15 - Treatment of conduct disorders

Summary

Among the many points detailed in previous chapters, we have learned that conduct disorder is one of the most frequent bases of clinical referral in child and adolescent treatment services, has relatively poor long-term prognosis, and is transmitted across generations. Because children with conduct disorder often traverse multiple social services (e.g. special education, mental health, juvenile justice), the disorder is one of the most costly mental disorders in the United States (Robins, 1981). (Children will be used to refer to both children and adolescents. When pertinent to the discussion, a distinction will be made and referred to accordingly.) Clearly, there is an urgent need to develop effective intervention programmes. At the same time, developing effective treatments for conduct disorder is daunting. The very nature of the disorder and the many facets with which it is associated portend many obstacles in merely delivering treatment let alone achieving therapeutic change. Nevertheless, within the past two decades, significant advances have been made in treatment. The present chapter reviews and evaluates advances in the treatment of conduct disorder. Promising treatments are presented and evaluated. Each of the treatments was selected because it has been carefully evaluated in controlled clinical trials. In addition to evaluating specific techniques, limitations of current treatment research and models of delivering service to conduct disordered youth are also discussed.

Key characteristics to consider in relation to treatment

From a treatment perspective, conduct disorder represents an array of child, parent, family and contextual conditions.