Disruptive, impulse control and conduct disordered behaviours in schools : a multisystemic intervention using rational emotive behaviour therapy

Abstract

Disruptive impulse control and conduct disordered behaviours present an ever-increasing problem in South Africa. This study aims to design an intervention for this based on a multisystemic approach within which framework, evidence-based Rational Emotive Behaviour Therapy (REBT) and contingency management are applied. Any such approach should include the environmental factors that influence and maintain the problem. The strength of this research is the utilisation of an embedded, pragmatic case study research design applied to four children, and one of each child’s parents and teachers. The embedded approach of studying more than one unit of analysis, includes environmental factors such as the home (represented by the parent) and the school (represented by the teacher) which may contribute to the development and maintenance of the problem behaviours. The children (11 – 14), vary in terms of race, culture, socio-economic status, and severity of symptoms. The case studies are used to examine the application, process, and effectiveness of a multisystemic intervention in South African schools. The commonalities and idiosyncrasies of the case studies, regarding the process of treatment and techniques, are noted. The children’s characteristics that influence the therapeutic process are discussed alongside the influence of the family and school contexts. The influence of the wider South African context on the problem is also considered. The efficacy of the process and theory are considered. The intervention was successful to varying degrees across most participants. These results are discussed along with the methods and techniques that were successful. Recommendations for future therapy are considered.