Cognitive Behavioral Intervention for Youth at Risk for Conduct Problems: Future Directions.

This article briefly overviews the history of cognitive behavioral intervention (CBI) for children displaying early signs, or actual diagnoses, of conduct disorders. A series of randomized control trials have identified evidence-based CBI programs for children with these behavior problems at various developmental stages from preschool through adolescence. Although it is critically important for the field to disseminate these existing programs as developed, we argue that it is important to also move beyond the existing evidence-based programs. Research should continue to test new comprehensive, multicomponent interventions, fueled by our evolving understanding of active mechanisms that contribute to children's externalizing behavior problems. The future of research in this area can also benefit from a focus on four central issues. First, research can address how single interventions can have meaningful impact on a range of transdiagnostic outcomes because the intervention mechanisms may affect those various outcomes. Second, rooted in implementation science, we are beginning to understand better how evidence-based programs can be disseminated in the real world, examining key issues such as the adequacy of training approaches and the role of therapist and organizational characteristics. Third, a major focus of research can be on how to optimize intervention outcomes, including a focus on microtrials, on tailoring of interventions, on examining rigorously how interventions are delivered, and on the integration of technology and of other approaches such as mindfulness training into CBI. Fourth, research can explore how the therapeutic relationship and the therapists' characteristics can play substantial roles in effective CBI with conduct problem children.

Spillover between interparental conflict and parent-child conflict within and across days.

The present study used a daily reporting design to examine the bidirectional spillover in conflict and conflict strategies between the interparental relationship and the parent-child relationship. Participants were 60 parents with a preadolescent child at risk for aggressive behavior. Parents reported on their experience of interparental and parent-child conflict and their use of constructive and destructive conflict strategies through daily telephone interviews over 7 days. Each day was divided into 3 equal time periods roughly corresponding to early morning, daytime, and evening. Time-lagged analyses investigated the spillover in conflict within and across days. Results revealed that the presence of interparental conflict significantly predicted the presence of parent-child conflict 1 time period later and 1 full day later. Likewise, the presence of parent-child conflict significantly predicted the presence of interparental conflict 1 full day later. In terms of conflict strategy use, results revealed that parents who engaged in constructive patterns of interparental conflict were more likely to engage in constructive patterns of parent-child conflict 1 time period later and 1 full day later. Reciprocal effects for constructive parent-child conflict predicting subsequent interparental conflict were significant across all 3 time lags assessed. There were no significant, bidirectional effects for the spillover in destructive conflict. Findings have important clinical implications. (PsycINFO Database Record

Adaptations to the coping power program's structure, delivery settings, and clinician training.

This article describes the conceptual framework for the Coping Power program that has focused on proximal risk factors that can actively alter preadolescent children's aggressive behavior. The results of initial controlled efficacy trials are summarized. However, consistent with the theme of this special section, some clinicians and workshop participants have indicated barriers to the implementation of the Coping Power program in their service settings. In response to these types of concerns, three key areas of programmatic adaptation of the program that serve to address these concerns are then described in the article. First, existing and in-process studies of variations in how the program can be delivered are presented. Existing findings indicate how the child component fares when delivered by itself without the parent component, how simple monthly boosters affect intervention effects, and whether the program can be reduced by a third of its length and still be effective. Research planned or in progress on program variations examines whether group versus individual delivery of the program affects outcomes, whether the program can be adapted for early adolescents, whether the program can be delivered in an adaptive manner with the use of the Family Check Up, and whether a brief, efficient version of the program in conjunction with Internet programming can be developed and be effective. Second, the program has been and is being developed for use in different settings, other than the school-based delivery in the efficacy trials. Research has examined its use with aggressive deaf youth in a residential setting, with Oppositional Defiant Disorder and Conduct Disorder children in outpatient clinics, and in after-school programs. Third, the article reports how variations in training clinicians affect their ability to effectively use the program.