This paper will briefly look at the use of cognitive behavioral therapy (CBT) in the treatment of a social suborder known as aggressive behaviour disorder. The findings of American Psychiatric Association Journal, 2000 will be discussed and more background information will be derived from the books by American Psychiatric Association Journal (2000) and it will shed light on the use of CBT in effective management of aggressive behaviour disorder in adolescents. Howell et al, (1993); “Are America’s Children’s Problems Getting Worse?” will describe aggression related behaviours and successful way of prevention and intervention while the former will introduce the CBT ,types of CBT used to treat social problems, its impacts based on a research evidence.
Nugget (2006), describes aggressive social disorder as aggressive conduct that causes or threatens physical harm to other people or animals or a non-aggressive behavior that causes property loss or damage, deceitfulness or theft, and serious violations of rules.
According to the journal by economic and social research council (2006), in the united kingdom 6.9% of boys and 2.8% of girls aged between five to ten years exhibit conduct behavior with 40% of those aged between seven and earth years old who are diagnosed with conduct disorder become persistent offenders as teenagers with 90 % of offenders having being diagnosed with conduct disorders during their juvenile ages.
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Cognitive behavioral therapies prioritize on the process of learning in the improvement and maintenance of behaviour. More often it involve the use of problem solving skills training which it has been evaluated it has proofed to be efficient in short term treatment of aggression and conduct disorders. This method is appropriate for treating of children who ail from families who are not able to engage in parenting program and the program is delivered in schools or other community setting. CBT programmes for children with conduct disorder and aggression takes quite a long period of up to 25-30 weekly sessions. Often the length of treatment depends on the severity of difficulties that are experienced. There are two types of CBT programs that can be applied: these are the social skills and anger coping skills training and the problem solving skills training.
Most children with behavioral problems occasionally portray difficult problems that include temper tantrums, aggressive outbursts which degenerate into a complex problem if it persists. These children are academically classified to as children with special educational needs.
Behavioral problem coexist with other range of problems like attention deficit hyperactivity disorder anxiety and even depression. This problem result into high costs for the child as disruptive behaviors is associated with low self esteem, depressive symptoms, poor academic achievement, poor social skills and low frustration tolerance. As adults these children will be more likely to experience substance abuse, relationship breakdown, unemployment and even mental disorders.
This is a meta-analysis review (a statistical technique combining results from several studies into one overall estimate of the effect of an intervention) of systematic reviews of CBT effectiveness in intervening with behavioral problems in children, also review of social skills training and covers programs which therapist work with the children in groups or on one-to-one settings.
First review is of study that was carried out on the slightly younger (average age 11.48) children which yielded a smaller yet positive results that led authors to suggest that CBT may even have a larger effect with the older school-aged children and adolescents than with younger children.
The third review focused on social skills training, and concluded that there is no evidence that this type of intervention improves behaviour disorders in children. the mean age of the children was 10.34, and the social skills training was delivered either to groups or on an individual basis.
From the reviews carried out it isn’t clear whether the children who received CBT were diagnosed with other related social problems/disabilities or other mental health issues. The CBT in this review was mostly delivered to children in groups at school and the group sessions normally lasted approximately one hour.
A review of randomized and non-randomized studies of programmes targeting aggression in schools, including CBT, suggests that a programme’s success depends on its strategy, implementation, format, and intensity. The authors stress the importance of having well-implemented, relatively intense, one-to-one programmes conducted by trained staff. (Joughin,2006).
Limitations: Despite the fact that CBT is regarded to be one of the techniques that have a clear and well evaluated structure , professionals have overlooked other alternative interventions that are widely used for example the consultation work and the paediatric liaison. These alternatives have not been evaluated leading to biased results towards approaches such as CBT.
CBT evaluations have the problem of often utilize programmes that are introduced for the purpose of research and not part of routine practice (demonstration programmes). This routine practice programmes have been proved to have a smaller effect than demonstration programmes.
Most of the studies omit a range of complex cases of disruptive behaviours that children present but are not necessarily associated with anger control. Children with behaviour problems require more than a single treatment approach otherwise many children continue to have conduct problems even after the treatment program has been completed.
It has been found that children diagnosed with additional social problems related to poor peer relationships or even those who come from dysfunctional families appear less likely to respond CBT programs.
The most beneficiaries of this intervention technique are the children with conduct disorder but are from lone parent families, from families with single parent is employed, with parents who have less or no educational qualifications and those living in low income household or in social sector housing
Conclusion: In Overall, child-based CBT interventions have been found to have a positive, but modest, effect in decreasing antisocial behaviour. The most promising effects were found by a recent meta-analysis of forty published and unpublished studies, measuring CBT’s effect on anger and anger-related outcomes. The children studied were aged between 7 and 18 (average age 12.5).
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