Re: behavior modification "specialty programs" for "troubled teens"

[Rick Barth <rbarth@xxxxxxxxxxxxx>]

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Freya: Since I often read your posts with great interest, I want to 
thank you for your many sterling contributions.  But, I must raise 
concern about the conclusion that "attachment-based" therapies are more 
effective than cognitive-behavioral treatments (I added the cognitive to 
your original reference to behavior modification, because most such 
interventions are now combined efforts, addressing information 
processing as well as social learning).

I have not seen the Fonagy and Roth works, but the single type of 
therapy judged to be harmful in the review by Saunders, et al, was an 
"attachment based therapy".

Saunders, B. E., Berliner, L., & Hanson, R. F. E. (2003). Child physical 
and sexual abuse: Guidelines for treatment (Final report: January 15, 
2003). Charleston, SC: National Crime Victims Research and Treatment Center.

Also,John Weisz, at UCLA, arguably the nation's leading scholar in the 
area of child and adolescent interventions has long found--and continues 
to find, in rigorous research syntheses that psychodynamic based 
interventions--which would include atttachment based interventions--are 
less effective than skill based interventions.  THis is an older 
citation,but his more recent work is confirmatory.

Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. 
(1995). Effects of psychotherapy with children and adolescents 
revisited: A meta-analysis of treatment outcome studies. /Psychological 
Bulletin, 117/, 450-468.

I know that your post was on a slightly different tack, but I wanted to 
clarify that there is strong evidence that we should not be promoting 
the effectiveness of attachment based therapies over other more evidence 
based interventions.

Rick



F.Schultz@SBCSocialServ.org wrote:

> This may not be entirely what you are looking for, but I would suggest 
> you look at "What Works for Whom", a new summary of studies for 
> evidence of efficacy for various forms  psychotherapy or psychological 
> interventions by Fonagy and Roth.  Peter Fonagy is a research director 
> for the Menninger Clinic and is a leading researcher on attachment 
> theory and attachment-based interventions.  The book is divided into 
> two sections, one for adults and one for children and adolescents.  I 
> seem to recall that it finds lasting benefits for "attachment-based" 
> therapies over behavior modification treatments.
>  
> The book does not comment on the legal issues regarding behavior mod, 
> just that it doesn't seem to have long-lasting beneficial results, 
> whereas other therapies DO, depending on the issues presented by the 
> child.
>  
> It would seem to me that in any legal challenge to placement in a 
> behavior mod program, efficacy of the intervention and whether the 
> restrictions on the child are warranted in order to insure a lasting 
> beneficial outcome would be an issue.
>  
> I looked at the web site you cited as your "agency" and did not find 
> anything that tells me anything about the group or agency you may 
> represent.
>  
> Freya Schultz
> Santa Barbara County Social Services
>
> ------------------------------------------------------------------------
> *From:* owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu 
> [mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu] *On Behalf Of 
> *Elisabeth Feldman
> *Sent:* Tuesday, October 12, 2004 8:32 AM
> *To:* Child Maltreatment Researchers
> *Subject:* behavior modification "specialty programs" for "troubled teens"
>
> Is anyone aware of outcome studies on private/nonadjudicated behavior 
> modification based "specialty" wilderness, boarding school and/or 
> residential treatment centers for "troubled" teens?
>  
> Is there anyone out there who is or knows of someone researching this 
> topic from the perspective of parental vs. minors rights (as most of 
> these programs deny constitutional rights of minors in favor of 
> parental rights, i.e. minors in these facilities have no right to 
> contact an attorney, sometimes no right to contact anyone except 
> parents, and even then, contact is monitored.)
>  
> Thank You,
>  
> Elisabeth Feldman
> The Troubled "Troubled" Teen Industry Research Group 
> <http://www.troubledteenindustry.blogspot.com>

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