Key Findings: Treatment of Disruptive Behavior Problems – What Works?

The Journal of Clinical Child and Adolescent Psychology has published a new study reviewing the research on treatments for disruptive behavior problems in children aged 12 years and under. This report also updates the evidence for what works best to treat children with disruptive behavior problems. In this study, CDC researchers looked at different approaches to treatment and found the best evidence was for parent behavior therapy, when delivered either as group therapy or individually with child participation.

Disruptive behavior disorders, such as oppositional defiant disorder and conduct disorder, put children at risk for long-term problems including mental disorders, violence, and delinquency. Getting the right treatment early is key, so this new evidence is important for health professionals caring for a child with a disruptive behavior problem. Healthcare professionals can use the information on what therapy works best in order to help parents of children with disruptive behavior problems find the right treatment. Read the article.

About this Study

The authors of the study reviewed every available research report from 1998 until 2016 that looked at treatment for disruptive behavior problems in children up to age 12 years. Studies that used similar approaches to treatment were grouped into categories, for example, behavior therapy, which focuses on changing behavior by building skills and learning to manage behavior, client-centered therapy, which focuses on managing feelings, attitudes, and perceptions of others, or play therapy, which provides a way for children to communicate experiences and feelings through play.

Studies were also separated into group or individual therapy and parent or child therapy. All of the results were reviewed and rated according to different levels of evidence. The highest rating was reserved for studies that had been tested in multiple settings by independent teams of researchers.

Main Findings

Treatment approaches with the highest rating for effectiveness are

• Group parent behavior therapy
• Individual parent behavior therapy with child participation

Other approaches like client-centered therapy or play therapy did not have enough studies or strong enough evidence of effectiveness to receive a high rating. More studies are needed to determine whether these approaches are effective for treating children’s disruptive behavior problems.

Parent Behavior Therapy

The research studies used approaches that involved therapists who were trained in specific behavior therapy programs, and that used a training manual and specific steps to work with parents on skills to help them manage their child’s behavior. During this type of parent training in behavior therapy, parents work with a therapist to learn strategies to create structure, reinforce good behavior, provide consistent discipline, and strengthen the relationship with their child through positive communication. It is possible that therapists who use these behavioral approaches, but don’t use a specific program can also be effective. However, more research is needed to understand what the essential components of the programs with best evidence are, and which therapy works best for different families. You can read more about what to look for when seeking behavior therapy.

CDC’s Activities on Children’s Behavioral Health:

CDC has activities focused on improving the lives of children and families affected by disruptive behavior disorders and related conditions, including attention-deficit/hyperactivity disorder (ADHD). Just as for disruptive behavior, in general, behavior therapy is an effective treatment for ADHD.

Experts recommend that children with ADHD ages 6 and older receive behavior therapy along with medication, and that children under 6 with ADHD receive behavior therapy first, before trying medicine for ADHD. Behavior therapy for young children with ADHD is most effective when it is delivered by parents. Therefore, CDC works to help families get the right care at the right time by raising awareness, increasing treatment options for families and providers, and exploring ways to increase access to behavior therapy.

More Information

• Child Development
• Information for Parents
• Positive Parenting Tips
• Essentials for Parenting Toddlers and Preschoolers

References

Kaminski, J. W., & Claussen, A. H. (2017) Evidence base update for psychosocial treatment of disruptive behaviors in children.
Journal of Clinical Child and Adolescent Psychology,  2017, 46:4, 477-499   http://www.tandfonline.com/doi/full/10.1080/15374416.2017.1310044