Evaluating cognitive-behavioral group treatment for disruptive adolescents in a special school

Deborah A. Hebert (2002)

This research compares the effects of an 8-week manualized cognitive behavioral group treatment program to the effects of the issue-based treatment program typically used in a special school setting for severely disturbed adolescents. Twenty-one students were divided into control and treatment groups, with control groups continuing to receive a previously scheduled weekly issue-based group, and the treatment group receiving an abbreviated manualized cognitive-behavioral treatment based on Wexler's (1991) Program for Innovative Self-Management (PRISM). Teachers, caretakers, and students were asked to rate participating students' functioning at pretreatment, posttreatment, and 2-month follow-up points using the Total Problems score from the Child Behavior Checklist (CBCL), Child Behavior Checklist, Teacher Report Form (CBCL-TRF), and Youth Self-Report (YSR) (Achenbach, 1991; Achenbach, Mc Conaughy, & Howell, 1987) and a single number chosen to represent the students' overall functioning, from the Children's Global Assessment Scale (CGAS) (Shaffer, Gould, Brasic, Ambrosini, Fisher, Bird, & Aluwahlia, 1983). Indicators of behavioral functioning in the school environment served as secondary sources of outcome data. The hypothesis that a cognitive behavioral group treatment would yield significant treatment effects superior to those of the favored topic-based treatment format was not supported. The expectation that a brief treatment model might yield effective results with this severely disturbed population, particularly when the treatment is offered in isolation rather that as one part of a more comprehensive treatment program, appears to have been overly optimistic. Treatment effects for this intervention may increase with boundary conditions consistent with Wexler's (1991) original model, where PRISM was integrated in a comprehensive wrap-around treatment program, with all program staff trained to simultaneously and consistently implement the treatment.