Labels vs Lens
“He’s just manipulative.”
This is a strategic behaviour to gain control or meet a need.
Why might running away feel rewarding?
Autonomy, escape, peer validation.
What distinguishes Conduct Disorder from ODD?
Violation of rights and criminal behaviour.
Scenario: A youth in the home is escalated, what is the first thing you should do?
What evidence-based model targets behaviour across home, school, and peers?
Multisystemic Therapy (MST).
“He doesn’t care about anyone.”
Emotional detachment as protection OR Possible callous unemotional traits.
What is theft reinforcing beyond the item itself?
Adrenaline, power, status.
What does “adolescent-onset type” mean?
Symptoms appear after age 10.
What fuels power struggles?
Emotional reactivity and public confrontation
What intervention focuses on reinforcing prosocial behaviours with consistent rewards?
Contingency Management.
“He lies for no reason.”
Avoidance of consequences, desire for status, or reinforcement history.
What might running away be reinforcing?
Escape from conflict, autonomy, peer connection.
What specifier indicates limited prosocial emotions?
Callous-unemotional traits specifier.
A youth with conduct disorder is caught lying about completing chores. When confronted, he becomes sarcastic and says, “Prove it.”
Remain calm, avoid engaging in a power struggle, state the expectation clearly, apply the agreed-upon consequence, and revisit skill-building later.
Scenario: A youth with conduct disorder demonstrates severe impulsivity and aggressive outbursts that do not improve with behavioural interventions alone. What additional support may be considered?
Psychiatric consultation for possible pharmacotherapy targeting impulse control or co-occurring mental health conditions.
“He’s just bad.”
Persistent pattern of rights violations + learned reinforcement history + possible attachment disruption.
If punishment increases behaviour intensity, what may be happening?
Power struggle reinforcement or attention reinforcement.
What factors increase risk of adult antisocial personality disorder?
Early onset + severe aggression + callous-unemotional traits.
A youth breaks property after being told he cannot leave the house. Staff begin raising their voices and arguing with him.
What mistake is occurring?
Escalation through emotional reactivity and public confrontation, reinforcing power struggle dynamics.
Why are SMART goals essential in conduct disorder treatment?
They create measurable accountability and allow consistent tracking across systems.
“Nothing works with him.”
Inconsistent systems, poor reinforcement alignment, and a lack of skill development may maintain behaviour.
Why does behaviour escalate when authority challenges youth publicly?
Threat to dominance → regaining control.
Why is early intervention critical in conduct disorder?
Behaviour patterns become entrenched and reinforced over time.
A youth continues stealing despite increasing punishments. What should shift in the intervention approach?
Assess behavioural function, strengthen reinforcement for good social behaviour, increase structure and supervision, and integrate skill development rather than escalating punishment.
Why is a multisystem approach more effective than individual therapy alone?
Because behaviour is reinforced across environments, so intervention must target peers, placement, school, and family simultaneously.