There is no one-size-fits-all treatment for kids and teens with Oppositional Defiant Disorder. The most effective treatment plans are tailored to the needs and behavioral symptoms of each youngster. Treatment decisions are typically based on a number of different things, including the youngster’s age, the severity of the behaviors, and whether the youngster has a coexisting mental health condition.
The goals and circumstances of the moms and dads also are important when forming a treatment plan. In many cases, treatment may last several months or more and requires commitment and follow-through by moms and dads as well as by others involved in the youngster’s care.
Treatment usually consists of a combination of:
1. Cognitive Problem-Solving Skills Training to reduce inappropriate behaviors by teaching the youngster positive ways of responding to stressful situations. Kids with Oppositional Defiant Disorder often only know of negative ways of interpreting and responding to real-life situations. Cognitive problem solving skills training teaches them how to see situations and respond appropriately.
2. Medication may be necessary to help control some of the more distressing symptoms of Oppositional Defiant Disorder as well as the symptoms of coexisting conditions (e.g., ADHD, anxiety, mood disorders). However, medication alone is not a treatment for Oppositional Defiant Disorder. Medication alone has not been proven effective in treating Oppositional Defiant Disorder. However, medication may be a useful part of a comprehensive treatment plan to help control specific behaviors.
Successful treatment of coexisting conditions often makes Oppositional Defiant Disorder treatment more effective. For example, medication used to treat kids with ADHD has been shown to lessen behavioral symptoms when Oppositional Defiant Disorder and ADHD coexist. When kids and teens with Oppositional Defiant Disorder also have a mood disorder or anxiety, treatment with antidepressants and anti-anxiety medications has been show to help lessen the behavioral symptoms of Oppositional Defiant Disorder.
3. Parent-Management Training Programs and Family Therapy to teach moms and dads and other family members how to manage the youngster’s behavior. Parents, family members, and other caregivers are taught techniques in positive reinforcement and ways to discipline more effectively.
Studies have shown that intervening with moms and dads is one of the most effective ways to reduce the behavioral symptoms of Oppositional Defiant Disorder in all age groups. Parent management training teaches moms and dads positive ways to manage their youngster’s behavior, discipline techniques, and age-appropriate supervision. It is the treatment of choice to prevent disruptive childhood behavior for many mental health professionals.
This approach embraces the following principles:
- Consistent punishment for disruptive behavior
- Decreased negative parenting practices, such as the use of harsh punishment and focus on inappropriate behaviors
- Increased positive parenting practices, such as providing supportive and consistent supervision and discipline
- Predictable, immediate parental response
4. Social-Skills Programs and School-Based Programs to teach kids and teens how to relate more positively to peers and ways to improve their school work. These therapies are most successful when they are conducted in a natural environment (e.g., at school, in a social group).
For preschool-age kids, treatment often concentrates on parent-management training and education. School-age kids perform best with a combination of school-based intervention, parent-management training, and individual therapy. For teens, individual therapy along with parent-management training has been shown to be the most effective form of treatment.
Behaviors that go along with Oppositional Defiant Disorder are difficult to change. Therefore, early identification and treatment of Oppositional Defiant Disorder give kids and teens the best chance for success.
Most treatment plans for kids and teens with Oppositional Defiant Disorder last several months or longer. For those with a more severe Oppositional Defiant Disorder, or Oppositional Defiant Disorder that does not respond to therapy, treatment can last many years and may include placement in a treatment center.
A residential treatment center only should be considered for families who are not able to provide therapy at home or at school. In-home services are preferable to residential placement and are often sponsored by state and local youngster welfare agencies.
Help for Parents with Oppositional Defiant Children and Teens