Medical News: Family Therapy Can Combat Conduct Disorders (if done right)

Medical News: Family Therapy Can Combat Conduct Disorders - in Pediatrics, Parenting from MedPage Today

Conduct problems? Drug abuse? What to do, who can help? Many people aren't sure who to turn to, A psychologist, counsellor, therapist, psychiatrist? Which profession? Research has shown that family therapy can help quell substance abuse and conduct disorders in children and adolescents, but is not as effective when the diagnosis is attention deficit hyperactivity disorder (ADHD), researchers said here today. Simply put, yes, a family therapist can be effective, but when there is underlying Attention Deficit Hyperactivity disorder, family therapy might not be the way to go. (although parent training, education and support are necessary).

This study (click above) is a 10-year review of published research and it found that two types of family therapy, parent management training and behavioral family therapy, are especially effective for conduct disorders. Many parents want to have family meetings, or have their child seen alone for therapy. That may simply not be the effective way to deal with these particular problems. Dr. Josephson, one of the co-authors of the review, which will be published in the September issue of the Journal of Child and Adolescent Psychiatry, presented these findings at a back-to-school health briefing sponsored by the American Medical Association and the National PTA.

Parent-management training teaches parents techniques such as positive reinforcement and working with children to develop problem-solving skills. Studies suggests that parent-management training can be an effective for conduct disorders for up to 14 years -- long enough for a child to complete elementary and high school. (In my office I often suggest some specific books by Dr. Russell Barkley on both ADHD and conduct disorder). Behavioural family therapy, practiced in my office, is a similar technique but it also incorporates "into treatment a variety of family, parent, and child factors that have been implicated as leading to disruptive disorders (e.g. parental stress, cognitions about the child, child temperament)." What the literature presented review suggested is that "ADHD core symptoms are better controlled by a combination of pharmacotherapy and board based intervention"s that include psychosocial interventions and may include family therapy.

Finally, Dr. Josephson said that family-based therapy may help in some of the current concerns about the side effects of pharmacotherapy, such as suicidal ideation. "When physicians and parents are partners in monitoring patients' safety, the family serves as a safety net that can facilitate several treatment goals." To sum up: Conduct Disorder (a specific diagnosis only your medical doctor of psychologist can determine) which is associated with ADHD is best treated first medically, then behaviourally, and last by family therapy. Parenting skills, education and coaching are critical components to success.

For more information on ADHD (Attention Deficit Hyperactivity Disorder, parenting, child behaviour, academic problems and relationship issues, please feel free to visit my website at www.relatedminds.com I also have specific information on ADHD available at www.adhdhelp.ca and information on my counselling and assessment services can be found at either the British Columbia Psychological Association (click here), Psychology Today (click here) or my AAMFT Family Therapist website (Click here). I am a registered Psychologist here in British Columbia, along with being a Registered Marriage and Family Therapist and teacher of special education. There is also some specific information on treatment for aggression and anger in children on my webpage called "The Angry Child," (Click here)

I look forward to hearing from you.

Dr. Jim Roche
Registered Psychologist
778.998-7975
Offices in Burnaby and Vancouver, British Columbia