Interventions need to be rooted in developmental processes

Simply attempting to reduce a known risk factor for childhood psychiatric disorder or pathology may miss the point. For instance, conduct disorder and deliberate self-harm are associated with low family income. Yet both clinical problems have increased over the last three decades in Europe in spite of increasing standards of living.(21) It is the processes which explain the associations of risk factors and disorder that are relevant.

Furthermore, the potent influences of family, peer group, and school on normal children's development have been well recognized and explored. Elements and processes within such areas that lead to poor psychological adjustment are well documented. The principles of developmental psychopathology apply. For instance, one of the most potent predictors of social adjustment and well being within normal development is peer relationships. Selman et a/.'(29 have made a direct attempt to improve these by joint counselling pairs of aggressive and withdrawn boys, during which the counsellors have attempted to move boys to a higher developmental level of understanding and management of interpersonal conflict. This draws upon an understanding of the development of social understanding originally developed by the author a decade or so earlier. Preliminary evidence for its effectiveness is positive in what has been a difficult area in which to intervene.

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