Theories of psychotherapy are one of the most crucial tools for mental health counselors and therapists as they provide them with a framework for interpreting the behaviors, thoughts, and feelings of their clients. Moreover, it helps them to navigate through the journey of their clients from diagnosis to post-treatment. In other words, theoretical approaches are critical to the successful completion of therapeutic processes.
Conduct disorder
Although research indicates that the most significant damage that occurs to society results from the actions of delinquent adolescent, it is stated that conduct disorder among adolescents often begin at the age of seven (American Psychiatric Association, 2000) . Studies indicate that conduct disorder results from a steady pattern of harming others, lying, breaking societal rules of behavior or even stealing. However, remote instances involving acute behaviors, running away or even vandalism is not enough to merit the diagnosis of a conduct disorder since most youngsters often exhibit cases of poor judgment in addition to bad behavior at least one time during their childhood. To settle that a child has a conduct disorder, he or she has to break the rules over and over again and additionally exhibit aggressive behavior and disregard others (American Psychiatric Association, 2000) . Therefore, these disturbances in behavior result in substantial clinical impairment involving social skills, occupational functioning, and more importantly academics.
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Causes of conduct disorder
The conditions that underlie the development of conduct disorder have been determined to be multifactorial. Neuropsychological testing conducted on conduct disorder indicates that youngsters and adolescents with conduct disorder have impairments in their frontal lobes of the brain (National Institute for Health & Clinical Excellence, 2007) . This interferes with their abilities to plan, avoid harm and learn from their negati ve experiences. However, the temperament of children is mostly considered to have a genetic basis. Therefore, adolescents and children who are said to have difficult attitude have high likelihoods of developing behavioral problems.
Moreover, children and adolescents who hail from disadvantaged and dysfunctional families or even disorganized homes have high risks of developing conduct disorders (American Psychiatric Association, 2000) . Peer group rejection and social problems, an d low socioeconomic status are other factors that have been found to contribute to delinquency among adolescents. Additionally, it has been noted that children and adolescents who exhibit aggressive and delinquent behaviors have distinctive cognitive and psychological profiles compared to youngsters with other mental health problems and control groups. All these contributing factors to conduct disorder primarily influence the manner in which children and adolescents interact with other individuals. On the other hand, research indicates that the etiology of conduct disorder consists of a correlation of genetic, social factors and family. In this situation, a child may inherit a baseline autonomic nervous system activity that is limited thus resulting in the need for greater stimulation to attain optimal arousal (American Psychiatric Association, 2000) . This aspect that is hereditary explains the high level of sensation-seeking activity that is associated with conduct disorder among adolescents.
Conduct disorder in children has been found to be a significant risk factor for anti-social behavior among adults. Therefore the key to diagnosing youngsters with conduct disorder lies in the identification of the origin of antisocial behavior found in difficult temperament and ineffective socialization. Moreover, research notes that conduct disorder among youngsters which persists through adolescents is mainly associated with co-morbidity, recurrence, and resistance to treatment.
Symptoms of Conduct Disorder
Clinically, conduct disorder has been associated with aggression or even serious threats of harming people or animals, deliberate destruction of property. Moreover, it is also associated with repeated violation of school and household rules and even both, and persistent lying to avoid consequences (National Institute for Health & Clinical Excellence, 2007) . More importantly, another feature includes an indifference concerning the welfare of others and little remorse about harming others.
Mostly, youngsters who are diagnosed as having conduct disorder often judge the world as an intimidating and antagonistic place. These children at times may tattle on their friends or even place the blame of something that they have done on others. Their circle of friends is few as a result of their limited interpersonal skills. More often, their family members and peers view them as irritating due to their indifference to their actions. Children with conduct disorder have low self-esteem internally although they appear to be tough, self-assured or cocky on the exterior.
Diagnosis
For conduct disorder to be diagnosed in children and adolescents, a child psychiatrist or mental health personnel who is qualified is needed. Additionally, a detailed history of the behavior of the child either from the guardians, teachers including observations of the child’s behavior, and psychological testing is mostly needed to guarantee the success of diagnosis (National Institute for Health & Clinical Excellence, 2007) . More importantly, parents who note that their children have symptoms of conduct disorder have to seek early help through evaluation and treatment.
