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Oppositional Defiant Disorder

Get Help with Oppositional Defiant Disorder

Uncooperative. Defiant. Hostile. Are these words that describe your child? If so, they may be struggling with Oppositional Defiant Disorder. Some oppositional behavior during adolescence is normal and expected. But there is a difference between an occasionally rebellious child or teen and one who has a consistent drive to defy authority.

Oppositional Defiant Disorder (ODD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as having three categories of symptoms:

Angry/irritable mood

  • Loses temper
  • Touchy/easily annoyed
  • Angry/disrespectful

 

Argumentative/defiant behavior

  • Argues with authority figures/adults
  • Refuses to comply with rules/requests from authority figures
  • Deliberately annoys others
  • Blames others for mistakes

 

Vindictiveness

  • Spiteful
  • Acts out of desire for revenge

 

For a child to be diagnosed with ODD, they must show four or more of the symptoms listed above for more than 6 months. In addition, oppositional defiant disorder symptoms must cause significant problems at home, school, work, and in social settings—the most recent version of the DSM added a criteria rating that placed high importance on this pervasiveness across settings when determining severity.

If you suspect or know that your child has ODD, it is strongly recommended that you also have them psychologically evaluated for other disorders as well. Many children  diagnosed with ODD are also diagnosed with ADHD. Other common co-occurring disorders to look out for are depression, anxiety, or learning/communication disorders.

Oppositional Defiant Disorder Treatment

Although difficult to deal with as a parent, oppositional defiant disorder is one of the most treatable mental health afflictions.

Family therapy and parent coaching have been found to be highly effective forms of treatment. Oppositional Defiant Disorder will often develop in a child predisposed to the illness who is in a home with either too much, or not enough structure. Family therapy and parent coaching are extremely helpful in teaching parents how to adapt their parenting styles to help their child be successful. Popular methods used in family therapy include parent-child interaction therapy, and setting up a behavioral monitoring and reward program system.

Medication is not a recommended form of treatment for ODD. However, since many children with ODD have also been diagnosed with ADHD, many take medication for this co-occurring disorder.

Parent support groups are highly recommended for families raising a child with ODD. Sharing encouragement, frustrations, and successful/unsuccessful strategies with others can be therapeutic and helpful.

Parenting Strategies

Many children with Oppositional Defiant Disorder respond well to adapted parenting strategies. In addition to meeting with a family therapist, try the following with your child:

  • Use positive reinforcement. When your child shows flexibility or cooperation, no matter how small, reward it!
  • If things get too heated, be willing to take a time out. If your child asks to take a time-out from an argument, not only allow it but praise them for recognizing their need for a break.
  • Pick your battles. Listen to your child’s wants, needs and fears. If there is room for compromise or you feel some may be valid, be willing to change your mind and do things their way. But if the issue is non-negotiable to you, draw a line and don’t be deterred by the tantrums.
  • Avoid conflict when you can. Children with ODD thrive on conflict and negativity. Often, they will draw you into a fight not because they care about the outcome, but just for the sake of fighting. If you see this happening, change the subject or walk away.
  • Make a list of rules with rewards and consequences. Communicate these clearly to your child and then stick to them.
  • Use natural consequences when possible. For example, if your teen oversleeps and misses the bus, do not rearrange your schedule to get them to school on time. If they are late, require them to face the consequences, such as detention, and do not take the blame.
  • If you are married, be united with your spouse. Children with ODD are masters at pitting spouses against one another. Whenever a decision regarding your child is made, communicate it to them with a united front.
  • Start every day with a clean slate. No matter what has happened in the past, give yourself and your child a fresh start to rebuild the relationship.