Enhancing generalization of a contingency-management intervention through the use of family problem-solving training: Evaluation with a severely conduct-disordered adolescent

The present case study reports the combined use of contingency-management and family problem-solving training (FPST) procedures in the treatment of an adolescent with severe conduct disorder. Despite clear behavioral improvements resulting from contingency-management procedures, the parents became increasingly frustrated with the adolescent and terminated services briefly. The subsequent addition of FPST resulted in additional improvements in behavior and improved interactions between the adolescent, parents and siblings. The family became more active in treatment and the focus of treatment moved away form “adolescent's problems” to the problems of the family. Evidence of the maintenance and generalization of FPST could be found in the family's spontaneous use of the procedures during the week. This led to increased opportunities for compliance and rewards for prosocial behaviors not included on the point system and the family's continued use of the procedures throughout a crisis period involving the adolescent's disturbed behavior. Limitations of FPST are discussed, as well as suggestions for future treatment research with severely conduct-disordered adolescents.