[Behavior therapy in children with aggressive dyssocial disorders]

Conduct disorder in children and adolescents is prevalent and has a poor prognosis: it is now considered to be a chronic condition that requires treatment as well as life-long monitoring. Two forms of behavior therapy, parent management training and training in problem-solving skills are currently seen as the most effective treatment. Parent management training is the treatment of choice for younger children, while for older children it should be supplemented with training in problem-solving skills. Parent management training is one of the best-researched therapy techniques for conduct disorder, deserving the criterion "empirically supported treatment" defined by the American Psychological Association. Training in problem-solving skills has led to therapeutic change in clinical samples and is qualified as "probably efficacious treatment". Limitations of both treatments include the high drop-out rate among parents and the fact that many youth improve but remain outside the range of normative functioning. To optimize treatment effectiveness, complex prevention programs have been developed in recent years. Results to date are mixed; however, two large ongoing studies, the FAST and the LIFT study, report positive first outcomes. A higher priority of conduct disorder and related problems in child-psychiatric and psychotherapeutic services would be desirable.