Cognitive behavioural therapy for violent behaviour in children and adolescents: A meta-analysis

Aggressive behaviours often co-occur with other emotional, behavioural, academic, and social relationship problems. During adolescence, these children often exhibit increased rates of school dropout, depression, juvenile delinquency, substance abuse, and poor peer relationships. Some definitions focus on aggression as an emotion; according to this framework, aggressive behaviours stem from anger. Other definitions emphasise the motivational aspect of aggression, wherein intentions are thought to indicate the behavioural characteristics. Cognitive-behavioural therapy (CBT) is one of the most extensively researched forms of psychotherapy. This paper aims to review the literature on the use of CBT for treating children and adolescents who demonstrate high levels of violence. Studies were searched for using several methods. First, we used large database of literature on psychological treatments of violence in general. Studies were traced by means of several methods. A large database of 240 papers on the psychological treatment of aggression and violence in general were used. This database was developed through a comprehensive literature search (from 1997 to March 2009) in which we examined abstracts in ERIC (19 abstracts), Psycinfo (30), and Medline (23). Keywords used in computer searches were: Aggression, Violence, CBT, cognitive-behavioural therapy, cognitive therapy, behaviour therapy, and behavioural activation. The options were used in computer searches so that all relevant topics within the broader categories were searched as well. Six studies met the inclusion criteria, all of which indicated beneficial results of using CBT. A meta-analysis suggested an effect size of - 0.094 for reduced violence as a result of CBT treatment; this is considered to be a medium effect. The differential effects of cognitive-behavioural therapy and affective education were variable, although they were also generally in the medium range. In this meta-analytic study, CBT treatment proved less effective in reducing aggressive behaviour. This review tentatively suggests potential for using CBT to reduce violence in children and adolescents. However, there is only a small body of research exploring this relationship at present. Further research is needed before any solid conclusions can be drawn. (C) 2011 Elsevier Ltd. All rights reserved.