Dr. Alan Kazdin is a former president of the American Psychological Association (APA) with numerous publications to his name and who, in 2000, edited the APA/Oxford University Encyclopedia of Psychology. Much of his professional work has focused on externalising disorders and problems in young people. These includes disorders that result in antisocial or disruptive behaviours such as oppositional defiant disorder (ODD) or conduct disorder (CD).
Devising effective, evidence-based treatments for these disorders is important. For instance, ODD often occurs alongside CD and Attention Deficit Hyperactivity Disorder (ADHD), and it has been argued that it is a better predictor of depression than depression itself. This does not mean that effectively treating ODD will necessarily help prevent depression, but this is a plausible possibility, and the effects of ODD are damaging enough on their own to make such efforts worthwhile.
The causes of externalising disorders are not fully known, although it has been suggested that both genetic and parenting factors play a role in ODD. Parents may react to troubling behaviour by giving way to a child’s wishes and this, in turn, reinforces that behaviour. For instance, in one study, what the researchers referred to as ‘timid discipline’ on the part of parents predicted worsening ODD symptoms and ODD symptoms, in turn, predicted timid discipline (although no such relationship was found for ADHD).
This is where Dr Kazdin and a model known as Parent Management Training (PMT) enter the picture. If parental behaviours influence conditions such as ODD then it seems reasonable to think that we can help treat the condition by changing these behaviours.
Parents involved in PMT work with a clinician who takes them through a classic behaviourist approach involving antecedents, behaviours and consequences. Antecedents are things like instructions, rules and prompts that attempt to anticipate desirable behaviours. Consequences can be positive or negative.
At the start of PMT, parents are taught to describe behaviours factually rather than emotively. They are told to initially avoid directing their child but to instead simply focus on positively reinforcing prosocial behaviours in an age-appropriate way. This does not necessarily mean a tangible reward like a sticker, it could be something a simple as a smile. Later, they attempt to be more directive and are introduced to what Kazdin refers to as ‘mild punishments’ such as a brief time-out or loss of a privilege.
This is the point where a lot of your backsides will start to itch. In education, we want to mince any words related to punishment. We talk of ‘contingencies’ or ‘response costs’ in order to try and dodge any charge of being punitive. I think there are two reasons for this. The first reason, which would be upheld by all good behaviourists, is that the focus should be on antecedents and positive reinforcement, with punishments playing a minor and infrequent role and certainly not being cruel, unusual or enforced with theatrical relish. It’s too easy to become sidetracked into a discussion focused solely on punishments and so we seek to play them down. The second reason we dislike discussing punishments is in deference to the progressivist tradition in education that essentially sees all attempts to control children as coercive and against nature. I have less sympathy for this impulse, given the results.
Some of you will find the principles of PMT familiar from your work as teachers because they map almost exactly onto behavourist approaches to classroom management. These are the methods they probably didn’t tell you much about as a trainee because they are coercive and run against progressive principles. That’s why I made them a focus of the chapter on classroom management in my new book (shameless plug – you can pre-order it here).
You may be wondering whether PMT is effective. From what I can gather, it is one of the most well-researched and effective treatments in this area of psychology and has been subjected to scores of randomised controlled trials (RCTs).
Which makes me wonder if the following hypothesis might be true: If we adopt similar approaches to classroom management, robust approaches that involve antecedents, behaviours and consequences, and we uphold these approaches consistently, then we might reduce the level of disruptive behaviour and, as a consequence, reduce the number of school exclusions.
Note that I have used the medical terms of ‘disorder’ and ‘treatment’ in this post without entering into a discussion about whether these are always appropriate.