Comprehensive Approaches to Treatment

Abstract

The chapter summary in the previous chapter provides a fairly pessimistic picture of our success in treating children and adolescents with conduct disorders. Until recently, this was the state of our knowledge. There were several “promising” treatments that had some degree of effectiveness but no single-treatment approach had proven to have a dramatic influence on most children or adolescents with conduct disorders (Kazdin, 1995). By evaluating these approaches to treatment within the context of our understanding of the nature and causes of conduct disorders, the reason for the limited effectiveness of these treatments may be apparent. Each approach was designed to alter a process believed to be crucial in causing the development of conduct disorders. However, each approach focused on a single process, such as poor parental socialization practices or deficits in social cognition or poor inhibitory control of behavior. This strategy ignores the fact that conduct disorders are multidetermined, with multiple interacting causal factors underlying the development of the behavioral disturbance. Furthermore, subgroups of children with conduct disorders may have different combinations of causal factors involved in the development of the disorder. Therefore, it is not surprising that interventions that focused on single causal processes and that attempted to treat all children and adolescents with conduct disorders in the same manner have proven to be inadequate.