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Aggression in Adolescents: Strategies for Parents and Educators

By Tammy D. Barry, PhD, Texas A&M University &
John E. Lochman, PhD, The University of Alabama

Childhood aggression is an important focus for educators and parents owing to its relative stability over time and consistent link to a variety of negative outcomes later in adolescence, including delinquency, substance use, conduct problems, poor adjustment, and academic difficulties (poor grades, suspension, expulsion, and dropping out of school). In addition, verbal and physical aggression often are the first signs, as well as later defining symptoms, of several childhood psychiatric disorders. These include Oppositional Defiant Disorder and Conduct Disorder, both of which have prevalence rates ranging from 6 to 10% in the general population and even higher among males, according to the American Psychiatric Association. This further highlights the need to recognize and treat aggressive behaviors early.

Characteristics

Aggressive behaviors can vary from problems with emotional regulation to severe and manipulative behaviors. There are various characteristics of aggression, which can include behaviors such as starting rumors; excluding others; arguing; bullying, both verbally (name-calling) and physically (pushing); threatening; striking back in anger; use of strong-arm tactics (to get something they want); and engaging in physical fights.

Notably, aggressive behaviors do not always involve physical contact with another person. Verbal aggression in elementary school years, such as starting rumors, excluding others, and arguing, can be part of a developmental trajectory leading to adolescent delinquency and Conduct Disorder.

Developmental Issues

Adolescents with a childhood onset of aggression, rather than an adolescent onset, are more likely to display the most persistent, severe, and violent antisocial behavior. Indeed, childhood aggression is often viewed as an indication of a broader syndrome, frequently involving oppositional and defiant behavior toward adults and covert rule-breaking behaviors. These behaviors could lead to more serious and recurrent violations in adolescence, such as stealing, vandalism, assault, and substance abuse.

Family and personal factors. The development of adolescent antisocial behavior is often considered to be the result of a set of family and personal factors, with the child�s aggressive behavior representing a substantial part of that developmental pattern. For example, children with difficult temperaments and early behavioral problems are at greater risk for later adolescent aggression and conduct problems. This developmental course is also set within the child�s social environment. For example, poor parenting practices, such as poor parental monitoring and supervision and high rates of harsh and inconsistent discipline, have been shown to contribute to children�s aggressive behavior.

Early social interactions. In early to middle childhood, children who show high levels of oppositional behavior and aggression may experience negative reactions from teachers and peers. This may also lead to problematic ways of processing social information, such as relying on aggressive solutions in problem solving when presented with social conflicts, expecting that aggressive solutions will work, and having difficulties interpreting social information accurately (such as attributing neutral behaviors by others as hostile). Aggressive children are at risk for many academic problems and, as their academic progress and social bond to school weakens (owing to problematic exchanges with teachers and peers), they become more vulnerable to influences from deviant peer groups.

Risks in adolescence. By adolescence, this developmental course results in a heightened risk of substance use, delinquent acts, and school failure. Likewise, certain environmental risk factors can play a role in moving an adolescent along this developmental pathway. For example, family dysfunction may be sufficient to initiate the sequence of escalating aggressive behavior. Living in poor, crime-ridden neighborhoods also adds to the environmental risk factors leading to seriously aggressive, problematic behavior.

Intervention

Effective strategies. In response to recent serious school violence (including incidents of schoolyard shootings), techniques to prevent violence and to intervene with at-risk aggressive youth have received significant attention from education policymakers. Recent research has identified effective treatments for aggressive youth. Group intervention programs, which are efficient in both time and cost, are often as effective as individual therapy in treating aggressive youth. Structured group programs can be used not only with youth presenting with aggressive behaviors, but also with those identified as at risk for aggressive behavior problems in an effort to prevent negative outcomes. Treatment strategies aimed at parents (such as improving parental monitoring and consistency in discipline), as well as treatments directly targeting children and adolescents (including cognitive behavioral treatments, such as problem solving and anger management training), have helped reduce behavioral problems and aggression in children and adolescents. Treatment outcome research indicates that a combination of interventions for both parents and youth may be the most effective.

Parent involvement. Even with adolescents, parents should participate in intervention programs when their teenager displays significant aggressive behavior. For example, the Adolescent Transitions Program is a parent training program developed by Tom Dishion and colleagues. It includes a parent-focused curriculum that teaches family management skills, limit setting and supervision, problem solving, and improved family relationships and communication patterns. The goals of the program are to prevent the development of antisocial behaviors among aggressive teenagers.

