Abstract
Over the years, evidence-based treatments for children with disruptive behavior disorders (DBDs; e.g., conduct disorder, oppositional defiant disorder) have been developed, however, there is not much information about the treatment children receive in usual mental healthcare settings. This study examined the common treatment provided in US ambulatory mental health clinics to children aged 3 to 9 years who are diagnosed with DBDs. An online survey was filled by appropriate respondents from 145 ambulatory mental health centers across 33 states within the US. The most common treatment provided for childhood DBDs was a combination of child therapy (CT) and parent training (PT) (n = 81, 56%), followed by family therapy (n = 42, 29%), CT (n = 17, 12%), and PT (n = 5, 3%). Behavioral and cognitive principles were reported as the most common treatment orientations across all types of treatment (n = 116/145, 80%). The mean number of sessions administered was 31.38 ± 22.72, and PT as a standalone treatment required approximately a third of sessions (10.6 ± 1.34). In treatments combining CT and PT, the utilization of specific parenting programs was associated with fewer administered sessions. Results suggest that the importance of parental involvement in treating DBDs is acknowledged in routine practice. However, more studies are needed to determine why certain types and orientations of treatments are favored over others.
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References
Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6(2), 61–74.
Balas, E. A., & Boren, S. A. (2000). Managing clinical knowledge for health care improvement. In J. H. van Bemmel & A. T. McCray (Eds.), Yearbook of medical informatics 2000: Patient-centered systems (pp. 2000–2070). Stuttgart: Schattauer.
Baumel, A., Pawar, A., Kane, J. M., & Correll, C. U. (2016). Digital parent training for children with disruptive behaviors: Systematic review and meta-analysis of randomized trials. Journal of Child and Adolescent Psychopharmacology, 26(8), 740–749.
Billingsley, P. (2008). Probability and measure. Hoboken, New Jersey: John Wiley & Sons.
Comer, J. S., Chow, C., Chan, P. T., Cooper-Vince, C., & Wilson, L. A. (2013). Psychosocial treatment efficacy for disruptive behavior problems in very young children: A meta-analytic examination. Journal of the American Academy of Child and Adolescent Psychiatry, 52(1), 26–36.
Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37(1), 215–237.
Garland, A. F., Bickman, L., & Chorpita, B. F. (2010). Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health and Mental Health Services Research, 37(1-2), 15–26.
Garland, A. F., Brookman-Frazee, L., Hurlburt, M. S., Accurso, E. C., Zoffness, R. J., Haine-Schlagel, R., & Ganger, W. (2010). Mental health care for children with disruptive behavior problems: A view inside therapists’ offices. Psychiatric Services, 61(8), 788–795.
Holden, G. W. (2014). Parenting: A dynamic perspective. London: Sage Publications.
Kazdin, A. E., Bass, D., Ayers, W. A., & Rodgers, A. (1990). Empirical and clinical focus of child and adolescent psychotherapy research. Journal of Consulting and Clinical Psychology, 58(6), 729–740.
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.
Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86–104.
McMahon, R. J., & Forehand, R. L. (2005). Helping the noncompliant child: Family-based treatment for oppositional behavior. New York, NY: Guilford Press.
Merikangas, K. R., & He, J. (2014). Epidemiology of mental disorders in children and adolescents. In J.-P. Raynaud, M. Hodes & S. S.-F. Gau (Eds.), From Research to Practice in Child and Adolescent Mental Health. Lenham, MD: Rowman & Littlefield.
Nutley, S., Walter, I., & Davies, H. T. (2003). From knowing to doing: A framework for understanding the evidence-into-practice agenda. Evaluation, 9(2), 125–148.
Odom, S. L. (2009). The tie that binds: Evidence-based practice, implementation science, and outcomes for children. Topics in Early Childhood Special Education, 29(1), 53–61.
Onken, L. S., Carroll, K. M., Shoham, V., Cuthbert, B. N., & Riddle, M. (2014). Reenvisioning clinical science: Unifying the discipline to improve the public health. Clinical Psychological Science, 2(1), 22–34.
Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from stage I. Clinical Psychology: Science and Practice, 8(2), 133–142.
Soni, A. (2009). The five most costly conditions, 1996 and 2006: Estimates for the US civilian noninstitutionalized population. Statistical Brief 248. Rockville, MD: Agency for Healthcare Research and Quality.
Weersing, V. R., Weisz, J. R., & Donenberg, G. R. (2002). Development of the therapy procedures checklist: A therapist-report measure of technique use in child and adolescent treatment. Journal of Clinical Child and Adolescent Psychology, 31(2), 168–180.
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All procedures performed in the study involving human participants were in accordance with the ethical standards of the Feinstein Institute for Medical Research institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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In this exempt study, consent was obtained from all individual participants included in the study by having them agreeing to participate after receiving appropriate information about the study and individual rights.
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Baumel, A. The Treatment of Childhood Disruptive Behavior Disorders in Ambulatory Mental Health Centers. J Child Fam Stud 27, 1110–1114 (2018). https://doi.org/10.1007/s10826-017-0957-4
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DOI: https://doi.org/10.1007/s10826-017-0957-4