Practice-Based Evidence on the Treatment of Conduct Problems in a Child/Adolescent

Abstract

In this discussion I respond to two commentaries on a case study of my treatment of Rafael, a 12-year-old boy presenting with conduct problems (Clement, 2011b). My response includes shorter consideration of a variety of specific points raised by the commentators. I also elaborate in some detail on one of the points raised concerning my system for measuring treatment outcomes in routine clinical practice. The approach adapts Goal Attainment Scaling, the Global Assessment Scale/Global Assessment of Functioning, and Smith and Glass's 1977 method of calculating treatment effect sizes (ESs). Finally, I frame my case study as an example of practice-based evidence for the effectiveness of psychotherapy.Key words: adolescent psychotherapy; birth defects; child psychotherapy; conduct problems; developmental assets; developmental trajectory; positive psychology; practice-based evidence; resilience; stealing; vandalism; clinical case studies; case studies ________________________________________________________________________ California requires at least one year of post-doctoral supervised experience before a person can become licensed as a psychologist. During my first year following graduate school I did my clinical work and research in the Children's Psychiatric Clinic at Harbor/UCLA Medical Center in Torrance, California. The head of the clinic arranged for a psychiatrist on our staff to provide me with the required pre-licensed supervision. The supervising psychiatrist and I had very different theoretical orientations. Unfortunately, we spent our early months of supervision arguing. The process was unrewarding for both of us. In thinking about what had been transpiring in our supervisory sessions, I decided to make a proposal. In our next meeting I reviewed what I perceived had been occurring in our meetings and suggested a change. I proposed that from that day forward I would describe to him what I was doing with each of my therapy cases and my rationale for doing so. Then I wanted him to tell me what he would do with