Family-based treatments are effective for substance abuse and conduct disorders in children and adolescents, according to a new, ten-year research review released this week. The treatment also helps reduce the behavior problems associated with attention deficit hyperactivity disorder (ADHD) and shows promise in treating depression and anxiety.
"There are some myths about family therapy, and one of them is that it's not effective," said Allan Josephson, M.D., chief executive officer of the Bingham Child Guidance Center in Louisville and co-author of the study. "However, the empirical support for its success has been growing. This paper documents that counseling and working with families is not only an intuitively good idea--there's scientific evidence for its effectiveness in specific conditions."
Dr. Josephson spoke today in New York City at the American Medical Association and National PTA media briefing, Back to School: Child and Adolescent Health. The study will be published in the September issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
In the paper, Dr. Josephson and co-author Guy Diamond, Ph.D., associate professor of psychiatry at the University of Pennsylvania School of Medicine and director of the Center for Family Intervention Science at the Children's Hospital of Philadelphia, examine most of the randomized clinical trials over the past decade that included parents in the treatment of child and psychiatric disorders--the definition of family therapy.
They found evidence that two types of family-based treatments are effective for conduct disorders, which may cause children or teens to be aggressive, destroy property or otherwise violate established rules. The first, parent management training (PMT), teaches parents techniques to promote good behavior in their children. These may include using positive reinforcement, awarding points for good conduct or working with children to develop problem-solving skills. Studies have shown that PMT can be effective for conduct disorders for as long as 14 years. Behavioral family therapy (BFT) is similar to PMT but also includes methods to reduce family factors that may contribute to a child's disruptive behavior, such as stress in the parents' lives or the child's personality.
Family therapy also has been shown to be as good or better than other types of treatment in reducing drug use and related behavior problems among children and adolescents with substance abuse. Though the treatment doesn't seem to help much with core ADHD symptoms, such as difficulty staying focused, family training in stress, anger management, communication and school advocacy can reduce the behavior problems normally associated with the condition, said Dr. Josephson, who is also professor and chief of the Division of Child and Adolescent Psychiatry at the University of Louisville School of Medicine.