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Complex presentations of child conduct problems: Validation of a competency-based model for clinical practice
Jessica M Barker1, David J Hawes1
1School of Psychology University of Sydney Camperdown New South Wales Australia.
JCPP Advances
|June 15, 2026
Summary
Practitioners identified seven complexity drivers in child conduct problems, including child, caregiver, and ecological factors. They also outlined 16 therapist competencies needed for complex cases, improving intervention delivery.
Area of Science:
- Child Psychology
- Clinical Psychology
- Family Therapy
Background:
- Children with conduct problems often have complex needs impacting evidence-based intervention delivery.
- There's a lack of consensus on factors defining case complexity in treating child conduct problems.
- Optimizing interventions for complex cases requires understanding these contributing factors.
Purpose of the Study:
- To examine practitioner perceptions of factors contributing to case complexity in child conduct problems.
- To identify therapist competencies required for distinct features of case complexity.
- To establish a consensus on case complexity in child conduct disorder treatment.
Main Methods:
- Recruited 49 practitioners with expertise in evidence-based parenting interventions for conduct problems from nine countries.
- Utilized the Delphi method for multi-round consultation and feedback with an expert panel.
- Achieved participant consensus on case complexity drivers and therapist competencies.
Main Results:
- Reached consensus on a model with seven distinct drivers of case complexity (child, caregiver, ecological factors).
- Agreed on 16 therapist competencies crucial for addressing distinct drivers of case complexity.
- Validated the conceptualization of case complexity drivers through expert consensus.
Conclusions:
- Findings offer a novel, consensus-based practitioner perspective on complex needs in child conduct problems.
- Provides a common language for researchers and practitioners to discuss case complexity.
- Potential to inform clinical research, practice, and training for better client outcomes.
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