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.