EFFICACY OF COGNITIVE RESTRUCTURING AND BEHAVIOURAL REHEARSAL ON CONDUCT DISORDER IN ADOLESCENTS IN SPECIAL CORRECTIONAL CENTRES IN LAGOS STATE

ABSTRACT

The work efficacy of Cognitive Restructuring and Behavioural Rehearsal on Conduct Disorder in Adolescents in Special Correctional Centres in Lagos State is concerned with adolescence which is the third phase of human development. This is characterized by stress and storm. Unresolved identity crisis coupled with some factors such as parenting styles, socio-economic status, religion, and peer pressure lead to conduct disorder. The rate of conduct disorder in adolescents is on the increase in the form of truancy, deceitfulness, theft, rule violations, rape, aggression or threats to others. These are becoming rampant and if nothing is done, there would be difficulty in having a healthy future for both individuals and the nation at large. The study adopts an experimental research with 3 x 2 x 3 x 3 factorial design. The variables in the study include the independent variables, which consist of cognitive restructuring, behavioural rehearsal and control group. The intervening variables are gender, socio-economic status and parenting styles while the dependent variable is conduct disorder. A sample size of 90 adolescents is purposively selected. Participants are randomly assigned into experimental and control groups. The three instruments relevant to this study are: Conduct Disorder Scale, Socio-Economic Scale and Parenting Styles Scale. Eight research hypotheses are raised and tested at 0.05 level of significance. The procedure for data collection include the pre and post tests administered to the participants. Participants are exposed to intervention sessions twice a week for the period of eight weeks. Data collected from the study are analyzed using both the descriptive and inferential statistical methods. The study reveals the order of prominence of subscales of conduct disorder to be deceitfulness and or theft, aggression, hostility and rule violation. The prevalent paternal and maternal parenting styles that is prominent is the authoritative parenting style, the prevalent parental socio-economic status is the medium. A significant difference exists in the pre-test and post-test. The results from the tested hypotheses are: There is no significant difference in the order of prominence in conduct disorder of the followings: prevalence of paternal and maternal parenting styles, cognitive restructuring and behavioural rehearsal and cognitive restructuring and behavioural rehearsal on the basis of gender and parental SES. Others include parenting styles, age, educational level, and length of stay at the correctional centres. There is a significant difference in the followings: degree of severity of conduct disorder before and after treatment, treatment of conduct disorder of participants in the two experimental groups when compared with the control group and cognitive restructuring and behavioural rehearsal on the basis of religion. Recommendations are proffered in the study.

Keywords: Cognitive Restructuring, Behavioural Rehearsal, Conduct Disorder, Adolescent, Parenting Style, Socio-Economic Status. Word Count: 428

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CHAPTER ONE

INTRODUCTION

1.1         Background to the Study

Conduct disorder is a serious behavioural and emotional disorder that can occur in adolescents. Adolescents with this disorder may display a pattern of disruptive and violent behaviour and have problems following rules (Hinshaw & Lee, 2003). It is not uncommon for adolescents to have behaviour-related problems at some time during their development. However, the behaviour is considered to be a conduct disorder when it is long-lasting and when it violates the rights of others, when it goes against accepted norms of behaviour and disrupts the child’s or family’s everyday life (Hinshaw & Lee, 2003; Goldberg, 2012).

The word ―adolescence‖ comes from a Latin word ―adolescere‖ which means to grow or to grow to maturity (Oladele, 1994; Martins, Carlson & Buskist, 2007). Psychologists have given different definitions of adolescence. Some define it as the transitional period of life between childhood and adulthood; while at other times it is called the period of teenage which is marked by changes in the body, mind and social relationships. This means that the transition is as much social as it is biological. Adolescence is the time between the beginning of sexual maturation (puberty) and adulthood. It is a time of psychological maturation during which a person becomes “adult-like” in behaviour. According to Sacks (2003), adolescence begins with the onset of physiologically normal puberty and ends when an adult identity and behaviour are accepted. This period of development corresponds roughly to the period between the ages of 10 and 19, which is consistent with the World Health Organization‘s definition of adolescence (WHO, 2013). Martins, Carlson & Buskist (2007) opine that adolescence starts from teen age and ends in the early twenties, while Gutgesell & Payne (2004) describe adolescence as a prolonged developmental stage that lasts approximately ten (10) years, nominally described as between the ages of eleven (11) and twenty-one (21). It is also noted that an adolescent progresses through stages of biological development as well as changes in psychological and social functioning. Developing proper emotions and controlling them is very essential

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during adolescence. Meeting social demands as well as eliminating the damaging effects of the emotions on attitudes, habits, behaviour and physical well-being, as well as control of emotions, is essential. Control does not mean repression but learning to approach a social situation with a rational attitude and repression of those emotions which are socially unacceptable.

