Background: Recent studies suggest that parent involvement with behavioral treatment for behavior problems may reduce parent stress in families with a child with autism spectrum disorder (ASD). However, it is not known whether high treatment adherence to protocols is associated with reduced parent stress nor what perceptions of treatment may moderate this relation.

Method: The current study examined the relation between parents’ adherence to behavioral treatments and parent stress, and whether parents’ perceptions toward treatment moderate this association. Participants were 190 mothers, fathers, or caregivers of a child with ASD. A bivariate correlation matrix examined associations between each variable, and three separate linear regression models regressed parent stress on treatment adherence, perceptions of treatment, and the interaction of the two. Covariates included child age and severity of behavior problems.

Results: Treatment adherence had a significant negative relation with parent stress. Treatment demandingness, but neither treatment relevance nor treatment effectiveness, emerged as a moderator for the association between treatment adherence and parent stress.

Conclusion: Evidence was found for an association between treatment adherence and parent stress with partial support that perceptions of treatment moderate the association. Specifically, high treatment adherence was associated with lower parent stress, and the effect was most pronounced when treatment demandingness was low. These findings have implications for clinicians and treatment providers who are well-positioned to monitor and address parent attitudes to aid positive treatment outcomes for both the child and the parent. Moreover, clinicians can consider the impact of treatment demandingness on the whole family system.