Cognitive-behavioral programs. Aggressive adolescents can also benefit greatly from cognitive-behavioral programs that provide new coping techniques for anger management and that teach them alternative ways of dealing with social conflict. For example, the Anger Control Program (developed by Eva Feindler and colleagues) focuses on teaching the adolescent how to modify his or her own aggressive and impulsive behavior when faced with aversive or stressful situations. This program has been shown to lead to significant changes in problem-solving ability and self-control among aggressive adolescents. Problem-Solving Skills Training (PPST) was developed by Kazdin and colleagues to treat Oppositional Defiant Disorder or Conduct Disorder in youth of varying ages. PPST involves 12 or more sessions designed to teach problem-solving steps; introduce effective ways to apply the steps, including application to real-life situations; and provide opportunity to role-play use of the steps, including with the parent. Kazdin and colleagues have also developed a Parent Management Training (PMT) program, consisting of 13 sessions focusing on observing behavior; positive reinforcement and attending; school intervention; holding family meetings; negotiating, contracting, and compromising; and dealing with low-rate, serious behaviors (such as fire setting). Kazdin notes that ideally both the youth and parent would be involved in each of the respective treatment programs. Outcome research shows that combined PSST and PMT are more effective than either program alone.

Intensive programs: Anger Coping. Intensive, comprehensive prevention programs have been developed and evaluated with high risk youth. Results indicate that aggressive behavior and other disruptive behavior symptoms can be reduced through early intervention. Follow-up studies suggest that adolescents who participated in these programs when younger have more positive outcomes. One such prevention program is Anger Coping, which was developed to reduce aggressive youth�s anger and behavior problems. This cognitive-behavioral program focuses on at-risk aggressive children and early adolescents age 9�13 and is designed to provide coping and problem-solving skills to deal with anger and resulting aggressive behavior. Based on promising findings for the Anger Coping Program, a more recent version, the Coping Power Program, has been developed. The Coping Power Program is designed to bring about change in the family system by working with both the youth and the parent separately.

The Anger Coping Program and the child component of the Coping Power Program aim to improve youth�s ability to regulate aggressive behavior, to function well in a variety of settings, and to better manage their anger. The programs are typically provided in a school-based group format. The Anger Coping Program includes 18 weekly sessions. The Coping Power Program includes 34 weekly sessions. The child component sessions cover material such as goal setting, organizational skills, perspective taking, emotional awareness, use of coping statements to deal with anger, relaxation training, social problem solving, making friends and negotiating with peers, developing positive peer relationships and avoiding deviant peer groups, and resisting peer pressure.

The Coping Power parent component is also based on cognitive-behavioral principles, and is designed to address caregiver and parenting risk factors for child aggression. Parents learn additional strategies that support the skills that their children learn in the child component, as well as some techniques for dealing with parenting stress. Parents learn how to create a positive home environment and to end the coercive cycle that may exist between them and their aggressive child.

Typically, parents meet during 16 meetings approximately once every 2 weeks in the late afternoon or evening hours at their children�s school. Sessions include academic support in the home, tracking and attending to their child�s behaviors, praise and rewards for positive behaviors, ignoring minor disruptive behaviors, giving effective instructions, establishing rules and expectations, use of �consequences for defiant or disruptive behaviors, handling their child�s behavior during the summer months, family cohesion building, family problem solving, and family communication.

There are many developmental implications for this treatment, and the main targets of intervention will change with the youth�s age. For example, parents of younger children may be taught to focus more on timeout procedures for inappropriate or defiant behavior, whereas a focus on monitoring and supervision should be primary for parents of aggressive adolescents. The benefits of the Anger Coping and Coping Power programs with aggressive youth have been established in studies that included random assignment to either participate in a group or to be in an untreated control condition (receiving care as usual).

Tips for Dealing With an Aggressive Adolescent

When dealing with an aggressive adolescent, teachers, and parents may use the following guidelines:

No child is always bad. Catch the adolescent behaving well and attend to and praise these positive behaviors. Provide additional opportunities to act appropriately and give positive feedback. If you only notice inappropriate and aggressive behavior, these behaviors may be used as a way to get your attention.

Respect. Always let the adolescent know that you care and respect him or her. Remind the adolescent that it is the inappropriate behaviors (not the individual) that you do not like.

Don�t ignore. Although ignoring minor disruptive behaviors (complaining) can be an effective way to decrease those behaviors, do not ignore inappropriate aggression.

Be positive. Remain calm and model positive problem solving for the adolescent. Do not become angry in response to his or her anger.

Don�t rationalize. Do not try to rationalize about the aggressive behavior or why you are invoking consequences; avoid a power struggle.

