Adolescent Externalizing Behaviors. Joshua Leblang, Ed.S., LMHC Division of Public Behavioral Health and Justice Policy.
Joshua Leblang, Ed.S., LMHC
Division of Public Behavioral Health and Justice Policy
Our youth now love luxury. They have bad manners, contempt for authority, they show disrespect for their elders … they contradict their parents…and tyrannize their teachers."
Socrates (c. 470-399 BC)
The number of boy burglars, boy robbers and boy murderers is so astoundingly large as to alarm all good men."
New York Times editorial in 1857
Disruptive disorders, such as oppositional defiant disorder and conduct disorder, are characterized by antisocial behavior.
It presents as collection of behaviors rather than a coherent pattern of mental dysfunction. As such, there is no “magic bullet” to fix the problem.
Morals, Values, and Self-Direction
Blueprints for Violence
“They are too rigid and cookbook”
“Doesn’t apply to real world kids with real world, multi-problem histories”
“Developed in some lab”
“Too difficult to implement in community setting”
“Just a band-aid and doesn’t address underlying issues and concerns”
“Another passing fad”
“My training and expertise are not valued”
Interventions showing beneficial effects in outcome research should be taught and used in preference to interventions that have not been tested and shown to be effective.
Programs that are integrative in nature (practice, research, theory) and use systematic clinical protocols ”clinical maps”
Model congruent assessment procedures
Focus on adherence and treatment fidelity
Clinically responsive and individualized to unique “outcome” needs of the client/family
Models that have strong science/research support
Parent and family connectedness
Parental school expectations
Parents involvement and awareness of sexual behaviors
Limit access to substances and weapons
Seek help for parental and familial problems/concerns
Seek support from other parents
Know community resources
1. Comprehensive, time-intensive
2. Earliest possible intervention
3. Timing is important
4. High structure is better
5. Fidelity to model is key to effectiveness
6. Need adult involvement
7. Active, skills-oriented programs are more effective
8. Programs that target multiple systems are most effective
9. Programs that are sensitive to the individual’s community and culture are best
10. Programs based on strong theoretical constructs and proven effective by evidence are best
Connecticut Center for Effective Practice (From meta-analysis published in 2005)
ALL focus on family/ caregivers
The goal of the MTFC program is to decrease problem behavior and to increase developmentally appropriate normative and pro-social behavior in children and adolescents who are in need of out-of-home placement.
MTFC treatment goals are accomplished by providing:
Close supervision; fair and consistent limits ; predictable consequences for rule breaking ; a supportive relationship with at least one mentoring adult; and reduced exposure to peers with similar problems.
The intervention is multifaceted and occurs in multiple settings. The intervention components include:
Intervention strategies: MST draws from research-based treatment techniques
Finding the Fit
Positive & Strength Based
Present focused, Action-orientated
Developmentally/ Culturally Appropriate
Evaluation & Accountability
Explaining delinquency and drug use, by D.S. Elliott, D. Huizinga and S.S. Ageton. Beverly Hills, CA: Sage Publications, 1985, 176 pp
Low School Involvement
Poor Academic Performance
Meets other anti-social peers
No changes at home
Youth gets in trouble
Sent to treatment
Meets other drug-using peers
Sent to treatment / group
Youth uses drugs
Now has greater access to negative peers, people to buy from
How can we best use this???