| dc.description.abstract | Abstract: The aim of this literature review is to give a description of the intervention called Collaborative and Proactive Solution (CPS), and to summarize the existing research findings regarding the outcome of the intervention when used in an outpatient setting. The Norwegian online journal Ungsinn´s (Youngmind) system of assessing the level of evidence is used to suggest an overall rating of the intervention. Ungsinn is based on standards of evidence listed by the Society for Prevention Research and other international systems of grading evidence. CPS is a relatively new cognitive-behavioral psychosocial intervention used with children and youth displaying externalizing behavior, including aggressive and disruptive behavior such as temper tantrums, hitting and kicking, disobeying rules and lying, and often diagnoses of Oppositional Defiant Disorder (ODD). Traditional interventions to treat externalizing behavior have primarily been based upon learning theories that assumes that the behavior have been learnt as a result of parenting practices. The child has learnt that disruptive behavior will provide them with something, or allow them to avoid something. The oldest and most documented approach is called Parent Management Training (PMT), and is often considered to be the first choice of treatment. Although there is considerable research documenting the benefits of PMT, there has also been research showing limitations of this intervention. In order to address the shortcomings of behavioral approaches, the CPS model was developed. CPS relies heavily on transactional theories of development, system theory and research in the neurosciences. It proposes that challenging behavior is a product of skill deficits in the domains of executive functioning, cognitive flexibility, emotion regulation and social skills. The aim of externalizing behavior is not to be purposefully oppositional, but to express that they are struggling with a particular demand or situation. Hence, the goals of CPS is to identify the skills a challenging child is lacking, identify the specific expectation the child is having difficulty meeting, and help child and adult collaboratively solve these problems. According to the model, skills are taught implicitly through the problem solving process (known as “Plan B”). There is an expending evidence base for the efficacy of CPS in reducing disruptive, externalizing behavior among children and youth. The studies that are included in this paper shows that improvements in children´s behavior were equivalent to the improvements found in a parent training control group (PMT). Review of the accumulating evidence indicates that CPS is an evidence based intervention. This paper proposes that CPS reaches level 4 on Ungsinn´s classifications system. However, there is still a need for more effectiveness studies to evaluate the model in a natural context and for longer follow-ups to see if the positive changes are sustained over time. There is also a need to find out how and why the treatment works (mediators), as well as identifying subgroups in which CPS is more or less effective (moderators). KEYWORDS: Collaborative and Proactive Solutions, CPS, evidence-based treatment, behavioral difficulites, externalizing behavior, Oppositional Defiant Disorder, children, youth. | nob |