Evidence-Based Psychosocial Treatments for Adolescents With Disruptive Behavior

Abstract

Objective This article updates the earlier reviews of evidence-based psychosocial treatments for disruptive behavior in adolescents (Brestan & Eyberg, 1998; Eyberg, Nelson, & Boggs, 2008), focusing primarily on the treatment literature published from 2007 to 2014. Method Studies were identified through an extensive literature search and evaluated using Journal of Clinical Child and Adolescent Psychology (JCCAP) level of support criteria, which classify studies as well established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on existing evidence. The JCCAP criteria have undergone modest changes in recent years. Thus, in addition to evaluating new studies from 2007–2014 for this update, all adolescent-focused articles that had been included in the 1998 and 2008 reviews were re-examined. In total, 86 empirical papers published over a 48-year period and covering 50 unique treatment protocols were identified and coded. Results Two multicomponent treatments that integrate strategies from family, behavioral, and cognitive-behavioral therapy met criteria as well established. Summaries are provided for those treatments, as well as for two additional multicomponent treatments and two cognitive-behavioral treatments that met criteria as probably efficacious. Treatments designated as possibly efficacious, experimental, or of questionable efficacy are listed. Additionally, moderator/mediator research is summarized. Conclusions Results indicate that since the prior reviews, there has been a noteworthy expansion of research on treatments for adolescent disruptive behavior, particularly treatments that are multicomponent in nature. Despite these advances, more research is needed to address key gaps in the field. Implications of the findings for future science and clinical practice are discussed.

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

“…Recently, a comprehensive review by McCart and Sheidow (2016) has updated findings from previous studies. Multicomponent treatments (e.g., Multisystemic Treatment and Treatment Foster Care Oregon) that target multiple changes in the client's various living environments, such as home, school, and juvenile correctional facilities, are now considered the most efficacious treatments for antisocially behaving youth, especially those involved in the juvenile justice system (McCart and Sheidow 2016).…”

“…The evidence is promising for interventions based on cognitive-behavioral theory and skills, including parent management training, child social skills training, and cognitive problem-solving skills or problem-solving skills training (Kazdin and De Los Reyes 2008;McCart and Sheidow 2016). Based on the research evidence, functional family therapy has also garnered significant research support (Boxer and Frick 2008;McCart and Sheidow 2016).…”

“…As Kazdin and De Los Reyes (2008) put it: "The extent to which the identification of EBTs has altered what is delivered to the public or the outcome of patients seen in treatment has yet to be demonstrated" (p. 231). There is a dearth of research literature on the evidence-base tested among antisocially behaving youth in community and home settings-that is, youth not involved with the juvenile justice or child welfare systems (McCart and Sheidow 2016). In addition, social agencies, many of which are resource-stressed, are not likely to be able to afford training in specialized programs to assure adherence and fidelity to EBP (McCart and Sheidow 2016), and often a select number of staff within an agency are trained in certain modalities with varying degrees of adherence to the EBP in practice.…”

“…There is a dearth of research literature on the evidence-base tested among antisocially behaving youth in community and home settings-that is, youth not involved with the juvenile justice or child welfare systems (McCart and Sheidow 2016). In addition, social agencies, many of which are resource-stressed, are not likely to be able to afford training in specialized programs to assure adherence and fidelity to EBP (McCart and Sheidow 2016), and often a select number of staff within an agency are trained in certain modalities with varying degrees of adherence to the EBP in practice. This leaves a large gap in information for clinicians in agency-based practice.…”

“…Multicomponent treatments (e.g., Multisystemic Treatment and Treatment Foster Care Oregon) that target multiple changes in the client's various living environments, such as home, school, and juvenile correctional facilities, are now considered the most efficacious treatments for antisocially behaving youth, especially those involved in the juvenile justice system (McCart and Sheidow 2016). The evidence is promising for interventions based on cognitive-behavioral theory and skills, including parent management training, child social skills training, and cognitive problem-solving skills or problem-solving skills training (Kazdin and De Los Reyes 2008;McCart and Sheidow 2016). Based on the research evidence, functional family therapy has also garnered significant research support (Boxer and Frick 2008;McCart and Sheidow 2016).…”