Behavior contracts. Set up a behavioral contract to help the adolescent take control of his or her own behavior. The contract should list target positive behaviors that are expected and a reward that can be earned for meeting a criterion number of these target behaviors. Rewards can be naturally occurring consequences, such as going to a movie with friends or a homework �pass.� The target behaviors should be stated as positive behaviors (the �Dos� rather than the �Do nots�). They should communicate your expectations. Therefore, if the adolescent often argues, the target behavior might be to discuss things calmly.

Effective commands. Use effective instructions and commands. Commands should be concise, direct, positively stated, and given one at a time. Avoid question commands (�Would you like to help me clean out the garage?�) because they provide an opportunity to say, �No.� Avoid �Let�s� commands, unless you actually plan to help with the task. Avoid commands that are vague, include multiple requests chained together, or that give too much explanation.

House rules. Set up house rules or classroom rules that must always be followed. These rules can focus on decreasing aggressive behavior. If the adolescent breaks a rule, then he or she is given an immediate consequence (that is, no warnings).

Negative consequences. When the adolescent does not follow instructions or other established expectations, breaks rules, or engages in aggressive behavior, provide prompt negative consequences. These can include extra work chores or loss of a privilege.

Communication. Increase ongoing communication and cohesion between yourself and the adolescent. The adolescent then will be more likely to come to you when a problem arises.

Problem solving. Model effective problem solving: identification of the problem; generating multiple potential responses, both positive and negative; evaluating alternative responses; and planning for implementation of the response. Help the adolescent to see problem solving in action and use opportunities to assist him or her in applying these principles to his or her own problems.

Relaxation. Teach quick but effective relaxation techniques (deep breathing, counting to 10) that can be used to calm down when he or she gets very angry.

Coping statements. Help the adolescent to develop a list of coping statements to deal with anger. Practice these statements in advance, so that he or she will be more readily able to use these statements when in provoking social situations.

Perspective taking. Aid the adolescent in understanding others perspectives, including what others may be thinking and feeling. Again, practice perspective taking in advance during non-provoking situations so that he or she will be better prepared to do so when provoked.

Negotiating. Teach the adolescent skills for negotiating needs with peers, parents, and teachers, so that the teen will be less likely to use aggression or defiance as a means of getting what he or she wants.

Autonomy. Help the adolescent develop autonomy by valuing his or her positive ideas and encouraging positive independent thinking and decision making. As experience with these positive experiences develops, the adolescent is less likely to respond in negative, aggressive ways.

Monitoring. For parents of adolescents, monitoring is crucial. This monitoring should be presented in a caring way, rather than as a violation of privacy. When parents take a genuine interest in their adolescent, the adolescent is less likely to engage in disruptive behavior. Ask who his or her friends are and what he or she does in his or her free time. Whenever your child is going out, know who is going, where he or she is going, how he or she will get there, what he or she will be doing, and when he or she will return home.

Techniques. Provide the adolescent with techniques for joining new, positive peer groups and avoiding deviant peer groups and negative peer pressure.

Evaluation. Whenever a teacher or parent is very concerned about ongoing inappropriate behavior, a comprehensive evaluation by a qualified mental health professional should be arranged to determine if more intensive treatment, such as therapy, is needed.

Resources

Kazdin, A. E., & Weisz, J. R. (2003). Evidence-based psychotherapies for children and adolescents. New York: Guilford. ISBN: 1572306831.

Larson, J., & Lochman, J. E. (2002). Helping school children cope with anger: A cognitive-behavioral intervention. New York: Guilford. ISBN: 1572307285.

Lochman, J. E., & Wells, K. C. (2002). The Coping Power Program at the middle school transition: Universal and indicated prevention effects. Psychology of Addictive Behaviors, 16, S40S54.

Reid, J. B., Patterson, G. R., & Snyder, J. (2002). Antisocial behavior in children and adolescents: A developmental analysis and model for intervention. Washington DC: American Psychological Association. ISBN: 1557988978.

van de Weil, N. M. H., Matthys, W., Cohen-Kettenis, P., & van Engeland, H. (2003). Application of the Utrecht Coping Power Program and care as usual to children with disruptive behavior disorders in outpatient clinics: A comparative study of cost and course of treatment. Behavior Therapy, 34, 421436.

Website

Centers for Disease Control and Prevention: Youth Violence in the United States www.cdc.gov/ncipc/dvp/youth/newfacts.htm

The National Institute of Mental Health: Children and Violence (booklets, fact sheets, andsummaries) www.nimh.nih.gov/publicat/violencemenu.cfm

Tammy D. Barry, PhD, is an Assistant Professor at Texas A&M University. John E. Lochman, PhD, is Professor and Saxon Chair in Clinical Psychology at The University of Alabama.

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