By Bob Seay
Families with teenagers who have behavioral problems benefit more when the adults receive parent training first, then include their son or daughter in later therapy sessions. Families in which all members attend therapy from the outset are less likely to stick with treatment, according to a new study.
The University of Massachusetts Medical School Department of Psychiatry's study, conducted by Russell Barkley, Ph.D., and other researchers, which was published in the December 2001 Journal of Consulting and Clinical Psychology.
Family therapy is known to be an effective way to resolve family conflicts, particularly when children and adolescents have Oppostional Defiant Disorder or Conduct Disorder. But what kind of therapy works best? Barkley's research compared two specific types of family therapy, Problem-Solving Communication Training (PSCT) and behavior management training (BMT). His team also compared the results of combining the two treatments.
While BMT teaches parents how to better manage their children's behavior, PSCT helps parents and teens develop more effective communication skills while discussing family conflicts. Five steps are involved in PSCT:
- Defining the problem
- Brainstorming possible solutions
- Deciding on a solution
- Implementing the solution
100 AD/HD teens and their parents were divided into two groups. One attended 18 weeks of PSCT only. Parents in the second group first attended nine behavioral management training sessions without their kids, then had nine PSCT sessions with their teens.
Researchers found equal results for families completing the study: 80% were functioning within the normal range by the end of therapy. "Neither treatment was superior to the other in the degree of change that occurred," notes Barkley.
But three times as many families dropped out of the PSCT-only group, compared to those in the combined BMT/PSCT group. The take home message: training parents first works best because more families stick with it.
The study appears to validate speculation by the developer of the problem-solving communication treatment, Arthur Robin, Ph.D. Robin has hypothesized that the high dropout rate was due to parents needing to gain control over their teens' disruptive, defiant behavior before they could engage the teen in constructive attempts to resolve problems.