An Alternative Therapeutic Intervention to Reduce Aggression and Other Behavioral and Emotional problems

Abused males and delinquent males who are emotionally disturbed are often placed in a residential treatment facility for therapy. The purpose of this study was two fold. First, the authors wanted to compare Children's Protective Service (CPS) residents to Juvenile Probation (JP) residents in order to determine differences which might need to be addressed in treatment plans. Secondly, the authors wanted to evaluate the use of an alternative therapeutic intervention (relaxation therapy) to reduce aggression and other behavioral problems.

In a previous study by Braud and Powell (1997), the authors evaluated 70 abused males. Eighty-seven percent of the participants had one or more learning disability. Reading remediation was given to a group (N=10) of reading disabled males resulting in a significant improvement in reading accuracy (+4 years 4 months) and reading comprehension (+5 years, 6 months) after 6-9 months of remediation. Visual-perceptual motor remediation was also provided to a group (N=10) of males with severe visual motor problems. These remediated participants made 5 years progress in visual motor skills after 6-9 months of remediation. Both remediated groups made statistically significant progress as compared to controls. In addition, the authors wanted to assess the behavioral and emotional improvement of the abused males who were still at the facility (N=34) the next year. These youngsters had been in group and individual therapy for a year. Their pretest and posttest scores on 21 emotional and behavioral measures were compared. However, anxiety was the only measure that showed significant improvement (Appendix A&B). Braud and Powell (1997) also found a high percentage (77%) of males with ADD in the total sample (N=70). Braud (1976) had previously used relaxation therapy to improve the behavior of hyperactive youngsters. Therefore, relaxation therapy appeared promising and was used in the following study.

The total sample included 65 males residing at one of the three Sheltering Harbour facilities in Harris County, Texas. The sample included 31 African Americans, 21 Caucasians, and 13 Hispanic males. Thirty-eight (38) of these youngsters were CPS residents while 27 were JP residents. The boys ranged in age from 11.0 to 17.4
(M=14.58).

Four tests were administered to measure the emotional and behavioral characteristics and to assess the effectiveness of the therapeutic intervention. Pre and posttest measures were collected. The Child Behavior Checklist (CBCL) is a 113 item Likert-type 3 point scale from "not true" to "very true" or "often true". The CBCL measures a broad range of behavioral and emotional problems. The CBCL was filled out by a counselor or one of the therapists at the appropriate facility.

The Modified Children's Manifest Anxiety Scale (MCMAS) was administered to each participant.

Items were read to children with poor reading skills. The 74 item self-report scale included the original 53 items from the Children's Manifest Anxiety Scale (Castaneda, McCandless, &Palermo, 1956) as well as additional items from the Minnesota Multiphasic Personality Inventory (Hathaway and McKinley, 1983) and additional items
developed by the senior author to assess the presence of phobias and depression. Items on the instrument were divided into eight scales: anxiety, somatic signs of anxiety, oversensitivity, fears/phobias, depression, concentration problems, thought disorder, and a lie scale. The number of items answered on each scale was divided by the total number of items on that scale to determine a percentage score. The items that comprise the Revised Children's Manifest Anxiety Scale (Reynolds & Richmond, 1994) were also scored to compare the children's scores to normative data.

The Multidimensional Self Concept Scale (Bracken, 1992) was administered to each participant. The examiner read all the test items to children with poor reading skills. The Multidimensional Self Concept Scale (MSCS) is a 150 - item instrument that yields an overall self concept score and six individual scales: social, competence, affect, academic, family, and physical. Each item is answered using a Likert-type 4-point scale from "strongly agree" to "strongly disagree". The instrument seemed particularly applicable to this population because of the inclusion of an academic and family scale.

The Test of Hyperactivity, Aggression, Short Attention Span and Psychopathic Deviance (TOHASP)_ was administered to each participant. The TOHASP is a 58-item inventory compiled by the senior author from several sources and inventories including Conners (1969), Davids (1971), the Braud Behavioral Rating, and the DSM-III-R (1987). The TOHASP was specifically compiled to measure problems known to be prevalent among abused males or common problems that were revealed in a pilot study by Braud and Powell (1997). The TOHASP is comprised of six scales designed to measure overactivity, short attention span, impulsivity, low frustration tolerance, aggressive oppositional behavior, and psychopathic deviance. The child rated each item on a
Likert-type 5 point scale from "no problem" (1) to "very severe problem" (5).

The total sample (N=65) included 35 current residents and 30 recently discharged residents. The discharged (D) and not discharged (ND) residents were compared on all measures. When it was found that these two groups differed statistically on only 4 measures out of 35 they were combined to yield a larger sample (N=65) so as to
compare CPS and JP residents. However, the authors were somewhat surprised to find that the two populations differed significantly on only two measures. Juvenile Probation residents admitted to significantly more symptoms of thought disorder (t(63)=-2.12, p=.038) and phobias (t(63)=-2.06, p=.043) on the Modified Children's Manifest Anxiety Scale. Neither of these two measures differed significantly when comparing discharged and not discharged residents.

The authors chose the Old Me, New Me Relaxation Program, a revision of Peace, Harmony, Awareness, (Lupin, 1996). The experimental group (N=20) received 12 relaxation sessions. Each session included the presentation of the relaxation exercise tape followed by one of the story tapes. Each story tape is comprised of a guided imagery trip with soothing sounds effects and music, (Beach, Star, Woods, Secret Place, Magic Mountain and Robin Returns). The story tapes were specifically written to help youngsters cope more effectively with a variety of issues including anger, aggression, frustration, impulsivity, oppositional behavior, hyperactivity, and cooperation.

Experimental participants (N=20) made statistically improvement as compared to controls (N=15) on aggression, attention span, and hyperactivity on the TOHASP (Appendix C). On the Modified Children's Anxiety Scale, experimental participants demonstrated significant improvement over controls on the anxiety scale, physiological scale, and the organic scale (Appendix D). The Children's Behavioral Checklist also demonstrated several areas of significant improvement of experimental participants over controls. Significance was found on the following scales: externalizing, internalizing, aggression, delinquency, and other problems (Appendix E). The authors hypothesized no significant changes in the self concept scores (MSCS) over such a short period of time and no significant changes were found.

The present study demonstrates the validity of relaxation therapy in reducing aggression and other behavior problems. The authors will discuss additional factors that have been found to increase the effectiveness of
relaxation therapy.