Treating oppositional defiant disorder generally involves several types of psychotherapy and training for your child — as well as for parents. Treatment often lasts several months or longer.
Medications alone generally aren't used for ODD unless another disorder co-exists. If your child has co-existing conditions, particularly ADHD, medications may help significantly improve symptoms.
The cornerstones of treatment for ODD usually include:
- Parent training. A mental health provider with experience treating ODD may help you develop parenting skills that are more positive and less frustrating for you and your child. In some cases, your child may participate in this type of training with you, so that everyone in your family develops shared goals for how to handle problems.
- Parent-child interaction therapy (PCIT). During PCIT, therapists coach parents while they interact with their children. In one approach, the therapist sits behind a one-way mirror and, using an "ear bug" audio device, guides parents through strategies that reinforce their children's positive behavior. As a result, parents learn more-effective parenting techniques, the quality of the parent-child relationship improves and problem behaviors decrease.
- Individual and family therapy. Individual counseling for your child may help him or her learn to manage anger and express feelings in a healthier way. Family counseling may help improve your communication and relationships, and help members of your family learn how to work together.
- Cognitive problem-solving training. This type of therapy is aimed at helping your child identify and change thought patterns that lead to behavior problems. Collaborative problem-solving — in which you and your child work together to come up with solutions that work for both of you — can help improve ODD-related problems.
- Social skills training. Your child also might benefit from therapy that will help him or her learn how to interact more positively and effectively with peers.
As part of parent training, you may learn how to manage your child's behavior by:
- Giving clear instructions and following through with appropriate consequences when needed
- Recognizing and praising your child's good behaviors and positive characteristics to promote desired behaviors
Although some parenting techniques may seem like common sense, learning to use them in the face of opposition isn't easy, especially if there are other stressors at home. Learning these skills will require consistent practice and patience.
Most important in treatment is for you to show consistent, unconditional love and acceptance of your child — even during difficult and disruptive situations. Don't be too hard on yourself. This process can be tough for even the most patient parents.
Feb. 06, 2015
- Oppositional defiant disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Nov. 20, 2014.
- Highlights of changes from DSM-IV-TR to DSM-5. American Psychiatric Publishing. http://www.dsm5.org/Pages/Default.aspx. Accessed Nov. 21, 2014.
- Gabbard GO. Textbook of Psychotherapeutic Treatments. Arlington, Va.: American Psychiatric Publishing; 2014. http://psychiatryonline.org/doi/full/10.1176/appi.books.9781585625048.gg40. Accessed Nov. 21, 2014.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 6th ed. Washington, D.C.: American Psychiatric Publishing; 2014. http://www.psychiatryonline.org/resourceToc.aspx?resourceID=5. Accessed Nov. 21, 2014.
- Facts for families: Children with oppositional defiant disorder. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Children_With_Oppositional_Defiant_Disorder_72.aspx. Accessed Nov. 21, 2014.
- Oppositional defiant disorder guide. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Oppositional_Defiant_Disorder_Resource_Center/Home.aspx. Accessed Nov. 21, 2014.
- Tervo RC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 16, 2014.
- Qaadir A (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 26, 2015.