Prevention
As research indicates, the developmental sequence of experiences often occurs during the development of conduct disorder. The series sometimes may start with parenting practices that are ineffective, followed by poor peer interactions and academic failure. These experiences mainly lead to depressed moods in addition to involvement in deviant peer groups. However, some researchers believe that other factors such as child abuse, history of academic failure, traumatic experiences, and genetic susceptibility contribute to an individual’s expression of conduct disorder (American Psychiatric Association, 2000) . Therefore, for prevention purposes, early detection and intervention into negative social experiences and family should be carried out to help disrupt the development of the sequence of experiences leading to aggressive and disruptive behaviors.
Cognitive-behavior Theory and Conduct Disorder
The cognitive theory, as presented in Kottler and Shepherd in the “ Introduction to Counseling: Voices from the Field” is a theory that was developed in the 1960s by psychotherapist Aaron Beck. It is a counseling theory that focuses on how the thinking of various individuals can change their feelings and behaviors. People often act emotionally and behaviorally to certain events according to their interpretations of those events. In short, the words that people say and the thoughts people have led to their emotions and subsequent behaviors (Gonzalez-Prendes & Resko) . For instance, if a person steps on your foot, you might interpret the action as being intentionally hurt by the individual. In response, you might become angry and may decide to retaliate against the foot-stepper.
On the other hand, you might also interpret this as the person being clumsy in which you might feel compassionate and forgiving. Although the environment of the situations occurrence is identical, the result is two sets of emotions and behavior that are entirely different from each other whose outcome comes from the way the person's mind integrates the event (McLeod, 2015) . Most therapeutic processes that are based on cognitive theory are brief and mainly oriented towards solving a particular problem. More importantly, the therapeutic operations that are conducted by cognitive therapists focus more on the present situation of a client rather than on their past lives.
Our interpretation of various events is critically linked to another type of cognition known as our individual core beliefs. Another complex blend of factors that originate from both nature and nurture are further thought to drive the formation of various individuals core beliefs. The cognitive theory of behavior assumes that there are some inherited dispositions involving temperament that interact with youngsters environments thereby influencing their ultimate personalities in addition to their personal, interpersonal strategies (McLeod, 2015) . As such, the theory of cognitive behavior provides emphasis on the importance of social learning concerning the personality development of various individuals. Research, therefore, indicates that childhood experiences in addition to trauma and abuse that might be experienced during childhood are some of the essential factors that influence people’s core beliefs about the world. In later years, these core beliefs are said to color and substantially distort the perceptions and interpretations of people’s subsequent experiences (Hoermann, Zupanick, & Dombeck, 2018) .
Therefore, the appraisal event of various individuals is not also influenced by their immediate experiences of a situation but also by their preconceived ideas and beliefs that were formed in the past. When the core beliefs of people are faulty, distorted or even biased, they often end up drawing incorrect and irrational conclusions about the meaning of events, thereby behaving in certain ways that cause unnecessary distress (Hoermann, Zupanick, & Dombeck, 2018) . Thus the explanation on cognitive behavior provided by Dr. Beck on personality disorders potentially asserts that people with personality disorders act in the manner in which they do just because of their core beliefs. When these core beliefs are distorted or biased towards certain situations, they can make people misinterpret events consistently.
Current Status of CBT
Cognitive Behavior Therapy (CBT) is used to help an individual become more aware of the instances in which they make negative interpretations. Additionally, it increases their awareness of their behavioral patterns that reinforce their distorted thinking. In other words, cognitive therapy helps people to develop alternative ways of behaving and thinking that aim at reducing their psychological distress (Westbrook, 2006) . In the landmark summary of psychotherapy efficacy by Roth and Fonagy (2005), the report indicates that CBT is strongly supported as a therapy for most psychological disorders in adults, and additionally has more support in more kinds of problems than any other types of behavioral treatments. Moreover, other than the evidence provided of CBT's efficacy, research further demonstrates that it is useful and can do well in ordinary clinical practice, even outside specialist research centers (Westbrook, 2006) .
