Complex presentations of child conduct problems: Validation of a competency‐based model for clinical practice

Abstract Background Children with conduct problems often present with a range of complex needs and many factors have the potential to complicate the delivery of evidence‐based interventions for conduct problems. Little, however, is known about how to optimise the delivery of such interventions for complex cases, and there has been a lack of consensus regarding the features that reflect case complexity in treating child conduct problems. The aims of this study were to examine practitioner perceptions of the factors that contribute to case complexity in child conduct problems, and perceptions of the therapist competencies necessitated by distinct features of case complexity when delivering these interventions. Methods Practitioners ( n = 49) with expertise in evidence‐based parenting interventions for conduct problems were recruited from nine countries. Using the Delphi method, participant consensus was established across multiple rounds of consultation and feedback with the expert panel. Results Experts reached consensus on a model comprising seven distinct drivers of case complexity among children with conduct problems, spanning child‐related factors, caregiver‐related factors, and broader ecological factors. Consensus was also reached regarding 16 therapist competencies of key importance to distinct drivers of case complexity, thereby validating the conceptualisation of these drivers. Conclusions These findings represent a novel consensus‐based practitioner perspective on the complex needs of children with conduct problems, and offer researchers and practitioners a common language for communicating information about case complexity. This perspective has the potential to inform clinical research, practice, and training, to better meet these complex client needs.