Evidence-based assessment and intervention for oppositional defiant disorder and conduct disorder in school psychology

Disruptive behaviour disorders (DBD’s) are highly prevalent childhood psychological disorders associated with pervasive impairment. They can affect the individual’s social adjustment and educational achievement, disrupt family harmony, place strain on resource-limited learning environments, impact juvenile justice systems and challenge wider society. This chapter reviews, from an international perspective, the theoretical underpinnings of DBDs including diagnostic systems, aetiological factors and current controversies in the literature. Commonly used assessment measures are discussed for both universal and selective screening of at-risk school populations and individual assessment of indicated youth. This is followed by a synopsis of evidence-based interventions, which are considered the gold standard in treating youth with externalising disorders in schools. The chapter concludes with a case study illustrating some of the challenges associated with the implementation of these types of interventions

The development and implementation of a pilot CBT for early psychosis service: Achievements and challenges

© 2014 Wiley Publishing Asia Pty Ltd. Aim: Cognitive behaviour therapy (CBT) is a clinically indicated treatment for first-episode psychosis. Despite this, CBT for early psychosis is not routinely available as part of standard mental health services in Australia. The aim of this pilot project was to develop a CBT for early psychosis service to be provided as an adjunct to existing community mental health services. This study examined the feasibility of this service model, delivered in a real-world setting. A secondary aim was to explore the effectiveness of this service, as measured by clinical and functional outcomes. Methods: Participants living in northern Sydney, Australia, and who had recently experienced a first episode of psychosis, were offered up to 20 sessions of individual CBT. Service feasibility was measured via attrition rates, therapy attendance and referrer feedback. Measures of psychosis, depression, anxiety and psychosocial functioning, were assessed pretreatment, after six and 12 sessions, and at 3 months post-treatment. Results: Nineteen clients attended treatment to completion. Survey feedback from referrers affirmed the positive impact of the service on clients' recovery. Additionally, clients showed improvements in symptoms of psychosis over the first three time points. Psychosocial functioning also shifted from the moderately to mildly impaired range by the end of treatment. Conclusions: The CBT for early psychosis service has been successfully integrated into the mental health landscape of northern Sydney. Outcomes of this pilot project are discussed with reference to the achievements of the service, as well as the obstacles encountered, and how they were overcome