Date of this Version
Family Assessment, ed. Jane Close Conoley & Elaine Buterick Werth (Lincoln, NE: Buros Institute of Mental Measurements, University of Nebraska-Lincoln, 1995).
Family assessment as a means of guiding research and practice in mental health and pathology has been carefully examined in the preceding chapters of this text. Individuals, whether healthy or disturbed, function in a network of social interactions, with the primary system of interaction being that of the family. Children, as part of that family system, are not only influenced by other family members within the system but also influence other members and, simultaneously, the dynamics of the total system. The complex network of social interchanges that comprise human functioning begin with the parent-child relationship (see Lerner & Spanier, 1978, for a dynamic-interactional model of development). The ongoing reciprocal interaction between individual family members and its effect on child development and behavior has become an area of increasing interest to researchers (Reid, 1978; Patterson, 1982; Wahler & Dumas, 1984; Hartup & Rubin, 1986; Laosa & Sigel, 1982).
The field of behavioral parent training, with the focus on parentchild interactions, has emerged from early research in applied behavioral analysis as an indirect treatment intervention, building on the skills of family members to instigate change in the management of child behaviors. Initially, empirical research in parent training consisted of investigation into the uni-directional linear effects of parent responses on child behavior. Early on, little attention was directed at exploration of the influence of child variables upon parent behavior. Research in parent training has since addressed the reciprocal nature of child behavior and parent management skills.
Until very recently, assessment of children has relied primarily on the individual child from a normative perspective to determine level of functioning, developmental status, personality characteristics, and normal and deviant behavior in order to guide clinical treatment and therapeutic processes. Within the past decade, the child assessment literature is placing an increasing emphasis on family variables and their influence on child health and pathology (Mash & Terdal, 1988; Prinz, 1986). Researchers and clinicians alike have long recognized the need to address childhood behaviors within the context of the environments in which they are manifest. The trend toward expanded assessment procedures that take into consideration family variables has also developed in response to the needs of children who exhibit antisocial behaviors and the needs of their families.
Research in the field of behavioral parent training has begun identifying family variables that place children at risk for the development of antisocial behavior patterns and has extended our understanding of the factors involved in the development, facilitation, and maintenance of various child behaviors. This understanding is especially instrumental in making determinations regarding normal and deviant functioning, prognosis for an individual and family, treatment planning, and treatment evaluation. Behavioral parent training, also referred to as child management training, is one of only a few treatment approaches that addresses the family rather than the individual child and has been found to be an effective form of treatment for children who exhibit antisocial behavior (Kazdin, 1987a). The present chapter investigates the family variables that have been found to correlate with conduct disorders and antisocial behavior in children and explores how parent management training has been used to assist families in the management of childhood behavior problems. Assessment techniques and procedures most frequently used in behavioral parent training to evaluate family interactional patterns in order to identify needs, guide the course of treatment, and determine program efficacy are described.
Just as there is a wide range of childhood behaviors considered normal at any age, the range of behaviors considered to be deviant is also broad. Both the determination of normality and the determination of deviancy are dependent upon contextual factors such as environment, expectations, and developmental level, as well as on the severity, intensity, and pervasiveness of the behaviors being considered (Kazdin, 1987a). In addition, what behaviors are seen as normal and what behaviors are viewed as deviant are dependent upon the perceptions of those observing or rating the behaviors. Certain antisocial behaviors are considered to be normal for a 2-year-old but are not acceptable for a 10-year-old (i.e., whining). Likewise, other behaviors such as hitting peers may be displayed normally at age 4 at a low level of intensity and because of contingencies in place in the environment, and may be extinguished before they escalate to higher levels of intensity or become pervasive. There are other behaviors, such as fire setting and cruelty to animals that are considered deviant solely on the basis of their severe ramifications, and very few occurrences of a particular behavior are enough to label the child as deviant or delinquent.
Antisocial behaviors are displayed at one time or another by almost every child and are defined by Kazdin (1987a) as violations of social rules and/ or as actions against other people. Antisocial behavior becomes problematic when it is demonstrated repeatedly over long periods of time or when the intensity of the actions are severe. Conduct disorders refer to antisocial behaviors that are of clinical significance and not considered to be within the normal range of functioning (Kazdin, 1987a). For the purpose of this chapter, the terms antisocial behavior and conduct disorders will be used interchangeably and include classes of behavior that are deviant or aversive to others within a social context. These terms may be used to refer to anyone or a combination of behaviors that involve breaking social rules and/ or societal laws, including aggression, disruptive behavior, destructive behavior, truancy, and lying (Kazdin, Siegel, & Bass, 1992).
Conduct disorders in children have a far-reaching impact, not only for the child, but for the family, the school, the community, and society in general. Research has indicated that childhood conduct problems correlate with school achievement (Oishi on, Loeber, Stouthamer-Loeber, & Patterson, 1984), social adjustment (McMahon & Forehand, 1988), self-esteem (Capaldi & Patterson, 1991), substance abuse (Kazdin, 1987a), depression (Patterson, Capaldi, & Bank, 1991), criminal behavior (Kazdin, 1987b), and other forms of adult antisocial behavior (Loeber, 1982). There is evidence to suggest the cycle of antisocial behavior and poor parenting is intergenerational and, therefore, the effects are not short-lived but chronic, persisting from one generation to the next (Elder, Caspi, & Downey, 1986; Kelso & Stewart, 1986; Robins, 1966).