Behavioral Management Services an Effective Intervention for Early Problem Behavior

ARLINGTON, Va. — The evidence is promising for the effectiveness of specific behavioral management interventions in improving child behavior and reducing potentially negative consequences of negative behavior later in life. The results of an extensive review were reported in the May issue of Psychiatric Services, a journal of the American Psychiatric Association, as part the series Assessing the Evidence Base.

Problem behavior early in life can be related to negative outcomes—academic problems and school dropout, substance use, and criminal involvement. Behavioral management services for children and adolescents are designed to help develop or maintain prosocial behaviors. The interventions for children and adolescents address problem behaviors, including noncompliance at home or school, disruptive behavior, aggressive behavior rule breaking, and delinquent behaviors.

In their review of studies and literature (1995-2012), Melissa H. Johnson, MA, MPH, and colleagues looked at three basic models of interventions: family centered, school-based, and integrated home-school programs. The family-centered behavioral interventions, such as the Parent-Child Interaction Therapy (PCIT) and the Incredible Years program, showed strong effects in reducing and preventing problem behaviors across a range of ages. Integrated interventions, such as Fast Track and Adolescent Transitions Program, demonstrated promising findings in preventing and reducing problem behaviors among diagnosed and atrisk children. Results of school-based interventions were mixed.

Behavioral management services are usually delivered through an individualized plan based on a clinical assessment. Examples of specific behavioral management treatment activities include identifying antecedents of behaviors, using motivating factors in reinforcements, developing plans to address identified problem behaviors, coordinating interventions across settings, and training other individuals in a child’s life to address behavior goals.

The authors conclude that for policy makers and payers the findings suggest a number of benefits of early implementation of behavior management interventions, including cost savings over later more intensive services, prevention of involvement with substance use or in the juvenile justice system, and reduced need for costly emergency services or residential treatment.

Assessing the Evidence Base Series
The Affordable Care Act stipulates that behavioral health services must be covered in new health plans, but not specifically which treatments. As a result, state, local and other decision makers are faced with the challenge of selecting services for health benefit plans. To inform these decisions, the Substance Abuse and Mental Health Services Administration (SAMHSA) commissioned a series of literature reviews on 13 commonly used, recovery-focused mental health and substance use services. Each article in the Assessing the Evidence Base (AEB) Series reviews what we know about the effectiveness of a particular service. The articles are being published in Psychiatric Services throughout 2014.

The American Psychiatric Association is a national medical specialty society representing more than 35,000 physician members specializing in diagnosis, treatment, prevention, and research of mental illnesses including substance use disorders. Visit the APA at www.psychiatry.org.

 

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