KP

Conduct Problems Treatment Overview

Conduct Problems Treatment (Part 1)

Overview of Treatment for Conduct Problems

  • What Does NOT Work:
    • Individual psychoanalysis
    • Group therapy
    • Punishment

Factors Influencing Treatment Effectiveness

  • Treatment success depends on:
    • Child’s age
    • Nature of symptoms
    • Family context
    • Distinctions between preschoolers and older children/adolescents

Parent Management Training (PMT)

Step 1: Understanding Causes of Disruptive Behaviors

  • Emotional intensity of disruptive behaviors has an effect size (ES) of 0.80, indicating strong correlation with treatment outcomes.

Step 2: Basic Learning Principles

  • Methods to change behavior include:
    • Selective ignoring of negative behaviors
    • Consistent reinforcement of positive behaviors

Token Economy System

  • Framework for behavior modification:
    • Identify a targeted behavior
    • Define a reward
    • Reward the behavior using tokens or points

Step 3: Discipline and Environmental Structuring

  • Importance of reducing disruptive behaviors through:
    • Disciplinary actions
    • Structuring the environment to foster appropriate behaviors

Time-Out Strategy

  1. Give a command to the child.
  2. Praise compliance with the command.
  3. Issue a warning if necessary.
  4. Again, praise compliance.
  5. If undesired behavior persists, issue a time-out.
  6. Release from time-out when ready.
  • Expected Outcomes:
    • Eliminates payoff for undesirable behavior
    • Leaves positive feelings in the parent
    • Can be applied to multiple children simultaneously

Parent-Child Interaction Therapy (PCIT)

  • Targeted Age Group: 2-7 years
  • Therapy sessions involve both parents and children with goals of:
    • Promoting sensitivity and responsiveness
    • Modeling prosocial behaviors
    • Teaching positive behavior reinforcement

Phase 1 (Child-Directed)

  • Techniques used include:
    • Praise: Attend to positive behaviors
    • Reflect: Expand on child's speech
    • Imitate: Create shared experiences
    • Describe: Focus on child’s interests and attention
    • Enthusiasm: Express acceptance and support
  • Ignoring undesirable behaviors instead of responding to them
  • Avoiding questions or exclamatory statements during this phase

Phase 2 (Caregiver-Directed)

  • Focus on:
    • Increasing realistic expectations for children
    • Decreasing hostile or coercive parenting practices
    • Implementing appropriate discipline techniques

Limitations of Parent Management Training

  • Requires active participation and perseverance from caregivers
  • Less effective for older children and adolescents; particularly those with conduct disorder (CD)

Step 4: Generalization of Appropriate Behaviors

  • Emphasizes the need to teach children how to carry appropriate behaviors into various contexts outside the home.