Review of Effective Therapeutic Treatment for Conduct disorder Adolescent Onset
Review of Effective Therapeutic Treatment for Conduct disorder Adolescent Onset
Conduct disorder is a psychiatric disorder. This disorder is one of the most complicated and pig-headed health issues that affect children and adolescents. The disorder is characterized by a longstanding representation of violations of rules and inconsiderate conduct. Common problematic behaviors include lying, stealing, physical violence, running away, and sexually compulsive behaviors. Conduct disorder has two subtypes that are childhood onset and adolescent onset. When the childhood onset conduct disorder is left untreated, the result is a poor prognosis. Adolescent conduct disorder has to be well thought-out in the social context. This is because the disorder is thought to be part of gang culture or the desire to meet basic endurance needs.
The adolescent onset conduct behavior has the adult develop the symptoms after the age of 11 (Clarizio, 1997). Proper diagnosis of conduct disorder in adolescent s manifests 3 of 15 symptoms that are categorized into four classes. These classes include aggression, theft or lying, destruction of property, and grave violation of rules over a duration of the past 12 months (pp. 253). The adolescent must also have demonstrated at least one symptom in the past six months consistently. Just about 2-9 percent of girls and 6-16 percent of boys satisfy the analytic criteria for conduct disorder (Searight, Rottnek, & Abby, 2001). Conduct disorders are severe despite being considered to be a normal part of an adolescent in need to satisfy they need for autonomy and influence from peers. Conduct behavior not only affects the child but also affects people in his surroundings. According to van de Weil, Matthys, Cohen-Kettenis, Engeland (2002, pp. 79), conduct disorder refers to instances where child demonstrates antisocial behaviors every day at school, home, or under situations regarded by others as unmanageable.
Increasing concern on conduct behavior is due to the fact that most of the adolescents engage in risky conducts that are considered criminal. These conducts end up endangering the victim and others around them. Offensive behavior directly against others includes verbal and physical aggression or engagement in bullying at home and school. Victims of aggression vary from schoolmates, siblings, figures of authority like law enforcers, staff at school, and parents. Apart from physical aggression, adolescents suffering from conduct behavior lie and steal from others. People are not the only target of conduct behavior as the adolescent can act in ways considered to be abnormal functioning like setting fire, running away, and truancy.
In order to effectively assists adolescents with conduct disorder therapeutic treatment is necessary. Therapy is essential given that the adolescent also have co-morbid diagnosis. Adolescent disorder occurs with other childhood psychiatric disorders such as substance abuse, oppositional disorder, Attention-deficit/hyperactivity disorder, and dependence disorders, and anxiety disorders (Singh, Lancioni, Singh Joy, Winton, Sabaawi, Wahler, & Singh, 2007, pp. 56). This makes the disorder among adolescents and children compounded thereby allowing the conduct progress to intensify and frequency progresses to adulthood (Hinshaw and Lee 2003). Adolescents have a 40% risk factor to develop severe adulthood psychological disturbance (Mpofu& Crystal, 2001, pp. 21) and 80% risk factor for meeting the psychiatric disorder criteria (Singh et al., 2007, pp. 56). In order to determine the most appropriate therapeutic intervention for conduct disorder in adolescents, this paper serves to report and analyze conduct disorder symptoms. This paper will also mention the empirical evidence supporting each treatment.
Scholarly literature obtained from ProQuest, PsychInfo, and CINAHL databases will be used in this report. There will also be a recreation of the dialogue of a hypothetical counseling session, incorporating the cognitive behavioral therapy. The literature review consistently mentions therapeutic treatment theories consistently as a treatment for conduct disorder adolescent onset. Therapeutic treatment theories used in the literature include family therapy, cognitive behavioral therapies, and multisystemic therapy. Although each therapeutic treatment theory contained individual techniques and results, the secondary goal for the interventions was to prevent the disorder from continuing and worsening as the young adolescent progressed into adulthood (Eyberg, Nelson, & Boggs, 2008, pp. 217).