When an individual reaches adolescence, he/she knows what type of behaviour is expected of him or her and which behaviours are unacceptable. Adolescents however misbehave from time to time for a variety of reasons. Perhaps, they feel that they need to assert their own independence or they wish to test the limits imposed on them. Sometimes, adolescents misbehave because they are experiencing internal distress, anger, frustration, disappointment, anxiety, or hopelessness. There are also those whose behaviour is consistently of concern to others. In such cases, the adolescents‘ behaviour is clearly outside the range of what is considered normal or acceptable. Perhaps, most alarming is that many of them show little remorse, guilt, or understanding of the damage and pain inflicted on people by their behaviour (Pruitt, 2000).

The future of any nation is largely determined by the well-being of adolescents. Dealing with adolescents has always been a challenge for both parents and helping professionals. Behavioural disorders typically develop in childhood and adolescence. While some behavioural issues may be normal, those who have behavioural disorders develop chronic patterns of aggression, defiance, open refusal to laws or regulations, disruption and hostility. Adolescents‘ behaviours can cause problems at home or school and can interfere with relationships. Adolescents with behavioural disorders may develop personality disorders, depression, or bipolar disorder as adults (Richard-Harrington, 2008).

According to Hinshaw & Lee (2003), Henderson (2009), American Academy of Child and Adolescent Psychiatry (2010) and Passamonti, Fairchild, Goodyer, Hurford, Hagan, Rowe & Calder (2010), the specific cause of behavioural disorder such as conduct disorder is not known but a number of factors such as genetic or biological factors, family, parental, child abuse, peer pressure, socio-economic status, lack of

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supervision, inconsistent discipline and environmental factors may contribute to its development.

§   Genetic factors- Human development is shaped by a continuous interaction between biology and experience. Every child is born with powerful inborn tendencies, and these tendencies can work both for and against the child. When a child is born with a genetically predisposed tendency toward mental health problems, the environment becomes critically important to support and guide the child in a positive and healthy direction. This can add stress to the already difficult job of parenting (Gelhorn, Stallings, Young, Corley, Rhee & Hewitt, 2005).

§   Family factors – Antisocial behaviour suggestive of conduct disorder is generally, mostly associated with single parent status (absentee father or mother), absence of parental figure, parental divorce, parental rejection of child, inconsistent management including harsh discipline, large family size, young age of mothers, parent with antisocial personality and alcohol dependence (Hinshaw & Lee, 2003).

§   Parental factors (marital conflict, parental mental illness, poor communication between parent and child, poor parenting skills).

§   Child abuse – Obinaju (2004) describes child abuse as any act which would amount to making a wrong and excessive use of the child, an act which excludes sympathy and humaneness from the treatment which the child receives and an act which would amount to an insult on the child. Also, Axmaker (2004) states that child abuse is any mistreatment or neglect of a child in non-accidental harm or injury and which cannot be reasonably explained. Child abuse can be verbal, physical, emotional, sexual and psychological. Abused adolescents can exhibit some behavioural disorders such as aggression, truancy, and infidelity among others.

§   Peer Pressure – Encarta (2009) defines peer pressure as a social pressure on somebody to adopt a type of behaviour, values, or attitude in order to be accepted as part of a group. Peer pressure can either be positive (good) or negative (bad).

Negative peer pressure is when an adolescent is coerced to do what is wrong.

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Persistent pattern of wrong act such as theft, truancy, hostility and the like are referred to as behaviour disorder.

§   Socio-economic status- Low socioeconomic status of parent, that is evident on the adolescents, thereby leading to not being accepted by their peers may appear to be some risk factors for the development of behaviour disorder in the latter.

§   Lack of supervision – Adolescents tends to misbehave grossly in the absence of supervision from either maternal, paternal or care giver figures. Simply, lack of supervision is when adolescents are free to do anything they want either at home or in school.

§   Inconsistent discipline – It is important that parents be consistent with whatever disciplining method is in use (or chosen) in the home. This is in order to avoid getting the children confused about certain behaviours and consequences. Parents or caregivers with contradictory attitude towards children‘s misbehaviours tend to confuse the latter on what is good or bad, acceptable or unacceptable to the society. Inconsistent discipline is simply punishing a particular behaviour at a time and refraining from punishing the same behaviour at other times.

