Increasing Effectiveness of Cognitive Behavioral Therapy for Conduct Problems in Children and Adolescents: What Can We Learn from Neuroimaging Studies?

Abstract

Cognitive behavioral therapy (CBT) is particularly relevant for children from 7 years on and adolescents with clinical levels of conduct problems. CBT provides these children and adolescents with anger regulation and social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Typically, CBT is combined with another psychological treatment such as behavioral parent training in childhood or an intervention targeting multiple systems in adolescence. The effectiveness of CBT, however, is in the small to medium range. The aim of this review is to describe how the effectiveness of CBT may be improved by paying more attention to a series of psychological functions that have been shown to be impaired in neuroimaging studies: (1) anger recognition, (2) the ability to generate situation appropriate solutions to social problems, (3) reinforcement-based decision making, (4) response inhibition, and (5) affective empathy. It is suggested that children and adolescents first become familiar with these psychological functions during group CBT sessions. In individual sessions in which the parents (and/or child care workers in day treatment and residential treatment) and the child or adolescent participate, parents then learn to elicit, support, and reinforce their child’s use of these psychological functions in everyday life (in vivo practice). In these individual sessions, working on the psychological functions is tailored to the individual child’s characteristic impairments of these functions. CBT therapists may also share crucial social-learning topics with teachers with a view to creating learning opportunities for children and adolescents at school.

Does the Worst of Both Worlds Effect Run Through Cognition? Testing Perceived Peer Delinquency/Drug Use and Moral Neutralization as Mediating Mechanisms

“…By the time neutralization beliefs surface, the individual has probably already been engaged in a pattern of antisocial behavior (Maruna & Copes, 2005) and so it may be more a matter of intervention than prevention when it comes to addressing these beliefs. Cognitive behavioral forms of intervention appear to be particularly effective in reducing delinquency (Matthys & Schutter, 2021; Özabaci, 2011) and substance use (Carroll & Kiluk, 2017; Ramchand et al, 2021) and so may be particularly relevant when working with patterns like the WBW that are mediated and maintained by cognitive factors as indicated by the results of the present study. Hogue et al (2020) identify the core elements that appear to make cognitive behavior therapy effective with adolescent conduct and substance use problems: functional analysis of behavior problems, prosocial activity sampling, cognitive monitoring and structuring, emotion regulation training, problem-solving training, and communication training.…”

Cognitive-behavioral reciprocity: Testing the bidirectional relationship between antisocial cognition and delinquency.

“…There are positive effects as well, chief among them being that reciprocal causal effects provide clinicians and policy makers with expanded opportunities for intervention and affected youths with new sources of unassisted or natural change. There is a large body of research indicating that cognitive behavioral therapy is among the most effective interventions for youthful offenders (Lipsey et al, 2000; Matthys & Schutter, 2021; Özabacı, 2011). Normally when people think of cognitive behavior therapy, however, they think of creating a change in cognition to effect a change in behavior, but cognitive behavior therapy can just as easily bring about a change in cognition through a change in behavior.…”

Lower digit length ratio and aggression in adolescents and young adults with boxer's fracture: A case‐control study

“…Mindfulness was shown to decrease aggression and hostility among young adults (Borders et al, 2010). Cognitive behavioral therapy (CBT) may aid anger recognition and the ability to generate appropriate solutions to social conflicts in children, adolescents, and adults (Blacker et al, 2008; Matthys & Schutter, 2021; Sukhodolsky et al, 2016), and these may prevent physical aggression through decreasing aggression and hostility. In accordance with that assumption, social skills training added to anger management was shown to be more effective than CBT only in physical aggression (Saliha et al, 2021).…”