Dr. Brendan Andrade studies strategies for managing disruptive behaviour in children
Families raising children with disruptive behaviour — which includes children with oppositional defiant disorder and attention deficit hyperactivity disorder — face numerous challenges. These kids often develop an unhelpful pattern of reacting aggressively towards adults and peers. Children with disruptive behaviour are also at higher risk of developing substance abuse problems, getting involved with crime and dropping out of school later in life.
Helping these children reduce their disruptive behaviours and build positive social behaviours is of tremendous importance; however, this is a challenge for clinicians, parents, and communities. Because each child is unique, there really isn’t a one-size-fits-all approach for managing difficult cases of disruptive behaviour.
At CAMH, Clinician-Scientist Dr. Brendan Andrade
is hoping to develop new strategies that will reach kids before major problems emerge.
“Basically, I want to know what we could do better,” explains Dr. Andrade. “The goal of our research is to understand why some programs work for some kids, but not for others.”
Dr. Andrade is head of a research project called Addressing Behaviour and Treatment Effectiveness Project (ABATE) that studies the effectiveness of clinic-based treatments aimed at kids with disruptive behaviour and their families. Currently, Dr. Andrade’s team is comparing two cognitive therapy programs, one of which is based on a widely-used program called Coping Power — a multicomponent parent-child group treatment.
In both treatments, children between the ages of 9 and 12 years old work on regulating their emotions and problem-solving. Depending on the type of treatment, a typical session might include role-playing or practicing skills in different situations with guidance from a clinician.
Meanwhile, parents also participate in sessions that focus on identifying personal stressors and understanding how problems might be best solved as a family. Similarly, these sessions are structured as either an individualized or group therapy intervention.
Six months following the last session, researchers follow up with children and families to evaluate their progress.
Currently, Dr. Andrade has conducted seven trials, each consisting of 15 sessions with six to eight families. Though the team won’t begin analyzing the data until the study is completed at the end of this year, Dr. Andrade has already noticed some differences in study participants.
“The kids in our study are getting better,” says Dr. Andrade. “We see differences in terms of better emotional regulation, managing their behaviours, and improvements in dealing with their mood and anxieties.”
At this point, it’s difficult to judge which children might benefit from which form of treatment. Both interventions have their merits, says Dr. Andrade. For instance, the one-on-one treatment seems to better address the emotional issues related to disruptive behavior, while the group therapy approach is heavily focused on problem-solving techniques.
“What is unique about this research is that we’re looking deeper into which therapies work best for different types of child characteristics,” says Dr. Andrade. “It could mean helping one child who might not have benefited from an existing program. That makes all the difference.”