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Oppositional Defiant Disorder

Treatments

Parent Management Training (Using the Webster-Stratton intervention).

Treatment Summary: The parenting program (Webster-Stratton, 1997) provided instruction and videotaped modeling of key parenting activities including appropriate play, and use of parental attention, praise, consequences, and appropriate discipline techniques, including time out. Videotaped vignettes demonstrated the principles involved; therapists used a manual to guide discussion and gave homework. Treatment was provided either to individual parents or to small parent groups (two to three parents). All parents enrolled in the therapist-led interventions were given a copy of Webster-Stratton's book, The Incredible Years (Webster- Stratton, 1992), which served as a companion work to the intervention.

  • Reference: Lavigne, J., LeBailly,S., Gouze,K., Cicchetti, C., et al (2008). Treating Oppositional Defiant Disorder in Primary Care: A Comparison of Three Models. Journal of Pediatric Psychology 33(5). 449-461
  • Submitter: Barry Crum

Brief Behavioral Intervention (BBI)

Treatment Summary: The focus of the treatment is on parent behavior management skills. The family's daily routine is analyzed to identify problems in current interaction. Brief Behavioral Intervention utilizes child directed play and the practice of differential attention such as praise and planned ignoring, giving effective commands and the effective use of time out. Support is provided in weekly counseling sessions with behavior logs for use in discussions and to show progress. Successful completion of each skill determines progress through BBI.

  • Reference: Axelrod, M.E., Garland, B.H., & Love, K.B. (2009). Brief behavioral intervention for young children with disruptive behaviors. Journal of Clinical Psychology in Medical Settings. 16, 263-269.
  • Submitter: Cynthia Gumbert

Treatment Algorithm for ODD

Treatment Summary: Comprehensive assessment is compiled to indicate whether ODD is a singular diagnosis, or has a chance of co morbidity. The first step is psychosocial interventions and behavioral therapy. A second step may be needed to assist the individual after several months without positive results. This entails a medication regimen using a psychostimulant such as atomoxetine, methylphenidate or amphetamine. In cases where multiple diagnoses are indicated, behavioral therapy and medication will vary according to severity and type of diagnosis that coincides with ODD. Medication provided should be prescribed starting with the lowest dose compared to the individuals needs and may be increased over time as needed.

  • Reference: Turgay, A. (2009). Psychopharmacological treatment of oppositional defiant disorder. CNS Drugs, 23(1), 1 - 17.
  • Submitter: Kelli A. Friddle