Parents need greater support to manage conduct disorders
Parents of children and young people with conduct disorders should be offered training programmes to help them deal with challenging and antisocial behaviour, says NICE.
Conduct disorders are a serious, but frequently unrecognised, mental health condition characterised by repeated and persistent misbehaviour that may include stealing, fighting, vandalism and harming people or animals.
These disorders are the most common reason for children to be referred to mental health services, with around 5 per cent of all children aged between 5 and 16 years diagnosed with the condition.
In the first national guideline in this area, NICE recommends group parent training programmes be offered to help support parents and carers of children and young people aged between 3 and 11 years who have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder, or have oppositional defiant disorder or conduct disorder or are in contact with the criminal justice system because of antisocial behaviour.
Group social and cognitive problem-solving programmes should be offered to children and young people aged between 9 and 14 years who are at high risk of developing oppositional defiant disorder or conduct disorder, or have oppositional defiant disorder or conduct disorder, or are in contact with the criminal justice system because of antisocial behaviour.
The guideline, developed in collaboration with the Social Care Institute for Excellence, also emphasises the importance of making an early diagnosis to ensure that children and their families are able to access the treatment and support they need to manage the condition.
If left untreated, many children will go on to have serious mental health problems as adults. The cost of not treating these children early on is huge not just to the NHS but also to society.
Professor Stephen Pilling, Director, National Collaborating Centre for Mental Health and facilitator of the Guideline Development Group, said: “The new guideline highlights the importance of supporting the child's parents or guardians in the treatment of the condition - recommending training programmes tailored specifically for them - as aspects of parenting have been repeatedly found to have a long-term association with antisocial behaviour.
“Many parents do an excellent job in caring for a child with a conduct disorder, but it can be incredibly challenging. Parent training programmes provide them with strategies for dealing with difficult children and how to better handle them going forward.”
Professor Peter Fonagy, Chief Executive of the Anna Freud Centre, Professor of Psychoanalysis at University College London and a member of development group responsible for the guidance, added: “We have five centres in the UK that are currently delivering parent training. We would like to see this rolled out in the next five years to cover the rest of the country.”
Professor Gillian Leng, Deputy Chief Executive, NICE, said: “The new NICE guideline includes a number of recommendations to support healthcare professionals to accurately diagnose and treat conduct disorders. It aims to significantly improve the lives of young people with a conduct disorder, which is a serious but frequently unrecognised mental health problem.”
Andrea Sutcliffe, Chief Executive, Social Care Institute for Excellence, added that collaborating with NICE enabled the social care perspective to be brought directly into the guideline.
“It is important not to concentrate solely on their clinical needs but also to consider their whole lives - as part of a family, school and local community.
“That is why it is crucial that everyone in health, social care and education work well together to provide the information and person-centred care necessary to improve the quality of life and life chances for children, young people, their families and carers.”
27 March 2013