The Swedish National Board of Health and Welfare has compiled the current research situation about the scientifically evaluated interventions that are best placed to reduce norm-violating behavior and relapses in crime in children.
In November 2021, the National Board of Health and Welfare published guidelines for working with children between the ages of 6 and 17. The recommendations are founded on a comprehensive scientific base and have been developed in collaboration with experts and researchers. The selection of interventions is based on the principles of risk, need and responsivity.
In line with these principles, the following are briefly recommended:
- In order to break a negative trend, treatment needs to focus on risk and protective factors that are important for continued norm-violating behavior. Above all, it is important to address the risk factors that maintain the child’s norm-violating behavior.
- Interventions shall be behavioral and skill-oriented with the aim of developing skills, thought and behavior patterns in children and parents. It is also important to influence risk factors in the family environment such as peers, school and leisure to create a supportive structure around the child.
- Interventions based on CBT and social learning theory provide the best conditions to reverse a negative development.
- In order to enable change, efforts need to be adapted to the child’s and parents’ receptiveness and include active motivational work. One must be aware that it takes time to change norm-violating patterns of behavior and to achieve lasting results. The work usually requires collaboration with several different actors.
- Those who will carry out the interventions needs to clearly formulate the child’s needs, goals and the treatment content of the interventions.
- The efforts and the child’s development need to be monitored continuously. To what extent are the objectives achieved?
For the 7-11 age group, behavioral parenting support programs should be offered. The aim is to reduce children’s norm-violating behavior by strengthening the parent-child relationship, parental supervision and supervision, and parents’ educational methods. You also need to offer multimodal CBT-based skill training programs. They are given to children in groups and aim to develop the capacity for emotion regulation, problem solving and social skills. Skills that are trained include contacting others, avoiding fights, following rules and dealing with angry feelings.
For the 12-17 age group, structured family treatment should be offered that applies behavioral therapy principles and skill training. In addition, structured and individually designed CBT-based behavioral and skill training should be offered for children at high risk of continued norm-violating behavior. The intervention can be given in both outpatient care and in an institution.
The CBT-based behavioral and skill training should aim to develop new behaviors, mindsets and skills. Components included are modeling, role-playing, homework assignments and positive reinforcement. Examples of skills to be trained are self-control, problem solving and consequence thinking. The intervention may also include cognitive restructuring and behavioral contracts in the form of an agreement on the commitment of the child and therapist and on privileges and sanctions for the child.
The interventions should be complemented by support for parents and the involvement of the school in order to influence more risk factors and to ensure that the child is supported by his or her surroundings in the process of change. It is therefore crucial to involve other staff to act as models and transfer coaches.
In other words, the guidelines in the report are exactly in the direction that PREPSEC, with its methods, is striving for! Gratifying to know we are working with the right focus!
The scientific evidence does not support exemplifying the intervention using any named method. In order for a method to be considered evidence-based, several randomized studies conducted by independent researchers are required. Often there are methodological shortcomings that make it difficult to draw firm conclusions about the effectiveness of a method. As a rule, you have to settle for what is called evidence-based practice. Evidence-based practice involves offering care and treatment according to the best available knowledge. The professional weighs his expertise together with the best available knowledge (research), the individual’s situation and wishes when deciding on interventions.
There are currently (2021) about 40 published studies on ART done in different contexts and with different target groups. The accumulated research indicates that ART increases the occurrence of prosocial behaviors, control of anger, and reduces the incidence of antisocial and aggressive behaviors. The overall assessment is that ART is well suited for children and adolescents with conduct problems and acting out behaviors.
However, there is clearly a need for more studies and evaluations that can demonstrate the impact of PREPSEC’s various methods and programs. High-quality research and studies are required!
Measures to counteract continued norm-violating behavior and relapse in crime. Knowledge support with recommendations for social services’ work with children 6-17 years. Published: 2021-11-08
See also: ART (Aggression Replacement Training) – State of the ART
December, 2020 at www.prepsec.org
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