Topic: Disruptive Behavior Treatment (Child & Adolescent)
Definition for Disruptive Behavior Treatment (Child & Adolescent):
Disruptive Behavior Treatment (Child & Adolescent) is defined as the treatment of youth with a diagnosis of a disruptive behavior disorder including Oppositional Defiant Disorder (ODD), Conduct Disorder, and Attention-Deficit/Hyperactivity Disorder (ADHD), or youth without a diagnosis who are exhibiting similar behaviors. Common symptoms may include arguing and refusing to obey rules, frequent defiance of authority, aggression towards people and animals, destruction of property, lying, theft, failure to take responsibility for bad behavior or mistakes, regular temper tantrums, hyperactivity, inattention, and impulsivity. In Oppositional Defiant Disorder, the rules broken are usually those in the family and the school, while in Conduct Disorder, the rules broken include the regulations and laws made by society. In Attention-Deficit/Hyperactivity Disorder, there is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at comparable level of development.
The CEBC has evaluated only replicable programs that do not use medication as an essential component of treatment. The Pharmacological Treatments for Children and Adolescents with Mental Health Disorders page has links to reputable organizations that list information on medications used to help treat children and adolescents with disruptive behavior and other disorders.
- Target population: Youth with a diagnosis of a disruptive behavior disorder including Oppositional Defiant Disorder (ODD), Conduct Disorder, and Attention-Deficit/Hyperactivity Disorder (ADHD), or youth without a diagnosis who are exhibiting similar behaviors
- Services/types that fit: Typically outpatient services, either individual, group, family therapy or other services that target youth directly or adults (caregivers, teachers, etc.) who work with these youth
- Delivered by: Mental health professionals or trained paraprofessionals
- In order to be included: Program must specifically target the reduction/elimination of disruptive behaviors as a goal
- In order to be rated: There must be research evidence (as specified by Scientific Rating Scale) that examines outcomes related to disruptive behavior, such as changes in symptom levels, behaviors, and/or functioning
Programs in this Topic Area
The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.
Ten Programs with a Scientific Rating of 1 - Well-Supported by Research Evidence:
- Coping Power Program8 to 14 year old children whose aggression puts them at risk for later delinquency
- GenerationPMTO (Individual Delivery Format)Parents of children 2-18 years of age with disruptive behaviors such as conduct disorder, oppositional defiant disorder, and anti-social behaviors
- Incredible Years, The (IY)The Incredible YearsParents, teachers, and children
- Multidimensional Family Therapy (MDFT)Adolescents 11 to 18 with the following symptoms or problems: substance abuse or at risk, delinquent/conduct disorder, school and other behavioral ...
- Multisystemic Therapy (MST)Youth, 12 to 17 years old, with possible substance abuse issues who are at risk of out-of-home placement due to antisocial or ...
- Parent-Child Interaction Therapy (PCIT)Children ages 2.0 - 7.0 years old with behavior and parent-child relationship problems; may be conducted with parents, foster parents, or other ...
- Problem Solving Skills Training (PSST)7 to 14 year olds with behavioral problems, particularly children who struggle to handle disappointments, frustrations, or problems calmly
- Promoting Alternative Thinking Strategies (PATHS)Universal populations (all children) as well as in small group settings for children with more serious behavior problems
- Treatment Foster Care Oregon - Adolescents (TFCO-A)
[Multidimensional Treatment Foster Care - Adolescents]Boys and girls, 12-18 years old, with severe delinquency and/or severe emotional and behavioral disorders who were in need ...
- Triple P - Positive Parenting Program® - Level 4 (Level 4 Triple P)For parents and caregivers of children and adolescents from birth to 12 years old with moderate to severe behavioral and/or ...
Six Programs with a Scientific Rating of 2 - Supported by Research Evidence:
- Collaborative & Proactive Solutions (CPS)Children ages 4-14 who experience oppositional episodes and their parents
- Community Parent Education Program (COPE) – non-responderParents of children with disruptive behavior
- Functional Family Therapy (FFT)11-18 year olds with very serious problems such as conduct disorder, violent acting-out, and substance abuse
- Parenting with Love and Limits (PLL)Children and adolescents aged 10-18 who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, and ...
