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Conduct Disorders: Assesssment & Diagnosis
Conduct Disorders continuing education addiction counselor CEUs

Section 16
Group Centered Treatment of Conduct Disorders in Adolescents

CEU Question 16 | CEU Answer Booklet | Table of Contents | Conduct Disorders
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs


History
Serving as a consultant to a large county detention center for youths diagnosed as having a conduct disorder, I was asked to assist with six adolescent boys. They ranged in age from 14 to 16. Unlike the other youths in adolescent boys Conduct Disorders social work continuing eddetention, these boys had not responded to the behavior modification program that was the modal treatment at the center. Their behavior was aggressive and hostile toward staff and peers. They would not follow the rules of the center and were frequently detained in isolation. The staff counselors reported that these boys would talk and be cooperative on an individual basis. However, once they were in a group with one another or with other youth or staff, they would revert to conduct disordered behavior.

Group Treatment
In keeping with the Adlerian approach to the treatment of adolescents (Mosak, 1979), I elected to see the six youths in group therapy. I met with them three times each week for a total of five weeks. My approach was based upon what I term “The Interview Method.” This is a nonauthoritarian method of inquiry that removes the person conducting the therapy from the position of authority and places authority within the group.

The Interview Method
The Interview Method of therapy is like that of reporting a news story. The person conducting the interview seeks to gain as much information as possible from the persons being interviewed. There is no criticism of the individuals nor of the information they are offering. There is no attempt to point out basic mistakes in private logic (Dreikurs, 1962). Logical inconsistencies or double standards are not mentioned. As Shulman has stated, “Never get smarter than the patient” (Shulman, 1973). The person conducting the interview merely seeks information.

The interview questions are structured in such a manner as to bring forth basic mistakes, but not overtly to call these to the attention of the individual. For example, one of the adolescents, Syd, made the statement: “Alt of the staff are assholes. They are always unfair and never listen to any of our suggestions.” To this I responded, “As I understand it, all of the staff are unfair and refuse to listen to any of your suggestions?”

By mere inquiry and active listening, I was able to accomplish three immediate therapeutic purposes. First, as Dreikurs (1969) pointed out, the most important function of group discussion was not solving problems, but giving everyone an opportunity to be heard. Second, I had removed myself from the authoritarian or teaching role that these adolescents had come to expect from adults. There was nothing in my manner that was a threat or an opportunity to mount a challenge. War between the generations (Dreikurs, 1965) was not possible because I did not take an offensive position nor would I be placed in a defensive position. Third, the adolescents became a group and censored each other.

Group Centered
When it became clear that I was not going to point to the over-generalizations and exaggerations, the peers of the person speaking would challenge the logic. Fred, in the example above, offered: “They are not all assholes. At least Bill and Jack are really pretty neat guys. Besides, Syd, you really ask for it when you throw food around the cafeteria.” If no challenge were forthcoming to basic mistakes or irrational arguments, I would query one of the other six members of the group as to their view. I was still staying within the interviewing mode. For example, one of the adolescents, Sam, stated: “All of the judges in the county are out to get teenagers, and once you get to court you are automatically guilty.” I turned to a second member of the group, Ralph, and asked: “Are your experiences and views the same as those of Sam?” When Ralph indicated that he also shared that opinion, a third member, Dick, commented: “Every one of us has been “Let off” at least once in the past when in fact we really were guilty, including Sam and Ralph.” The other group members nodded their heads in agreement with Dick, and Sam and Ralph gave a smile of recognition.

Results
By the second week, the staff was reporting signs of cooperation from these six adolescents. After four weeks, none of the six had been placed in isolation during the past week for rule violation. The group meetings ended after five weeks because two of the youth had been discharged on probation and the other four were slated for discharge when a suitable foster home could be found.

Conclusions
The “Interview Method” of therapy can be used with any group of adolescents. It has the advantage of placing responsibility for confrontations in the hands of the members themselves. Adolescents will assume this responsibility when the person leading the group presents a group-centered approach. The more intense the felt discouragement in past contacts with adults, the more the adolescent anticipates control, criticism, and domination from the adult. This discouraged anticipation can be disarmed with “The Interview Method” of therapy.
- Croake, James W., Treating Conduct Disorder in Adolescents; Individual Psychology: The Journal of Adlerian Theory, Research & Practice, Jun86, Vol.42 Issue 2, p270, 4p
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #2
The preceding section contained information about the group-centered treatment of adolescents with conduct disorder. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 16
What is an advantage of the “Interview Method”? Record the letter of the correct answer the CEU Answer Booklet.

 
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