Effective treatment of conduct disorder adolescent onset has been associated with cognitive behavioral therapy. Of all conduct disorders treatment for the last two decades, 22% of 50% treatment studies have been through cognitive behavioral therapy while less than 5% has been through traditional forms therapy (Mopfu and Crystal 2001, pp.22). Cognitive behavioral therapy takes different approaches which are applicable at the level of an individual, or family and group settings. At the level of an individual, cognitive behavioral therapy requires the therapist to meet with the client and address any cognitive disruptions in their behaviors. Therapeutic techniques used on conduct disorder adolescents range from affective education, behavioral modification to training cognitive skills. Affective education entails raining on relaxation; behavior modification deals with training to control anger and cognitive skills training covers cognitive restructuring (Blake and Hamrin, 2007, p. 218). Individualized cognitive therapies are aimed at dealing with self-regulating behaviors. For children and adults with conduct disorder, cognitive behavioral therapy provides a platform for them to take on and take charge of their personal behaviors. As a result, the children and adolescents are assisted in mental health recovery through training on anger and aggression management and problem solving methods (Singh et al., 2007, pp. 57). In order to reinforce the learned skills, the child or adolescent is provided with homework requiring the implementation of the skills obtained from therapy into real life situations.
Children and adolescents with conduct disorder face numerous challenges in the social contexts as their social cues are perceived inappropriately by others resulting to aggressive responses. Cognitive behavioral therapy addresses the issue of negative reactions among adults through the use of anger coping interventions or anger training programs. In cognitive behavioral therapy, the adolescent is trained to take perspectives and made aware of psychosocial arousal as a forerunner to antisocial actions. In addition, anger coping interventions are aimed at training the adolescent on the use of self instruction, or problem solving and self talk procedures. According to Mpofu & Crystalv (2001, P. 24), role playing in cognitive behavioral therapy assists the adolescent in managing anger. Here, the adolescent is involved in a therapist-insinuated situation that elicits a natural response from him or her. The adolescent is then guided appropriately on how to respond and avoid inflicting aggression.
In group settings, anger management can also be applied with the adolescent being involved in role playing with his or her peers or within the group setting. Through group settings, adolescents learn how to handle situations provoking anger through problem solving. All the while, the adolescent practices appropriate self statement and social response in reaction to diverse difficulty situations. Through group settings, the adolescent is subjected to situations that provoke them to anger within the social setting. Under these conditions, the adolescent is provided enough support to assist him, or her to practice the newly learnt anger control strategies. The greatest benefit of group anger control technique lies in the consistency of reinforcement and practice of anger coping interventions. The frequency and intensity of the group anger control sessions are also of intense benefit to the adolescent. According to Glover-Orr (1999), group anger control strategies in cognitive behavioral therapy could minimize the occurrence and harshness of behavioral troubles among adolescents and children with disruptive conduct. Blake and Hamrin (2007, p. 213) demonstrate that reports from parents serves well in demonstrating observed decreased frequency and severity of problematic behaviors among their adolescents and children.
Through the training of problem solving skills, the adolescent is provided with assistance on handling their self regulation and impulse control. This is done by encouraging the adolescent to stop and remain tranquil, to think about the problem before acting, and to consider the outcomes of their anticipated inappropriate behaviors (Mpofu & Crystal, 2001, p. 25).
The impact of behaviors exhibited by adolescent with conduct disorders affect both the adolescent and the people around them. The most affected are parents or guardians of children or adolescents with conduct disorder. Parents or guardians have to deal with numerous challenges both at home and within the school setting. They also have to get involved with mental health systems and the juvenile court system as a result of behaviors demonstrated by their children or adolescents. Blake and Hamrin (2007) reveal that poor parenting may ultimately influence antisocial behaviors in children through the support of poor social capability and educational breakdown (p. 210). Given the emotional toll that occurs to the family members and even poor parenting, systematic family therapy is observed as a successful way of treating adolescents with behavior chaos.
Family therapy maybe defined as a psychotherapeutic endeavor deemed at modifying relations between or among family members and try to find for the advancement of family performance as a unit and the performance of the individual members (Pinsof, 1986). From the definition, a family is viewed as a unit consisting of a child or adolescent. When the child or adolescent, part of the family unit, are negatively affected the entire family or unit is affected and malfunctions. Through family therapy, the family is made to understand the symptoms of conduct while being provided with the most effective ways of cope with the problem within family settings. The family is also provided with knowledge on how to communicate effectively with each other. Through the provision of family therapy, parent-child relational problems, marital discord between wife and husband, and sibling relational problems is done. In conduct disorder, family therapy is essential in dealing with conflict arising between the adolescent and parents.
For families with a child or adolescent with conduct disorder, cognitive behavioral approach offers training of parents or parent’s management that is incorporated as part of the family therapy. Social interaction processes between parents and child form the foundation for parent training programs model and are believed to be responsible for the persistence of antisocial behaviors. Consequently, parent training models are used to teach parents how to promote desirable behavior and at the same time minimize unwanted conduct.
