An Inch On the Impossible

Quick. Name the naion's most costly mental health problem.

It's conduct disorder. And millions of schoolkids have it They am highly antisocial, often interpreting neutral events, such as being bumped into, as acts of hostility. They am given to violence, cruelly, vandalism, stealing, truancy, sexual activity, and running away from home. Those who have it carry misery with them, often becoming adult criminals - and passing destructive behavioral patterns on to their children.

The disorder defies most attempts at therapy, probably because it's embedded in a constellation of problems affecting family as well as child. Typically, parents are themselves dysfunctional, by circumstances or depression, lacking skills in child-rearing and dealing in harsh, even violent, but ineffective discipline.

Yet Yale psychologist Alan E. Kazdin believes he can make a dent. In a study of 97 kids, ages 7 to 13, he found that treating both parents and children could make improvements detectable in the kids up to a year later. Such combined produced greater and longer-lasting results than treating either parents or children alone.

Children were taught problem solving skills. They learned how to generate options for interpreting and dealing with specific. They learned responses that were nonviolent and rehearsed them. Parents were individually trained in the same skill& They also learned how to their children's forts, and how discipline consistently without resorting to physical means.

Kazdin and his colleagues looked at 46 of the 76 kids who completed therapy. After combined treatment only 8 of 20 kids were still seriously misbehaving, compared with 11 of 15 who got child-only treatment and 9 of 11 in parent-only training. A year later, half of the combined group were seriously misbehaving compared with 13 of 15 in the child-only group and 10 of 11 in the parent-only group.

"Far from viewing our therapy as a cure," says Kazdin, it is more accurate to view it as treatment that, like insulin for diabetics, helps keep symptoms under control." A shot in the arm.