Oppositional Defiant Disorder & Conduct Disorder

OPPOSITIONAL DISORDER & CONDUCT DISORDER: TREATMENT, PREVENTION AND WHAT PARENTS CAN DO
Written by Alex Childress, Intern

Many children and teens display many of the symptoms of ODD and CD at times, but there are some ways to tell whether your child suffers from the disorder. (Click here if you need a description of the symptoms of ODD and CD.) If these behaviors disrupt social and/or academic functioning, and are consistent (do not only happen as a result of an “episode” or mood swing), your child could be diagnosed with ODD. As a parent, you may see some signs that you are dealing with a child or teen with ODD, such as the feeling that you must always be on your toes to avoid an outburst, these behaviors are creating problems in the family, or setting boundaries and consequences does not stop the behavior.

There are many causes of ODD, including biological defects, genetics, and environmental influences such as dysfunctional families and a history of substance abuse. Before taking any action, it is important that a psychologist determines whether your child actually has ODD and identifies what types of treatment to use.

Since there are many similarities between the symptoms of ODD and conduct disorder, it is important that a psychologist determine how serious the symptoms are. Both disorders include defiance, difficulty in school, disobedience, anger and resentment, and disrespect for brothers and sisters. However, one thing a psychologist may look at to differentiate between the two is how the child or teen treats animals. If he or she is cruel or physically abusive family pets, conduct disorder may be the more likely diagnosis. Legal trouble is another indicator of the more serious conduct disorder rather than ODD. Multiple instances of criminal behavior like setting fires, breaking and entering and assault are consistent with a diagnosis of conduct disorder.

Although a psychologist should implement the treatment, parents are often the most effective resource in helping their children deal with ODD and conduct disorder. The most important thing for a parent to remember is never to give up on your child or yourself and to realize that sometimes it is necessary to change some of your own behaviors in order to change your child’s. For example, always be supportive and understanding, and praise and reinforce positive behaviors. Your child’s psychologist can help you determine ways you can be most helpful and be part of the solution. A psychologist can teach you additional skills to elicit cooperation, including setting appropriate limits and developing effective intervention plans. Some helpful tips for parents of children with ODD and conduct disorder include:

• Always focus on positive rather than negative behavior; give positive reinforcement when your child exhibits cooperation or obedience
• Set reasonable, age-appropriate boundaries and be consistent when enforcing them. For example, if your child refuses to do his or her chores, punish the behavior in the same way every time.
• Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child.
• Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”
• Don’t take on the burden of managing your child by yourself; try to get help and support from other adults in the child’s life like your spouse, teachers and coaches. Maintain your other interest so that your child’s ODD doesn’t consume all your time and energy.
• Manage your own stress with exercise and relaxation.
• Make sure your child gets plenty of sleep every night.
• Develop a consistent daily schedule that incorporates your own and your child’s interests, and get into a routine.
• Work with your child to pinpoint the emotions or anxiety that may be maintaining or worsening their symptoms.
• Encourage your child to join extracurricular activities or get exercise to provide an outlet for pent-up energy and stress.

Prevention is a key aspect of the treatment of disruptive behavior disorders such as ODD and conduct disorder. Parents can be instrumental in preventing the disorder from progressing by using parent management strategies recommended by a clinician. Children and adolescents can benefit from psychoeducational programs that help them deal with conflict and regulate their emotions and behaviors effectively. In children, parent management, social skills training, conflict resolution and anger management have been used as effective prevention methods. For adolescents, psychoeducation programs like cognitive interventions and skills training, vocational training and academic preparations can reduce some of the symptoms associated with ODD and conduct disorder.

When choosing an intervention plan, take into account the recommendations of a psychologist because making the wrong decision could be more detrimental than beneficial. For example, residential programs like boot camp are not the right choice for many children and teens. These programs may be overly restrictive and may not enhance your child’s sense of self-esteem and responsibility. School-based programs have showed promising results as well in reducing bullying, antisocial behavior and negative peer influence.

There are several effective methods of treatment for disruptive behavior disorders such as ODD and conduct disorder. Treatment programs should be designed by a psychologist and specialized to each individual child and family’s needs. It must last at least several months to be effective and can occur either continuously or in periodic sessions. Treatment may include individual therapy, family therapy and/or school-based intervention. Sometimes medication is used as part of a treatment plan, but it is rarely effective without being paired with behavioral therapy.

• Cognitive-behavioral therapy (CBT) is a treatment technique that involves changing a person’s thoughts and beliefs in order to change his or her problematic behaviors. CBT is a general term for several different types of therapies that meet these criteria. Previous research has proven it and effective and cost-efficient method for treating ODD and conduct disorder. It can be administered to individuals or to groups.
• Individual therapy
• Family therapy
• Community-based therapy – focus on the child or adolescent in the context of different environments. These include family, school and community influences.
• Social skills training

Lepage Associates offers an extensive list of services geared toward children and adolescents. We provide unique options for adolescents, including a media room that allows teens to express themselves using movie clips, CDs or other media. Some may prefer to sit outside during therapy or take a walk on the America Tobacco Trail that backs up to the office. Our therapists specialize in many aspects of counseling for teenagers, including self-esteem and self-improvement, building positive relationships with friends and family, regulating and understanding emotions, and adjusting to the pressures of school.

The clinicians at Lepage Associates also believe children respond to different methods of therapy and a variety of environments, depending on their individual needs. “Play and talk” therapy for children help them develop social and problem-solving skills, expressing emotions in positive ways and adjusting to school among others. We provide services for both children and parents directed at dealing with childhood disorders, specifically ODD and how to manage it a home and at school.

The therapy, coaching and consulting that Lepage Associates’ clinicians provides to parents can be beneficial in educating them about their child or teen’s disorder and empowering them to help their child or teen help themselves. Meeting with one of the psychologists who specializes in parenting children or adolescents with psychological disorders will equip parents of children with ODD and conduct disorder with the skills to manage it. Early and targeted therapeutic intervention with the child or teen can be quite effective in eliminating the behaviors and helping your child or teen be a happy and symptom-free.

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