Perceptions of Service Efficacy Among Young Adults with Childhood Histories of Conduct Problems

Services developed to address conduct problems in school contexts show limited efficacy. The current study examined how young adults with childhood histories of conduct problems retrospectively understood service efficacy, inefficacy, and what suggestions they had for service improvement. Participants were 41 young adults from Québec (17-21 years old; 53.7% women; 78% white; 77% below the low-income cut-off for single-person households) who had received services for conduct problems starting in childhood. They completed semi-structured interviews about their service usage experiences. Thematic analysis was used to identify how participants discussed themes relating to efficacy, inefficacy, and service improvement. While considerable overlap was observed in how participants and educational professionals understand efficacy (e.g., reduced symptoms) and inefficacy (e.g., worsening symptoms), participants also noted key differences in terms of how they perceived efficacy (i.e., using services to avoid punishment) that are not generally considered by educational professionals. Including user perspectives when assessing service efficacy and inefficacy can provide crucial insight for improving services for youth with conduct problems, providing a starting point for understanding how users evaluate service success, and how they saw services as influencing their psychosocial outcomes.