Can Social Competence Training for Children with Behavior Problems Have Long-Lasting Effects?

What you need to know

A social competence training program for children with conduct problems showed lasting benefits 10 months after treatment ended
The program was more effective than a control group activity in reducing oppositional behavior and improving prosocial behavior
90% of children who received the social competence training showed improvement at the 10-month follow-up compared to before treatment

Background on conduct problems in children

Conduct problems, including oppositional defiant disorder (ODD) and conduct disorder (CD), are among the most common reasons children are referred for mental health treatment. These disorders involve persistent patterns of defiant, aggressive, or rule-breaking behavior that cause significant problems at home, school, and with peers.

Without effective intervention, conduct problems tend to persist and can lead to serious issues later in life, including criminal behavior, substance abuse, and mental health problems in adulthood. Finding treatments that produce lasting improvements is therefore crucial.

The Treatment Program for Children with Aggressive Behavior (THAV)

This study examined the long-term effects of a program called the Treatment Program for Children with Aggressive Behavior (THAV). THAV is designed for boys ages 6-12 with ODD or CD. It uses cognitive-behavioral therapy techniques to help children develop better social and problem-solving skills.

Key components of THAV include:

Individual sessions tailored to each child’s specific behavior problems
Training in anger management and impulse control
Social skills practice through role-playing
Parent training to reinforce skills at home
Coordination with teachers to support positive behaviors at school

The program aims to address the underlying factors that contribute to and maintain aggressive behavior patterns.

Study design and methods

The researchers followed up with 76 families whose sons had participated in a previous study comparing THAV to an active control group. In the original study:

Boys ages 6-12 with ODD/CD were randomly assigned to either 24 weeks of THAV or a control condition called PLAY
PLAY involved 12 group play sessions but did not teach specific social skills
Both groups were assessed before and after treatment

For this follow-up study:

Families were re-assessed 10 months after treatment ended
Parents completed questionnaires about their child’s behavior
The researchers compared the THAV and PLAY groups to see if benefits were maintained

Key findings on long-term effects

The study found several indications that THAV produced lasting benefits:

Stability of improvements

For children who received THAV:

Reductions in aggressive and rule-breaking behaviors were maintained 10 months later
Improvements in social skills and prosocial behavior remained stable
Some areas like oppositional behavior and ADHD symptoms showed continued improvement over time

Superiority to control group

When compared to the PLAY group at 10-month follow-up, the THAV group showed:

Significantly lower levels of oppositional/defiant behavior
Significantly higher levels of prosocial behavior
A trend toward lower overall aggressive behavior (nearly significant)

Clinical significance

90% of children who received THAV were rated as “improved” at follow-up compared to before treatment
Only 58.5% in the PLAY group were rated as improved
No children in the THAV group got worse, compared to 2.5% in PLAY

Implications for treatment of conduct problems

These findings suggest that THAV can produce meaningful, lasting changes in behavior for many children with conduct problems. Some key implications include:

Benefits of individualized, skills-based approaches

By tailoring cognitive-behavioral strategies to each child’s specific behavior triggers and deficits, THAV appears to facilitate lasting skill development. This individualized approach may be more effective than generic group interventions.

Importance of multi-component treatment

THAV combines child-focused therapy with parent training and school involvement. This comprehensive approach likely contributes to maintaining gains across different environments in a child’s life.

Potential for continued improvement

The fact that some behaviors showed further improvement months after treatment ended is encouraging. Children may continue applying and refining their new skills over time.

Value of booster sessions

Given the positive long-term trajectory, periodic booster sessions to reinforce skills could potentially extend and enhance treatment benefits even further.

Limitations and future directions

While promising, this study had some limitations to consider:

It only included boys, so effects for girls are unknown
All measures relied on parent reports, which can be biased
The follow-up period was relatively short at 10 months

Future research could address these issues by:

Including girls and a more diverse sample
Incorporating teacher reports and direct behavioral observations
Conducting longer-term follow-ups of 2-5 years
Comparing THAV to other evidence-based treatments

Conclusions

THAV appears to produce lasting improvements in behavior for many boys with conduct problems
Benefits are maintained and sometimes continue improving 10 months after treatment
Individualized social skills training may be more effective than general group activities
Further research is needed on longer-term effects and applicability to broader populations

Overall, these findings are encouraging for the treatment of childhood conduct problems. They suggest that with the right intervention approach, many children can achieve meaningful, sustained improvements in their behavior and social functioning. For families struggling with a child’s conduct issues, seeking out evidence-based programs like THAV that teach specific social and emotional skills may offer the best chance for long-term positive outcomes.