About Conduct Disorder
What does it look like?
How common is it?
What causes it?
How long does it last?
What treatments are effective?
A review of the evidence
What's new?
Resources
A review of the evidence
Parent training for child conduct disorder and
oppositional defiant disorder: Does it work, and is it cost-effective?
Dretzke J, Frew E, Davenport C, Barlow J, Stewart-Brown S, Sandercock J, et al
The Bottom Line:
Parent training/education appears to be effective in reducing challenging behaviours in children and adolescents up to the age of 18, at least in the short term. This review could not determine whether or not there was a better result if programs were provided on an individual basis, or in groups, or if the training program focused on behaviour management or also tried to improvement the parent-child relationship. It appeared that more hours and additional work with the child alone improved the effectiveness of the program. Parent training/education costs far less than out-of-home care or incarceration for criminal activity, so it is a potentially cost-effective therapy for children with conduct disorder. |
What problem is being addressed?
The behaviour of children and adolescents with conduct disorder or oppositional defiant disorder can cause disruption and unhappiness in their homes. It is also a risk for school failure and can lead to criminal activity. Many treatments are used to treat these severe disorders but not enough is known about which of them is effective in reducing the symptoms. Little is also known about the cost-effectiveness of different treatments for conduct disorder.
What intervention is being tested?
This is a review of parent education/training programs which are designed to help parents learn to successfully manage their children’s challenging behaviour. A variety of programs were assessed, some using behaviour management techniques, others also teaching skills to improve the relationship between parent and child. Some were group based, while others were offered on an individual basis. They included programs delivered in the community or in a specialized clinic.
What is the real scientific evidence?
37 randomized controlled trials (RCTs) of parent education/training programs were evaluated for this review. Most of the studies had flaws in the way they were conducted and had different participant groups. They were taught by different kinds of practitioners, and were carried out for different lengths of time. All of these factors can influence the ability to analyze treatment effects. However, there was sufficient data to draw preliminary conclusions.
Taken together, the studies showed that it is likely that parent training/education programs are effective in helping to change child behaviour, at least in the short term, when compared to no treatment at all. It appeared that programs with more hours spent in parent instruction and those with a child training component were more effective.
The study found that parent training/education costs considerably less than placement in group homes, foster care, or residential treatment frequently used for children and adolescents, or imprisonment if these children and teens later begin to engage in criminal activity.
The preceding is a summary of:
Dretzke J, Frew E, Davenport C, Barlow J, Stewart-Brown S, Sandercock J, et al. The effectiveness and cost-effectiveness of parent training/education programmes for the treatment of conduct disorder, including oppositional defiant disorder, in children. Health Technology Assessment. 2005, 9(50): 1-250. Commissioned by the HTA Programme, U.K. Department of Health, on behalf of the National Institute for Health and Clinical Excellence.
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