about a shared interest and listening to the answer.

### Common mistakes

- Practising without the child's interest can feel corrective, so let them choose the goal.
- Bullying is not a social-skills failure, so involve responsible adults if a child is being targeted.

### Trusted how-to guides

- [ADHD: supporting relationships (undated)](https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/), Norfolk and Waveney Children and Young People's Health Services, NHS

## Sources

- [EBI-ADHD umbrella review: re-estimated dataset, commit 86eff22a9ffb](https://raw.githubusercontent.com/CorentinJGosling/EBI-ADHD-UR-2025/86eff22a9ffb/datasets/dataset-ur-adhd.csv), Gosling et al., BMJ accompanying open data, 2025 (Tier 1 guideline)
- [Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making](https://pmc.ncbi.nlm.nih.gov/articles/PMC12651917/), BMJ, full text via PMC, 2025 (Tier 1 guideline)
- [ADHD: supporting relationships (undated)](https://www.justonenorfolk.nhs.uk/nd-digital-library/understanding-neurodiversity/adhd/), Norfolk and Waveney Children and Young People's Health Services, NHS, 2026 (Tier 1 guideline)

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General information about ADHD, not a diagnosis or an individual treatment plan. Tailoring changes the order of suggestions; it does not assess you. Medication decisions belong with you and a qualified clinician.

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