Lecture 20 - Treatment of Conduct Problems Flashcards
What are the guiding principles for effective treatment of conduct problems?
- Target the ecology of the child (i.e., family and peer relationships / interactions
- Take a developmental perspective
- Be formulation/hypothesis-driven
- Form a strong therapeutic team
FIX CARD
What are the core components of treatment?
What are the predictors of treatment outcomes?
McCart et al., 2006
Interventions that do not address ecological dynamics are less likely to produce lasting change
Predictors of poor outcomes:
- socioeconomic disadvantage
- minority group status
- younger maternal age
- parental psychopathology
What are the 4 predictors of poor outcomes?
- socioeconomic disadvantage
- minority group status
- younger maternal age
- parental psychopathology
What are the best treatments for conduct problems in Early- to Middle-Childhood?
Parent training
aka: Parent Management Training; Social learning based parent training; Behavioural Family Intervention, etc
What are the best treatments for conduct problems in late Childhood/Adolescence?
Parent training + youth-focused components (e.g., Multisystemic Therapy)
A developmental perspective informs…
Hint: 3 things
- when is the optimal time for intervention
- which family environment variables should be targeted
- how to best involve the child
What are some Procedures to Encourage Positive Behaviour
- Catch your child being good
- Suggest targets for young children
- Reward Behaviour
What are some suggested targets to Encourage Positive Behaviour in children?
– following instructions
– speaking in a nice voice
– playing nicely, independently
– accepting “no” for an answer
What are some ways to reward behaviour?
– descriptive praise
– physical contact
– privileges, tangible rewards
– Parental Time!
How should one conduct “TIME OUT”?
- A brief period (~ 1 minute) where access to reinforcers are denied
- Quiet time - in a chair
- in a separate room – safe, neutral, boring
- ends when child is quiet and under control
- Time in must be fun, loving and full of praise and encouragement
- must be attachment neutral
What are some problems with TIME OUT?
- Parent waits too long before using time out
- Parent uses it emotionally
- Child gets very distressed - gets sick, destroys room
- Fight starts again as soon as time out ends
- Multiple children
What are the key parenting targets for child behaviour change in Early-to-middle childhood?
Coercive cycles (reinforcement traps)
What are the key parenting targets for child behaviour change in Late childhood/adolescence?
Monitoring and supervision
skills for regulating child activities outside home
FIX CARD
Older children/adolescence as active participants….
- With physical development, child increasingly capable of resisting the limit- setting strategies that are effective with younger children (time-out).
- The unique developmental tasks of adolescence…unique family challenges re: problem-solving and communication…best targeted with parents-children jointly.
- Emerging cognitive resources (abstract reasoning, perspective taking, meta-cognition) to engage in self-regulatory skills training not possible at younger ages.
