The Differential Test of Conduct and Emotional Problems as an Evaluative Tool for the Willie M. Program
West Heather A., Verhaagen, David A., Adolescence
Specialized Youth Services (SYS) was established in 1980 as the result of a class-action lawsuit against the state of North Carolina. The lawsuit, known as Willie M., mandated appropriate treatment for a class of emotionally disturbed children and adolescents. In order to be certified as a Willie M. class member, a child must meet five criteria: (1) be under the age of 18; (2) be diagnosed as having an emotional, mental or neurological handicap; (3) have a history of violent and assaultive behavior; (4) not be receiving adequate services to meet his/her needs; and (5) have been institutionalized or involved with the juvenile courts. Each area program is required to develop and execute a comprehensive plan of habilition for these individuals, ensure that they are receiving an appropriate education, and establish for each client the least restrictive but most appropriate type of treatment setting possible (e.g., their own home, group home or a secure facility).
An evaluation process is essential in a program treating aggressive and assaultive youth. It is a well-studied phenomenon that aggressive behavior in children is likely to predict serious, associated problems in adults. Considering this link with later adjustment, interventions targeting early aggressive behaviors are especially important (Lerner, Hertzog, Hooker, Hassibi, & Thomas, 1988).
Specialized Youth Services addresses the treatment needs of Willie M. clients. They are diagnosed with various disorders and often have co-morbid diagnoses (e.g., ADHD and anxiety disorder). Conduct disorder, however, is most often associated with Willie M. class members because of their frequent aggressive and dangerous behaviors.
SYS designs treatment programming to address these behavior problems. The agency is charged with the mandate of helping clients reduce these antisocial behaviors and progress "toward the goal of independent community living," as stated in the Second Set of Stipulations of the court settlement.
The purpose of the present study was to implement the Differential Test of Conduct and Emotional Problems (DT/CEP) as a tool to assess the extent to which SYS was successfully reducing antisocial behavior and accompanying emotional problems of its Willie M. clients. Although there is no established treatment protocol, a reduction in the scale scores of the DT/CEP was interpreted as indicating that treatment was effective.
Thirty-six Willie M. class members (25 males and 11 females) aged 10-17 were rated by their case managers. Each client was diagnosed with conduct disorder and often a comorbid diagnosis. All clients had been involved with the SYS program for various lengths of time.
The subject pool dropped to 28 (20 males and 8 females) at the second evaluation because eight clients had either aged out of the program or had moved out of the served area. All clients in the study were actively engaged in treatment during the entire period of assessment.
The types of treatment included outpatient therapy encompassing individual, family, and group therapies, in-home treatment involving parent training and direct interventions, and residential treatment including group homes, independent living arrangements, and independent residential treatment. These treatments were either implemented individually or in combination, depending on the needs of the client.
Clients were rated on the DT/CEP (Kelly & Vitali, 1990) which includes 63 true or false statements concerning each subject. The statements form two scales: the Conduct Problem (CP) Scale, and the Emotional Disturbance (ED) Scale. Examples of statements on the two respective scales include: "constantly fighting or beating up others," and "often complains of nightmares and bad dreams." This test was chosen because it targets the behavioral and emotional problems often seen in Willie M. …