Quality statement 5: Multimodal interventions

Quality statement

Children and young people aged 11 to 17 years who have a conduct disorder are offered a referral for multimodal interventions, with the involvement of their parents or carers.

Rationale

Multimodal interventions have been shown to be effective in helping older children and young people with a conduct disorder to manage their behaviour in different social settings. Parental participation is an important part of the intervention because the focus is on changing the environment around the young person, which can then help to change the young person's behaviour. Given the variety of interventions available, it is important to offer evidence-based multimodal interventions to ensure that the intervention is delivered effectively and appropriately.

Quality measures

Structure

Evidence of local arrangements to ensure that children and young people aged 11 to 17 years who have a conduct disorder are referred for multimodal interventions, which involve their parents or carers.

Data source: Local data collection.

Process

a) Proportion of children and young people aged 11 to 17 years who have a conduct disorder who take part in multimodal interventions.

Numerator – the number of children and young people in the denominator who take part in multimodal interventions.

Denominator – the number of children and young people aged 11 to 17 years who have a conduct disorder.

b) Proportion of parents or carers of children and young people aged 11 to 17 years who have a conduct disorder who are involved in multimodal interventions.

Numerator – the number of parents or carers in the denominator who are involved in multimodal interventions.

Denominator – the number of parents or carers of children and young people aged 11 to 17 years who have a conduct disorder.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that they provide multimodal interventions that adhere to an evidence-based model and involve parents or carers for children and young people aged 11 to 17 years who have a conduct disorder.

Health and social care practitioners ensure that they offer multimodal interventions to children and young people aged 11 to 17 years who have a conduct disorder and involve their parents or carers in the intervention.

Commissioners ensure that they commission services that provide multimodal interventions that adhere to an evidence-based model and involve parents or carers for children and young people aged 11 to 17 years who have a conduct disorder.

What the quality statement means for patients, service users and carers

Children and young people aged 11 to 17 years who have a conduct disorder take part in a programme of support, which involves their parents or carers and is focused on helping them to improve how they interact with their family, when they are at school and in other settings within their community.

Source guidance

Definitions of terms used in this quality statement

Multimodal interventions

These interventions are suitable for children and young people who have a diagnosis of a conduct disorder, those in contact with the criminal justice system for antisocial behaviour, or those who have been identified as being at high risk of a conduct disorder using established rating scales of antisocial behaviour (for example, the Child Behavior Checklist and the Eyberg Child Behavior Inventory).

Multimodal interventions should involve the child or young person and their parents and carers and should:

  • have an explicit and supportive family focus

  • be based on a social learning model with interventions provided at individual, family, school, criminal justice and community levels

  • be provided by specially trained case managers

  • typically consist of 3 to 4 meetings per week over a 3- to 5‑month period

  • adhere to a developer's manualand employ all of the necessary materials to ensure consistent implementation of the programme. [Adapted from Antisocial behaviour and conduct disorders in children and young people (NICE clinical guideline 158), recommendation 1.5.14]

Equality and diversity considerations

Practitioners should support access to services and the uptake of interventions by children and young people, and their parents and carers, by being flexible in relation to settings and offering a range of support services. Recommendations 1.7.7 and 1.7.8 provide examples of settings and support services.

Practitioners should have training to ensure that they have a good understanding of the culture of families with whom they are working. Interpreters should be provided if no practitioner is available who speaks a language in which the family members can converse fluently. Consideration should be given to the specific needs of:

  • girls and young women with conduct disorders

  • looked-after and adopted children and young people.