Antisocial and aggressive behavior in children (conduct disorder) is extremely difficult to treat in light of the stability of the problem, untoward long-term prognosis, and the diverse domains of dysfunction in the child, parent, and family with which the problem is associated. Significant advances have been made in treatment. Seven treatments with strong evidence in their behalf with children and adolescents are reviewed and include parent management training, multisystemic therapy, multidimensional treatment foster care, cognitive problem-solving skills training, anger control training, functional family therapy, and brief strategic family therapy. Parent management training is directed at altering parent-child interactions in the home, particularly those interactions related to child-rearing practices and coercive interchanges. Multisystemic therapy focuses on the individual, family, and extrafamilial systems and their interrelations as a way to reduce symptoms and to promote prosocial behavior. The multidimensional treatment foster care model focuses on youth who are in placement and who are to return to their parents or more permanent foster care. Behavioral treatments in the placement and in the setting to which the child is returned are part of a comprehensive effort to integrate treatment and community life. Cognitive problem-solving skills training focuses on cognitive processes that underlie social behavior and response repertoires in interpersonal situations. Also cognitively based, anger control training includes problem-solving skills training in the context of groups in the schools. The program has an additional component that includes parent management training. Functional family therapy utilizes principles of systems theory and behavior modification for altering interaction, communication patterns, and problem solving among family members. Brief strategic family therapy focuses on the structure of the family and concrete strategies that can be used to promote improved patterns of interaction. This treatment has been developed with Hispanic children and adolescents and has integrated culturally pertinent issues to engage the families. Questions remain about the long-term impact of various treatments, the persons for whom one or more of these treatments is well suited, and how to optimize therapeutic change. Even so, the extensive evidence indicates that there are several viable treatments for conduct disorder. Disseminating these to professionals and children and families remains a key challenge.
The Effects of Parent Management Training, Problem-solving Skills Training and the Eclectic Training on Conduct Disorder in Iranian Elementary School Students
