Anger-coping intervention programs
The anger-coping intervention programs seek to train children
and adolescents with conduct disorder in perspective-taking, awareness
of physiological arousal as a precursor to anti-social action,
use of self instruction or self-talk procedures and problem-solving
strategies (Kendall et al., 1990; Lockman, 1992; Lochman and Dunn,
1993). Specific cognitive behavioral techniques that have been
used as part of anger-coping intervention programs include role-plays,
modeling, biofeedback and behavioral experiments in appropriate
ecological settings. Role-plays involve reactions to hypothesized
social situations and possible consequences to the self and others.
Participants of the role-plays are usually the adolescent with
conduct disorders and the therapist, or a peer if a group intervention
is being used (Kendall et al., 1990; Batsche, 1996). Modeling
techniques are used to teach appropriate appraisal of and response
to potentially ambiguous social situations. Emphasis in role-playing
is on the need to engage in extensive information processing before
selecting a solution, as well as procedures in correct solution
implementation. Use is made of video, bibliotherapy, and role-plays.
Biofeedback training, as part of anger-coping intervention is
meant to assist the child with a conduct disorder to recognize
physiological symptoms that prelude aggressive and irrational
solutions to social problems, and prime the child to take preventive
action (e.g., thought diversion; muscle relaxation). Home-work
tasks are given to enable try-outs of the newly learnt behaviors
in real-life situations.
Problem-solving skills training programs
The focus of problem-solving skills training is on teaching children
and adolescents with conduct disorder cognitive-behavioral methods
of self-regulation and impulse control (Elias and Weissberg, 1989;
Kazdin, 1996). Therefore, problem-solving skills training seeks
to remedy both cognitive deficiencies (e.g., impulse control)
and cognitive distortions (e.g., inappropriate attributions).
The specific procedures used are: (a) stop, calm down, and think
before you act; (b) say the problem and how you feel; (c) set
positive goals; (d) think ahead of consequences; and (e) go ahead
and try the best plan. Participants are trained to self-question
(e.g., `What am I supposed to do?') and to self-prompt in seeking
alternative solutions (e.g., `I have to look at all my possibilities?'),
perspective-taking (e.g., `How could a peer, or a parent or counselor
consider the situation?'); selecting a pro-social solution (e.g.,
`How does my selected solution meet my goals or needs?'; `How
is my chosen solution likely to affect other people who may be
involved?'), self-monitoring in solution implementation (e.g.,
`Am I achieving my intended goal?'; `Is there anything else I
need to consider?'), solution evaluation or appraisal in relation
to original goal (e.g., `I did a good job'; or `I could do even
better'); and solution sharing (e.g., `I would like to share my
success with a peer, counselor, sibling, parent'). Use is made
of video, live modeling, didactic presentation, small group discussion
and competitive and cooperative games (Spivack et al., 1976; Elias
and Weissberg, 1989; Kazdin, 1996). Problem-solving skills training
has been complimented with a parent management training program
to create a supportive environment in the home for the skills
learnt in therapy (Kazdin, 1996; Kazdin and Weisz, 1998).
Problem-solving skills training programs share many
elements with anger-coping intervention programs with the exception
that problem-solving skills apply to self-management in wider
range of behaviors. Empirical studies support the effectiveness
of problem-solving skills training in improving children and adolescents'
problem-solving, social relations with peers, school adjustment
and reducing the incidence of minor delinquent acts (Spivack et
al., 1976; Elias and Weissberg, 1989; Kazdin, 1996). However,
like with the anger-coping intervention programs, problem-solving
skills training is less effective with early-onset or more severe
forms of conduct disorder (Short and Shapiro, 1993; Kazdin, 1996).
Treatment effects also tend to erode over time (Kendall, 1987;
Lochman, 1992).
