The prevalence of conduct disorder among males under the age of 18 runs from 6 percent to 16 percent, according to Dr. Jack Apsche and Dr. Christopher Bass. The disorder consists of an array of behavioral problems that exceed normal issues expected to be found in youth. Problematic behavioral may include violence, delinquency, various criminal behavior, substance abuse, sexual abuse perpetration and bullying. An array of treatment options exist for this disorder. Often, a combination of different types of treatment are the most effective.
Parental Training
Dustin Pardini and Dr. John Lochman write in the book "Cognitive Therapy With Children and Adolescents" that many treatment programs for conduct disorder include use of parent training. Parents learn to use positive reinforcement techniques as a primary means of interacting with his or her child. Instances when the child shows prosocial behavior yield a reward from the parent, in the form of a tangible reward, attention or praise. This approach is coupled with use of extinction techniques, designed to eliminate unwanted behavior. These may include use of timeouts and selective ignoring.
In addition, parents are encouraged to be strict but flexible with the child. Often, parents become caught up in the child's problem behavior, losing sight of positive interactions with him. Therefore, parents are encouraged to increase the frequency of caring and supportive interactions.
Behavioral Techniques
Behavioral techniques may be employed at home and school. Pardini and Lochman describe the use of a behavioral program that allows the child to earn points for engaging in desirable behavioral. These points serve as an immediate reinforcement for positive behavior and may be exchanged later for bigger rewards.
Dr. Jerome Stumphauzer writes in "Helping Delinquents to Change" that the use of punishment often becomes used as a frequent means to discontinue problematic behavior in adolescents with conduct disorder. Stumphauzer argues, however, that this means of behavioral change "is the least effective principle for [change]." He suggests that punishment may serve a role in immediately stopping behavior. Following this, positive reinforcement should be employed to shape prosocial behavior.
Interpersonal Problem Solving
According to Pardini and Lochman these strategies include teaching the child about empathy, building positive problem solving skills, focusing on the evaluation of consequences of behavior and practicing prosocial behavior through role play with caregivers, teachers or a therapist. While evidence exists regarding the effectiveness of these strategies, parent training appears the better approach, with the combination of both these strategies as the most effective means to treat conduct disorder.
Mode Deactivation Therapy
Apsche and Bass describe Mode Deactivation Therapy, or MDT, for conduct disorder in an issue of "International Journal of Behavioral and Consultation Therapy." MDT is designed to stop and change problematic thoughts, feelings, motivations and behaviors the child displays in reaction to certain triggering situations. For example, the child believes that people cannot be trusted as they will eventually harm him. This thought process poses problems in situations where the child attempts to form new relationships with caregivers, teachers, children or therapists. Therefore, MDE would work to change the thought and problematic behaviors that may stem from it.
Medication
Dr. Oleg Tcheremissine and Dr. Lori Lieving describe in their article titled "Pharmacological Aspects of Treatment of Conduct Disorder in Children and Adolescents" that several types of medications appear effective in the treatment of conduct disorder. These include antipsychotics, mood stabilizers, antidepressants and stimulant medication. They point out that most effective treatment is usually obtained with the use of medications in conjunction with other treatments as mentioned.
References
- "CNS Drugs"; Pharmacological Aspects of the Treatment of Conduct Disorders in Children and Adolescents; Oleg V. Tcheremissine, M.D. and Lori M. Lieving, M.D.; 2006
- "Cognitive Therapy With Children and Adolescents"; Mark A. Reinecke, Ph.D., Frank M. Dattilio, Ph.D., and Arthur Freeman, Ph.D.; 2003
- "Helping Delinquents Change: A Treatment Manual of Social Learning Approaches"; Jerome S. Stumphauzer, Ph.D.; 1986
- "International Journal of Behavioral and Consultation Therapy"; A Review and Empirical Comparison of Three Treatments for Adolescent Males With Conduct and Personality Disorder. Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training; Jack A. Apsche Ph.D. and Christopher K. Bass, Ph.D.; July 2006
- National Institute of Mental Health: Targeting the Most Aggressive Children May Be Cost-Effective Prevention of Later Conduct Disorders