- Treatment Foster Care Oregon for Preschoolers (TFCO-P)
[Multidimensional Treatment Foster Care for Preschoolers]Preschool foster children aged 3-6 years old who exhibit a high level of disruptive and anti-social behavior which cannot be ...
- Tuning in to Kids (TIK)Parents and caregivers of children with disruptive behavior between 18 months and 18 years of age; can be used with parents and ...
Ten Programs with a Scientific Rating of 3 - Promising Research Evidence:
- Aggression Replacement Training® (ART®) – non-responderChronically aggressive children and adolescents ages 12-17
- Child-Centered Play Therapy (CCPT)Children ages 3-10 who are experiencing social, emotional, behavioral and relational problems
- Child-Parent Relationship Therapy (CPRT)Parents of children ages 3- 8 with behavioral, emotional, social, or attachment disorders
- Collaborative Problem Solving® (CPS)Children and adolescents (ages 3-21) with a variety of behavioral challenges, including both externalizing (e.g., aggression, defiance, tantrums) and ...
- Connect: An Attachment-Based Program for Parents and CaregiversCaregivers (biological parents, foster parents, kinship caregivers, etc.) of preadolescents (ages 8-12) and adolescents ages (13-19)
- Defiant Children: A Clinician’s Manual for Assessment and Parent TrainingParents of children ages 4-12 years who are defiant or who may qualify for a diagnosis of oppositional defiant disorder (...
- Families FirstFamilies and referred children who are at-risk as a result of family conflict, lack of parenting skills, child abuse, childhood ...
- Helping the Noncompliant Child (HNC)Parents of children (age 3-8 years old) who are noncompliant and have related disruptive behavior/conduct problems
- I Can Problem Solve (ICPS)Low- and middle-income 4-12 year olds, including African-Americans, Caucasians, Hispanic, and Asian populations
- Parenting WiselyFamilies with children at risk for or with: behavior problems, substance abuse problems, or delinquency
Four Programs with a Scientific Rating of NR - Not able to be Rated:
- Fast Track ProjectChildren at high-risk of conduct problems beginning at age 6-7 (1st grade) through age 15/16 (Grade 10)
- Parent Project's Changing Destructive Adolescent Behavior, TheThe Parent Project's Changing Destructive Adolescent BehaviorParents of what are collectively referred to as "strong-willed," or out-of-control adolescents and older children (11-17 years old), ...
- Parent-Child Care (PC-CARE)Caregiver and child age 1-10 years who has or is at high-risk of developing behavior problems or who is adjusting ...
- Signposts for Building Better BehaviourParents of children with an intellectual disability who display difficult behaviours
Why was this topic chosen by the Advisory Committee?
The Disruptive Behavior Treatment (Child & Adolescent) topic area is relevant to child welfare because documented research shows that children who enter the child welfare system, particularly those that are removed from their home, experience a significantly higher rate of mental health problems, including disruptive behavior than children in the general population. This is not surprising, and is likely the result of a number of contributing factors. These factors may include events that precipitated child welfare intervention including abuse, neglect, and abandonment, as well as factors associated with placement, including separation, loss, anger, and fear.
While the child welfare system has historically focused on the physical and safety needs of children, emerging practice within agencies across the country is to now take into account the emotional needs of children as well. Child welfare agencies along with mental health providers have come to recognize the need for timely, appropriate, and effective disruptive behavior treatment services that support children and families in achieving successful outcomes. In addition, early assessment and timely treatment intervention have been recognized as playing a key role in ensuring successful outcomes for children. As a result, a growing number of new initiatives and programs are being implemented within California counties that support the delivery of an array of mental health services to children and families receiving child welfare services. These services range from mental health screening and assessment to individualized treatment for identified needs.
Additionally, there is heightened awareness among professionals that the delivery of children's mental health services must be carefully coordinated across child serving agencies to thoroughly address their complex needs. Whether children remain living with their parents or are placed outside the home, it is critical that all children in the child welfare system be screened and assessed. Moreover, parents and caregivers must be trained to identify early signs of mental distress enabling them to seek early intervention and appropriate care and treatment.
Division Chief, Community-Based Support Division
Los Angeles County Department of Children and Family Services
Amanda Jensen Doss, PhD, Assistant Professor
Child Division of the Department of Psychology, University of Miami
Coral Gables, FL