Attribution retraining
Attribution retraining is primarily targeted at remedying cognitive
distortions in children and adolescents with conduct disorder
(e.g., inaccurate attribution of hostile intent to others). It
seeks to encourage children and adolescents with conduct disorder
to associate inconsistent or uninterpretable social cues by others
to uncontrollable or accidental causes, and avoid inappropriate
retaliatory aggression. The gist of the training is `When in doubt,
act as if it was an accident', or `Give others the benefit of
the doubt'.
In attribution retraining (e.g., Hudley and Friday, 1996), adolescents
with conduct disorder participate in role-plays, video demonstrations
and social situation analysis with peers without conduct disorders
under the supervision of trained educational aides. The core of
attribution retraining is encouraging participants with conduct
disorders to search for, interpret and accurately categorize verbal,
physical and behavioral social cues by others and to choose non-aggressive
responses. Peers without conduct disorder are included in order
to model non-aggressive behaviors and encourage social bonding
with a non-deviant social group. The personal and social benefits
of accurate perception or interpretation of socio-behavioral cues
by others, and non-hostile responses are emphasized in the didactic
exercises.
Attribution training was successful in reducing conduct disorder
in adolescents (Hudley and Friday, 1996). There are no studies
that have examined the long-term benefits of attribution retraining
in adolescents with conduct disorder or its effectiveness with
children.
Rational-emotive behavior therapy
Morris (1993), applied rational-emotive behavior therapy to treating
conduct disorder. The goal of the treatment was to achieve reduction
in trait anger and associated irrational thinking and depressed
state in 12 adolescents with conduct disorders. The clients were
taught how to identify awfulizing, low frustration tolerance,
irrational beliefs, automatic thoughts and negative self-appraisal.
The ultimate goal was to develop in participants: (a) good feelings
about themselves; (b) a firm belief in the ability to succeed;
(c) an appreciation of the ability to perform to one's best ability;
(d) determination to achieve goals; and (d) relating to others
in a tolerant and supportive way. Particular skills that were
trained included goal-setting, time management, self-acceptance,
self-confidence, self motivation and relationship skills. Adolescents
with conduct disorder who underwent rational-emotive behavior
therapy achieved the treatment goals better than a comparison
sample with attention deficit hyperactivity disorder. Rational-emotive
behavior therapy seemed to work best with relatively pure cases
of conduct disorders rather than those adolescents with conduct
disorder comorbid with other disorders. There are no studies that
have examined the use of rational-emotive behavior therapy in
treating conduct disorders in children.
- Mpofu, Elias and Ralph Crystal, Conduct disorder in children:
challenges, and prospective cognitive behavioral treatments, Counselling
Psychology Quarterly, Mar2001, Vol. 14 Issue 1, p21-32, 12p
Personal
Reflection Exercise #3
The preceding section contained information about types
of intervention strategies for treating conduct disordered youth.
. Write three case study examples regarding how you might use
the content of this section in your practice.
Reviewed 2023
Update
Conduct Disorder
- Mohan, L., Yilanli, M., & Ray, S. (2023). Conduct Disorder. In StatPearls. StatPearls Publishing.
Peer-Reviewed Journal Article References:
Lavner, J. A., Barton, A. W., Adesogan, O., & Beach, S. R. H. (2021). Family-centered prevention buffers the effect of financial strain on parenting interactions, reducing youth conduct problems in African American families. Journal of Consulting and Clinical Psychology, 89(9), 783–791.
Porta, C. M., Bloomquist, M. L., Garcia-Huidobro, D., Gutiérrez, R., Vega, L., Balch, R., Yu, X., & Cooper, D. K. (2018). Bi-national cross-validation of an evidence-based conduct problem prevention model. Cultural Diversity and Ethnic Minority Psychology, 24(2), 231–241.
Reil, J., Lambie, I., Horwood, J., & Becroft, A. (2021). Children who offend: Why are prevention and intervention efforts to reduce persistent criminality so seldom applied? Psychology, Public Policy, and Law, 27(1), 65–78.
QUESTION
19 What types of intervention programs are suitable for
conduct disordered youth? To select and enter your answer go to Test.