Multisystematic therapy in yet another approach used in treating adolescent conduct disorder. This therapy offers an intense approach to conduct behavior as it combines both cognitive behavior therapy and family therapy. According to Eyberg et al (2008), multisystemic therapy supports responsible behavior and serves well in preventing the requirement to engage in out of home placement. This is possible through the provision of intense family and community founded interventions that are designed for the family particularly (Eyberg et al., 2008, pp. 228). The treatment process offered by multisystemic therapy is concentrated as the therapist has to get together or get in touch with the family severally throughout the treatment period. Again, the family has unrestricted access to the therapist so as to have any concerns addressed. In order to accommodate the family, therapy sessions are held both in the office setting and at home.
The aim of accommodating the family is to make sure they are comfortable and can easily relate observed behaviors of concerned with the child’s living environment. There are nine core principles that guide multisystemic therapy. These core principles as stated by Eyberg et al (2008) include assessment of how family current social environment maintains the identified problems, emphasizing positive family systems aspects, and focusing on interventions aimed at increasing responsible behaviors. In addition, core family theory principles include orienting family-specific interventions and ensuring that the family understands them, promotion of youth interactions outside the family, and evaluating treatment plans and positive outcome consistently. Multisystemic systems also entail teaching caregivers the skills required to solve multiple context problems (p. 228).
Multisytemic therapy is characterized by its ability to address both the needs of the family and the adolescent across all domains in life. This therapy also implements consistent adolescent treatment among life domains. Through multisystemic therapy, Cotrell and Boston (2002) demonstrated that parents’ behavioral problems reports on their delinquent adolescents, who were repeated offenders, reduced considerably.
The most appealing approach, of all the three described, is multisytemic therapy. Through multisystemic therapy approach, the treatment of adolescent conduct disorder is the most effective. This is as a result of its characteristic as being family centered and containing family driven philosophy. However, the implementation of this therapy is time consuming. This drawback is outweighed by the fact that this approach considers both the individualized needs and those of the family. As a result, therapists addressing conduct disorder adolescent or children onset should be dedicated to meeting the needs essential in effectively addressing the symptoms exhibited by the adolescent. Similarly, the therapist must work towards addressing the family’s emotional toll on its members’ experience.
Treating children and adolescents with conduct disorder requires the use of a holistic approach on treatment. A holistic treatment approach is only available through multisystematic approach as both the affected individual and their families’ needs are put into account.
This paper reveals that, although conduct disorder is seen as a normal part of children growth, it is results to behaviors with extremely severe consequence. To those around the adolescent, these behaviors result intense impacts on those around them. For this reason, effective treatment and intervention is essential in counteracting the unconstructive symptoms linked to the disorder. The aim of any intervention strategy on conduct disorder is to reduce problematic conducts. Intervention also aims at improving day-to-day functions of the adolescent. Interventions are also directed improving family relations. In this case, the choice for the best treatment technique is essential.
References
Blake, C.S., &Hamrin, V. (2007). Current approaches to the assessment and management of anger and aggression in youth: a review. Journal of Child and Adolescent Psychiatric Nursing, 20(4), 209-221.
Clarizio, H.F. (1997). Conduct disorder: developmental considerations. Psychology in the Schools, 34(3), 253-265.
Cottrell, D. & Boston, P. (2002). Practitioner review: the effectiveness of systemic family therapy for children and adolescents. Journal of Child Psychology and Psychiatry, 43(5), 573-586.
Eyberg, S.M., Nelson, M.M., Boggs, S.R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior.Journal of Clinical Child and Adolescent Psychology, 37(1), 215-237.doi: 10.1080/15374410701820117
Mpofu, E.&Crsytal, R. (2001). Conduct disorder in children: challenges, and prospective cognitive behavioural treatments. Counseling Psychology Quarterly, 14(1), 21-32. doi: 10.1080/09515070110053355
Searight, H, S, Rottnek, F., and Abby, S. L. (2001). Conduct disorder: diagnosis and treatment in patient care. American family physicians journal. Vol. 63. Iss. 8. P. 1579-1589.
Singh, N.H., Lancioni, G.E., Singh Joy, S.D., Winton, A.S.W., Sabaawi, M., Wahler, R.G., & Singh, J. (2007). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15(1), 56-63.
Van de Wiel, N., Matthys, W., Cohen-Kettenis, P.C., & van Engeland, H. (2002). Effective treatment of school aged conduct disordered children: recommendations for changing clinical and research practices. European Child & Adolescent Psychiatry, 11, 79-84.
Is this your assignment or some part of it?
We can do it for you! Click to Order!
