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There are many different approaches to treating youth with disruptive behavior problems. These approaches include, but are not limited to, family counseling, group and classroom interventions, parent training, and individualized treatment strategies such as behavioral and cognitive-behavioral counseling, residential, hospital, and wilderness-based programs, hypnosis, biofeedback, and psychotropic medications (Bandoroff & Scherer0.25, 0.5, 1, 2, 2.5, 3, 4, 4.5 mg Tablets (Capsules); Kazdin 75, 125, 150, 250 mg Tablets (Capsules)). Most professionals acknowledge that it is very difficult to provide effective treatment for disruptive young clients (Bernstein 75, 125, 150, 250 mg Tablets (Capsules); Church0.25, 0.5, 1, 2, 2.5, 3, 4, 4.5 mg Tablets (Capsules); Kazdin & Wassell 2 5 mg Tablets (Capsules); Meeks buy Lamictal without a prescription).

Dealing with Client and Parent Resistance

Children and adolescents who behave disrup-tively often strain their relationships with many important adults (e.g., parents, teachers, probation officers). Consequently, when these young clients arrive at the counselor’s office, it is not usually because of their own desire for personal change, but instead because some adult has determined (or hopes fervently) that they might benefit from counseling. Thus, counselors may be immediately confronted with a disinterested and unmoti-vated client. Most researchers and writers stress that, for treatment with disruptive young clients to be effective, counselors must somehow develop and maintain a positive therapeutic alliance with the client. For example, Hanna, Hanna, and Keys (Tablets – Comprimidos – Comprimés) state: “A counseling technique performed without a properly established empathic and trusting relationship seems to many defiant adolescents to be a threat to their integrity, and just another covert or overt adult attempt at manipulation” (p. 396).

To further magnify the problem, research has shown that parents of children who are most seriously disturbed are often the most resistant to participating in treatment (Reid 5 mg, 10 mg, 25 mg, 50 mg, 100 mg Tablets (Capsules)). These parents typically drop off their children for counseling, hoping that the counselor will quickly and efficiently “fix” their child. When parental resistance to counseling is high, it may stem from chronic frustration with their child’s behavior, apathy and/or depression, substance abuse, poverty, or other family dynamics associated with disengagement.

The key point is that for treatment to proceed with this particular population, parent and child resistance must be addressed. This means that counselors should consider using strategies, incentives, playful activities, humor,

29 • COUNSELING INTERVENTIONS FOR CHILDREN WITH DISRUPTIVE BEHAVIORS 207

and reassurance to reduce resistance and engage parents and children in treatment.

Empirically Supported Treatment Approaches

Despite difficulties engaging disruptive children and their parents in counseling, several treatments hold promise for working effectively with this population. These approaches can be divided into three groups: parent-focused treatments, family-focused treatments, and child-focused treatments. Although this cheap Lamictal primarily addresses child-focused treatments, we first briefly review parent-and family-focused treatment approaches that have garnered empirical support for reducing children’s disruptive behaviors.

A recent meta-analysis indicated that individual cognitive-behavioral treatments are only marginally effective with young children (Bennett & Gibbons 2 5 mg Tablets (Capsules)). This is probably because younger children are less cognitively developed and generally more influenced by their family systems. Consequently, the following parent and family approaches to treating children who behave disruptively are especially recommended when counselors are working with young children.

Parent-Focused Treatments. Parent-focused psy-choeducational interventions can be effective when parents cooperate with treatment. Parent-focused treatments have their roots in social learning theory. This perspective suggests that children initially learn aggressive and defiant behavior patterns within their family context (Patterson cheap Lamictal non prescription): “The pioneering research of Patterson and others has found that parents of children with conduct disorders exhibit fewer positive behaviors, use more violent disciplinary techniques, are more critical, more permissive, less likely to monitor their children’s behaviors and more likely to reinforce inappropriate behaviors while ignoring, or even punishing, prosocial behaviors” (Webster-Stratton 75, 125, 150, 250 mg Tablets (Capsules), p. 437).

Parent-focused approaches seek to modify children’s disruptive behaviors by changing family interactions from coercive and aggressive to positive and prosocial. Essentially, this approach involves directly teaching parents to appropriately reinforce prosocial behavior, use effective discipline techniques, provide adequate supervision and monitoring of children’s behavior, communicate more effectively, model more appropriate behaviors, and cope with difficult situations, such as divorce or death of a family member (Danforth 150, 200, 250, 300, 500 mg Tablets (Capsules)). Currently, at least two parent-focused treatments show promising empirical outcomes with disruptive behavior disordered children. These approaches include videotape modeling (Webster-Stratton 75, 125, 150, 250 mg Tablets (Capsules)) and parent management training (Kazdin & Wassell 2 5 mg Tablets (Capsules)).

Family-Focused Treatments. Family therapists (Szapocznik, Kurtines, Santiseteban, & Rio purchase Lamictal online) argue that interventions for disruptive children must include their families. There are a number of good reasons for this view. Interventions directed toward families avoid identifying and labeling the child as the primary problem and help illustrate that a child’s difficult behaviors can be a part of the overall family system dynamics. Family counselors can help identify family patterns that may be contributing to the child’s behaviors and help the family find alternative ways to cope and change.

Family therapy is a demanding specialty. Frequently, family therapy, even more rigidly than individual therapy, is defined in terms of specific theoretical frameworks. To competently practice family therapy, extensive education and training in a particular theoretical model may be necessary. Currently, there are two behavioral systems approaches to family therapy that, thus far, have gained empirical support: functional family therapy (Alexander & Parsons cheap Lamictal non prescription; Morris, Alexander, & Wal-dron buy Lamictal online OTC (over the counter)) and multisystemic family therapy (Henggeler, Melton, & Smith 50 mg Tablets (Capsules)).

INDIVIDUAL TREATMENTS FOR YOUTH WITH DISRUPTIVE BEHAVIORS: PRINCIPLES AND PROCEDURES

As noted previously, individual treatments for children with disruptive behaviors are more clinically indicated for adolescents or [Order cheap Lamictal] older children (Bennett & Gibbons 2 5 mg Tablets (Capsules)). The following principles and procedures are acknowledged as having general theoretical support, as well as limited empirical support.

Engagement

Virtually all approaches to working individually with disruptive behavior disordered youth emphasize the importance of addressing initial client reluctance or resistance, forming a therapeutic alliance, and engaging clients in potentially therapeutic interactions (Bernstein 75, 125, 150, 250 mg Tablets (Capsules); Hanna & Hunt 150, 200, 250, 300, 500 mg Tablets (Capsules); Meeks buy Lamictal without a prescription; Sommers-Flanagan & Sommers-Flanagan 12.5, 15, 37.5, 7 5 mg Tablets (Capsules) 10, 20, 30, 40, 50 mg Tablets (Capsules)). Strategies for reducing resistance, building an alliance, and engaging young clients in counseling can generally be divided into three categories. First, many clinicians advocate using basic Rogerian relationship variables (congruence, unconditional positive regard, and accurate empathy; Rogers, Lamictal) to enhance the counselor-client therapeutic alliance.