Outcome findings and issues in psychotherapy with children and adolescents: Externalizing disorders

Youth with externalizing disorders are a heterogeneous group with varied, severe, and persistent emotional, social, and behavioral challenges. Effective psychotherapy to prevent and reduce the morbidity and societal costs associated with externalizing disorders is imperative. Psychotherapies for youth with externalizing disorders include those completed with the youth, their parents, the family, and the broader family and community systems. This chapter first reviews the etiology and conceptual frameworks that underpin psychotherapies for youth with externalizing disorders. Next, the evidence-base and components of widely used psychotherapies are discussed along with the factors that promote or limit psychotherapeutic engagement and effectiveness. Although a number of empirically supported psychotherapies exist, these are only moderately effective for reducing externalizing behavior, so consideration is given to future innovation that may be necessary to improve effectiveness and enhance outcomes