Family therapy for conduct disorder: Parent/caregiver perspectives on active ingredients

Youth with conduct disorder and their families are difficult to treat and remarkably unresponsive to therapy. A main challenge is treatment engagement. This study’s aim was to explore the family’s evaluation of active ingredients in family therapy for conduct disorder and discover if those ingredients correspond with the research literature. The intention was to gain more insight into currently known active ingredients and identify any not yet recognised to promote treatment improvement. The study was a qualitative design, using semi-structured interviews with parents/caregivers, to explore the experiences of families. Four families who had successfully completed Family Centred-Feedback Informed Therapy, a therapy for youth with conduct disorder, in a regional area of Queensland were involved. A six-step-framework thematic analysis was applied whereby the data were analysed and interpreted through the lens of current research (and foundational models and theory). The parents/caregivers who participated in this study endorsed the six known active ingredients of successful family therapy for conduct disorder: therapist adherence, therapeutic alliance, creating a family focus, improved family communication, parenting skills, and delivery in the home. Additional parent/caregiver key ingredients were: putting the problem into words, recognising and adjusting expectations, responding with sensitivity, and youth sees parent/family commitment. Considering a main challenge to successful treatment of conduct disorder is the early engagement of youth and their families, these findings are important. Eliciting parent/caregiver views can add to a more complete investigation of change processes to help obtain maximum gains for families and youth. With this knowledge program developers and therapists may recognise and target specific client factors, including relational factors and beliefs to optimise engagement and change across treatment. The current study results support qualitative research methods in further treatment development including cultural adaptations to programs.