Abstract
Background & Objectives: Conduct disorder is a psychiatric disorder in children and adolescents that is characterized by frequent and persistent norm–breaking behavior and violation of the rights of others. Adolescents with behavioral problems are more likely to commit crimes, be sexually abused, or use drugs, which may worsen their mental health. Poor academic achievement and career failure may negatively affect the health–related quality of life of these individuals in adulthood. Psychological problems in adolescents with behavioral disorders lead to many problems in their future, and it seems necessary to follow up on their issues and treat them. Cognitive–behavioral group therapy for adolescents with conduct disorder has been less studied, and in these studies, its effect on psychological adjustment has received less attention and investigation. Since no study has investigated the effectiveness of group cognitive behavioral therapy on the psychological adjustment of adolescents with conduct disorder, this study aims to examine the efficacy of this therapy.
Methods: This study employed a quasi–experimental design with a pretest–posttest control group. The statistical population consisted of adolescents with conduct disorder who were referred to psychological and psychiatric clinics in Ahvaz City, Iran, in 2023. Among the community members, 30 qualified volunteers were included in the study; 15 were randomly assigned to the intervention group and 15 to the control group. The inclusion criteria were having a conduct disorder with the approval of a psychiatrist, an age range of 14 to 18 years, not using other psychotherapy methods, and drug therapy. The exclusion criteria included absence from a treatment session and failure to complete the questionnaire during the research. All samples completed the consent form to participate in the study. The scores of the Bill Adjustment Questionnaire (Bell, 1961) were compared before and after cognitive behavioral therapy. The initial patient assessment was conducted on the first day and lasted 90 minutes. The patient's file and information, including treatments performed so far, were also completed. The treatment protocol used in this study consisted of 8 sessions of group cognitive–behavioral therapy, developed based on the treatment protocol of Amirkhanloo et al. (2022) and approved by three professors from the Psychology Department of Yazd University of Science and Arts, specializing in cognitive–behavioral therapy.
Individuals in the intervention group received 8 cognitive behavioral therapy sessions twice a week in a group setting over four weeks. However, no therapy was provided to the control group. Data analysis was done using covariance analysis in SPSS version 17. The significance level of the tests was set at 0.05.
Results: The results showed that the psychological adjustment variable and all its subscales, including adjustment at home, adjustment in health, social adjustment, emotional adjustment, and occupational adjustment, decreased significantly in adolescents with conduct disorder in the intervention group after receiving treatment compared to the control group (p < 0.001). The results regarding the effect size also indicated that 68% of the difference between the intervention group and the control group in the psychological adjustment component was due to the implementation of group cognitive behavioral therapy.
Conclusion: According to the results of the present study, eight 90–minute group cognitive–behavioral therapy sessions lead to the improvement of the psychological adjustment of adolescents with conduct disorder living in Ahvaz city. So, group cognitive–behavioral therapy can be used as a complementary treatment along with other treatment methods to treat psychological problems of adolescents with conduct disorder.
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