New perspectives on intervention for conduct disorder.

We are pleased to offer a second issue on the theme of aggression in children and adolescents. In our first special issue we touched on the diverse etiological factors and developmental trajectories related to aggressive behavior. This volume is unique in presenting papers on the prevention of conduct problems and describing specific treatment approaches for children and adolescents with clinically diagnosable conditions. Moreover, this collection of papers reverberates application of multifocal, multi-tier approach. The prevention of childhood disorders is an essential yet often overlooked component of best practice in the provision mental health services. It is particularly important in relation to conduct disorder (CD) because once established CD is costly to treat and the consequences for development are considerable. In this volume, Pepler provides an insightful analysis of the prevention of bullying from a developmental-systemic perspective, drawing attention to the needs of the individual child and the importance of social-relational contexts. She emphasizes the need to ‘scaffold’ the vulnerable child away from bullying through careful consideration of his/her strengths and weaknesses in navigating social relationships and helping them to better meet their needs through prosocial rather than aggressive behavior. This is complemented by equally thoughtful analysis of ‘social architecture’ – the structuring of social-contexts in which bullying occurs to reduce risk, promote healthy relationships and advance values of respect, acceptance and non-violence. These two principles – ‘scaffolding and social architecture’ – offer important guidelines to structure the development individualized therapeutic plans, social programs and social policies that prevent or reduce the prevalence of bullying. Leadbeater and Hoglund’s paper take us a step further into prevention science by providing a description of a school-based program designed to reduce bullying and enhance social relationships. The WITS program (Walk away; Ignore; Talk it out; Seek help) program helps children develop skills for negotiating interpersonal conflicts and responding to provocative peer behavior. It also changes the school culture by providing a common language for students, teachers and parents to discuss the problem of bullying and alternatives that promote healthy social development. Analysis of longitudinal data revealed significant decreases classroom levels of bullying in schools provided with the WITS program compared to control classrooms. Together these two the Pepler and Leadbeater papers bring attention to the fact researchers and practitioners are beginning to integrate theory and research across the continuum of child behaviour problems, from those that occur in everyday life and to those associated with conduct disorder as a syndrome. This beckons a new era in understanding and managing childhood behavior problems – one that is based on the strong theoretical and empirical analysis, clear methodological strategies and grounded practice. Although prevention is always preferable, it is not always possible: we are far from providing universal prevention programs and not all children respond to such initiatives. Furthermore, although many cases of CD develop in childhood approximately half of all cases emerge in adolescence. Once CD is entrenched it can be exceptionally challenging to treat; indeed many practitioners hold pessimistic views about the likelihood of positive treatment outcomes in this population. Fortunately research over the past decade has identified a number of promising and empirically supported treatments for CD. In particular, there is growing support for interventions which target parenting practices that have been shown to be associated with the development of conduct disorder. In the current volume Osbuth and colleagues summarize evidence on the efficacy of parenting interventions in the treatment of conduct disorder. They point out that few interventions specifically target parenting practices associated with adolescent development and provide a synopsis of the developmental challenges of adolescence as they relate to parenting. Obsuth, et. al. present promising evidence on the effectiveness of a manualized parenting group for caregivers of conduct-disordered adolescents. This intervention targets caregivers of youth with severe conduct disorder, aggressive and violent behavior, self-harm behavior and a myriad of other social functioning issues. Given the problems in generalizability often noted in treatment trials of highly selected clinical samples, these results are indeed promising as they offer hope to practitioners who work with adolescents with complex and severe conduct disorder.