Oppositional Defiant Disorder, Part 2
Treatment of Choice
Parent management training — in which parents learn to change the way they react to their child’s behavior — is often highly effective in treating ODD. Between weekly sessions, the parents practice what they’ve learned from the therapist and report back on their progress.
“It’s carrots and sticks,” says Brady. “On the carrot end, you work on giving your child praise and rewards for cooperating. On the stick end, you lay out clear consequences for misbehavior.”
Keep the following in mind when starting a parent management training program:
1) Accentuate the Positive
Many parents of oppositional children are so focused on bad behaviors that they have trouble reinforcing positive ones. Yet positive reinforcement is the heart and soul of parent management training.
Instead of yelling at or spanking a child for bad behavior, parents are taught to take a different tack. “The parents are asked by the therapist what to do if they want their child to stop screaming, slamming the door, or throwing breakable objects,” says Alan Kazdin, Ph.D., in Parent Management Training, a manual for therapists. “The answers involve reinforcing talking quietly, closing the door gently, and handling objects with care and not throwing them.”
2) Enthusiasm Counts
Parents should be enthusiastic when praising their ODD child. Specify the praiseworthy behavior and, ideally, include some non-verbal gesture. For example, you might say, “It was wonderful the way you played so quietly while I was on the phone!” and then give your child a kiss.
Tailoring rewards and punishments to your child’s specific abilities and needs is important. But consistency in the way you treat your child — the way you set rules and convey expectations — is the key to cleaning up an ODD child’s act.
Above all, never lose sight of the fact that oppositional kids have a great deal to offer, once their behavior is under control. They’re often bright and engaging, with their own way of looking at the world.
“Once you work through their defiance, there’s a lot there to like,” says Riley.
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