ART – Aggression replacement training
Summary
Introduction
ART (aggression replacement training) is a structured group-based intervention aimed at adolescents and young adults struggling with aggression management and emotional regulation difficulties. AART (adapted aggression replacement training) is a Nordic modification of the intervention. Its development was based on the original ART intervention. The aim of the ART and AART interventions is to reduce aggressive and violent behaviour, especially in the 12–29 age group. The intervention is particularly aimed at strengthening young people’s self-awareness, interpersonal skills and social cognitive abilities.
Objective and research question
This systematic literature review assesses the effectiveness of the ART and AART interventions on the basis of research literature. The review answers the following questions: In how much detail are the ART and AART interventions described? Do the ART and AART interventions have evidence-based effectiveness, applicable to Finland, in reducing aggressive behaviour or other behavioural problems, and strengthening social skills, among adolescents and young people aged 12–29?
Data and research methods
A systematic literature search was carried out using the PCC search strategy (Population, Concept, Context), which focused on the question: What research has been done on the ART and AART interventions? The following keywords were used: P = children of primary school age, adolescents; C = aggression replacement training, ART, adapted aggression replacement training, A-ART, AART, adapted ART. Context was omitted to avoid an excessive restriction of the results of the search. The primary area of interest in the search was effectiveness studies carried out on the intervention, although other types of studies were also included. A systematic search was carried out for the following six reference databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus. In addition, a search for publications in Finnish was performed on the Finna.fi service, and the search was supplemented by a manual search.
Results
Based on quasi-experimental studies (N=11) identified through a literature search, the ART intervention was evaluated to have positive effects on reducing adolescents’ aggressive behaviour and developing their anger management skills in, for example, a prison environment. Similarly, behavioural problems among children and adolescents were found to have decreased, and their social skills were found to have strengthened, in schools and institutions. According to some studies, the ART intervention could also benefit children younger than the target group of the intervention. The quality of the research designs varied from poor to satisfactory. The literature search did not yield any randomised controlled studies, or any studies on the AART intervention, for inclusion in this review. The intervention descriptions presented in the intervention guides were sufficiently comprehensive, and the implementation support available in Finland was assessed to be sufficient for ensuring the high-quality implementation and fidelity of the ART and AART interventions.
Methodology evaluation
Evidence regarding the effectiveness of ART on aggressive behaviour among adolescents and young adults aged 15–20 has been established in studies that lacked a control group. However, the intervention’s effectiveness regarding behavioural problems and social skills development in children and young people aged 5–20 has been examined in studies in which ART has been compared with standard practices or the effects have been evaluated without a control group. Research on outcomes and effectiveness has been carried out particularly in the Nordic context but, to our knowledge, no research evidence from the Finnish context is available. As no separate research has been carried out on the effectiveness of the AART adaptation of the intervention, evidence of its effectiveness remains unclear based on this review.