§   Environmental factors- The environment in which an adolescent is raised can contribute to the kind of behaviour such an adolescent will put up. For instance, the influences of parents, extended family, care giver and others with whom he or she has regular contact profoundly affect his or her emotional, cognitive and social development. Healthy environment will produce healthy adolescents while unhealthy environments will encourage or promote behavioural disorder.

Adolescents‘ behavioural disorder may include: lying, smoking, use of alcohol and or drugs, involvement in early sexual activity, skipping school and having higher than average risk of suicide. Adolescents may also have other mental, emotional or behavioural disorders like attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) among others (Hinshaw & Lee, 2003; American Academy of Child and Adolescent Psychiatry, 2010).

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Conduct disorder as one of the major constructs in this study is a behavioural disorder characterised by a consistent pattern of harming others or their property, or breaking major accepted rules or standards of behaviour. Individuals must be developmentally able to understand and follow the standards of behaviour in order to be considered as having conduct disorder (Evans, 2012). According to APA (2000), conduct disorder is defined as a repetitive and persistent pattern of behaviour that violates the rights of others or in which major age-appropriate societal norms or rules are violated. The symptoms of the disorder fall into four main subscales or dimensions: aggression to people and animals, destruction of property, deceitfulness, and serious violation of rules (Frick & Nigg, 2012). Frick, Stickle, Dandreaux, Farrell & Kimonis (2005) are of the opinion that conduct disorder is an important psychiatric disorder for a number of reasons which are closely related to criminal and violent behaviour that is associated with problems in adjustment across the lifespan.

Adolescents with conduct disorder often view the world as a hostile and threatening place (Evans, 2012). Friends and family members become upset with their misbehaviour and become more irritated when they do not show remorse or guilt over their actions (Evans, 2012). Based on the mentioned causes of behavioural disorder, it is obvious that adolescents with behavioural disorders will not just hurt themselves but also hurt others. Parents, caregivers and society at large report cases of adolescent behaviour or conduct disorder to juvenile courts, remand or correctional homes or centres but these measures are not sufficient in correcting conduct disorder. Different psychological interventions like cognitive restructuring, behavioural rehearsal, token economy, thought-stopping, self management, reinforcement, punishment, modelling and family therapy are some of the measures put in place by professional counsellors and psychologists to treat or correct conduct disorder (Obalowo, 2004; Edelson, 2004; Aderanti & Hassan, 2011).

In this study, cognitive restructuring and behavioural rehearsal are the two treatment interventions used.

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Cognitive restructuring

Cognitive restructuring was originally developed by Albert Ellis (1989). It is a psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts. There are many methods used in cognitive restructuring, which usually involve identifying and labelling distorted thoughts, socratic questioning, thought recording, identifying cognitive errors, examining the evidence (pro-con analysis or cost-benefit analysis), understanding idiosyncratic meaning/semantic techniques, reattribution, guided imagery and listing rational alternatives (Huppert, 2009). Thus, this study attempts to compare the efficacy of cognitive restructuring and behavioural rehearsal.

Behaviour rehearsal

Dewey (2007) reported that Albert Bandura’s Principles of Behaviour Modification of 1967 introduced the concepts of vicarious reinforcement, modelling, and behaviour rehearsal to behaviour therapists. Behaviour rehearsal is the acting out of behaviour to learn it and refine it as a skill. It involves clients rehearsing their social skills in the therapy session and eventually moving to real-life situations. For instance, role-playing, requires the client to imagine the stressful situation very vividly, but in addition to thinking about (and feeling) the stress, the client now engages in physical actions that practise what might be done to reduce tension. In role-playing contexts, filmed simulations are sometimes used with discussions of what is happening. Behavioural rehearsal is accompanied by vicarious modelling, that is, observing holistically what a model does in a similarly stressful situation and noticing what happens to that model (Bandura, 1986). Also, at other times, the client or the practitioner might take the role of the client in acting out the scene. Other variations include members of the group taking turns to act out one or more roles and providing feedback and support for the other actors (Schinke, Gilchrist, Smith, & Wong, 1979).

Special Correctional Centres

Special Correctional Centres were formerly known as remand homes. Collins English Dictionary (2009) defines a remand home as an institution where juvenile offenders.