The overarching goal of this study is to improve the effectiveness of treatment of children referred for Conduct Disorder. The study focuses on understanding how treatment produces changes (mediators) and factors that contribute to outcome (moderators). The model underlying the study is that therapeutic change is influenced by characteristics that children, parents, and families """"""""bring with"""""""" them to treatment, by characteristics that emerge during the treatment process (e.g., alliance, adherence), and by the intervention and associated features (e.g., therapist behavior, characteristics). The proposed study focuses on the first two components and will: 1) identify child, parent, and family factors that contribute to therapeutic change and 2) test key processes during the course of treatment that explain therapeutic change. Children (N=200, ages 6-12, including European and African American families) referred to outpatient treatment and who meet diagnostic criteria for Conduct Disorder will participate. All children and parents will receive problem-solving skills training and parent management training as a combined treatment. The central predictions are that: 1) responsiveness to treatment will be influenced by child dysfunction and impairment, parent dysfunction and stress, and adverse family relations in the home and by initial parent expectancies about treatment processes and outcome, and 2) therapeutic change will be mediated by a positive parent-therapist relationship, few perceived parent barriers to treatment during treatment, and parent and child adherence and compliance with treatment. The study will also permit evaluation of the predictions across the two ethnicities. Apart from improving the effectiveness of treatment for Conduct Disorder, the study is intended to advance a heuristic model for child therapy research more generally. The model conceptualizes antecedents, emerging processes, and interventions as sources of influence on outcome. Also, the design of the study permits evaluation of processes and causal models to help explain the processes of change.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
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Price, Leshawndra N
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Yale University
Schools of Arts and Sciences
New Haven
United States
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Kazdin, Alan E; Durbin, Kelly A (2012) Predictors of child-therapist alliance in cognitive-behavioral treatment of children referred for oppositional and antisocial behavior. Psychotherapy (Chic) 49:202-17
De Los Reyes, Andres; Kazdin, Alan E (2009) Identifying evidence-based interventions for children and adolescents using the range of possible changes model: a meta-analytic illustration. Behav Modif 33:583-617
Kazdin, Alan E (2007) Mediators and mechanisms of change in psychotherapy research. Annu Rev Clin Psychol 3:1-27
Kazdin, Alan E (2006) Arbitrary metrics: implications for identifying evidence-based treatments. Am Psychol 61:42-9; discussion 62-71
Kazdin, Alan E; Whitley, Moira K (2006) Pretreatment social relations, therapeutic alliance, and improvements in parenting practices in parent management training. J Consult Clin Psychol 74:346-55
Kazdin, Alan E; Whitley, Moira; Marciano, Paul L (2006) Child-therapist and parent-therapist alliance and therapeutic change in the treatment of children referred for oppositional, aggressive, and antisocial behavior. J Child Psychol Psychiatry 47:436-45
Kazdin, Alan E; Whitley, Moira K (2006) Comorbidity, case complexity, and effects of evidence-based treatment for children referred for disruptive behavior. J Consult Clin Psychol 74:455-67
De Los Reyes, Andres; Kazdin, Alan E (2006) Conceptualizing changes in behavior in intervention research: the range of possible changes model. Psychol Rev 113:554-83
Nock, Matthew K; Kazdin, Alan E (2005) Randomized controlled trial of a brief intervention for increasing participation in parent management training. J Consult Clin Psychol 73:872-9
De Los Reyes, Andres; Kazdin, Alan E (2005) Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull 131:483-509

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