Additionally, another evidence of the effectiveness of CBT in behavioral therapy is stated by the UK National Institute for Clinical Excellence (NICE). In particular, it is an agency that is charged by the government to survey various evidence of the evidence of the effectiveness of different behavioral treatments (Westbrook, 2006) . Moreover, the agency is also tasked with making recommendations about the procedures that need to be made available in the National Health Service. For instance, regarding the treatment of depression, NICE (2004) maintains that when treating patients with mild depression, health care personnel’s should consider a guided self-help program that is based on CBT (Westbrook, 2006) . Moreover, regarding the individual’s psychological treatment for moderate, severe and treatment-resistance depression, CBT is the best treatment choice. Additionally, for individuals with post-traumatic stress disorder, NICE (2005) postulates that these people should be offered a trauma-focused cognitive behavioral therapy.
Since CBT mostly involves training on problem-solving skills, it has been widely evaluated, and there is evidence for its short-term efficacy in the treatment of conduct disorder and aggression in youngsters. CBT is used for the treatment of a wide range of problems for both adult and children (Gonzalez-Prendes & Resko) . CBT emphasizes certain cognitive techniques designed for producing changes in thinking thereby resulting in changes in behavior and mood. Moreover, it also provides emphasis on the behavioral learning process and the manner in which the external environment can change both behavior and cognition. CBT for adolescents and youngsters mainly involve a variety of behavioral performance-based procedures during therapy and constitute the family and even school. Therefore, the length of treatment for conduct disorder considerably varies and further depends on the severity of the difficulties experienced by a child (McLeod, 2015) . As such CBT processes for children with conduct disorder strongly focus on social cognition in addition to interpersonal problem-solving. Therefore therapeutic programmers for children and adolescents with conduct disorder often take up to twenty-five to thirty weekly sessions where the therapist or mental counselor actively involves and tries to develop a collaborative relationship with the youngster to stimulate him or her to think for himself or herself. This approach mainly aims at giving the child an opportunity to try things out and consequently develop new skills.
Mainly, CBT is used as an improvement tool to solve problem abilities among youngsters and adolescents with conduct disorder (National Institute for Health & Clinical Excellence, 2007) . Training children with this behavioral problem help them to deal with external issues that might provoke this behavior. F irst, the child is encouraged to generate potential solutions that may accrue to a problem after which the therapist decides on the best solution and identify the steps in implementing it. Secondly, the child practices these steps, and after that, the whole therapeutic process is evaluated (American Psychiatric Association, 2000) .
Research indicates that clients who develop potential ways of thinking subsequently get better from psychological problems. As such when these patients develop the necessary skills that enable them to identify, evaluate and change their thinking, they are more likely to get better (National Institute for Health & Clinical Excellence, 2007) . CBT thus aims at improving the beliefs of conduct behavior clients by treating their views as a testable hypothesis that is examined through behavioral experiments. In this manner, the counselor asks questions mainly to elicit meaning, function, usefulness, and consequences of the belief that the client may hold rather than telling the client that their opinion is wrong. Moreover, CBT further challenges adolescents to make conscious choices and to accept full responsibilities for the decisions that they may cause. More importantly, CBT therapy has been found to be potentially useful in the treatment of all forms of antisocial behaviors that may include socially undesirable behaviors, stealing, or even faulty thinking (American Psychiatric Association, 2000) . Since CBT involves self-management, the techniques of self-management employed in the treatment of conduct disorder help delinquent individuals to manage their behavior.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.
Gonzalez-Prendes, A. A., & Resko, S. M. Cognitive behavioral therapy.
Hoermann, S., Zupanick, C. E., & Dombeck, M. (2018). Cognitive-Behavioral Theory Of Personality Disorders. Retrieved December 2018, from Mental Help: https://www.mentalhelp.net/articles/cognitive-behavioral-theory-of-personality-disorders/
McLeod, S. (2015). Cognitive Behavioral Therapy. Retrieved December 02, 2018, from https://www.simplypsychology.org/cognitive-therapy.html
National Institute for Health & Clinical Excellence. (2007). Conduct disorder programs. Retrieved December 02, 2018, from Community Care: http://www.nice.org.uk/page.aspx?0=529846, 1672(1672), 32-33.
Westbrook. (2006). Basic theory, development and current status of CBT. In An Introduction to Cognitive Behavior Therapy (pp. 1-14).
