Incidences of early teens displaying disobedience through such acts as talking back, disobeying or arguing with their teachers, parents and older people, especially during the age of two are common experiences. When such kind of behavior lasts longer than six months, parents should take caution since the child may be suffering from a medical condition known as the oppositional defiant disorder (ODD) (webmed.com).
Oppositional defiant disorder is a medical condition common in children and in which a child shows a continuous pattern of vindictiveness to persons in authority, argumentative or defiant behavior or irritable or angry mood (webmed.com). The behavior expressed by children with ODD affects their normal activities both at school and at home. Children with ODD also have other behavioral conditions such as anxiety disorders, depression (mood disorders), learning disabilities and attention deficit disorders.
There is no single cause of oppositional defiant disorder. According to a study by Ghosh, Abhishek, Anirban Ray, & Aniruddha Basu (2017) categorizes the causes of ODD into psychological factors and etiopathological factors (including individual-level factors, and genetics). WebMD cites brain injuries, genetics and environmental factors as the major causes of ODD.
Katy Winter’s article in the Daily Mail titled, Mother reveals agony of watching toddler daughter self-harm after temper tantrums caused by behavioural problems, presents a case of a child with ODD. Elisa began to show odd behavior and with time the condition worsened when she began to harm herself, biting her arms as a result from her temper tantrums. Her mother, Jenna got worried of her condition despite previously dismissing Elisa as being naughty. On seeing the doctor, Jenna would later be told that Elise had oppositional defiance disorder. The revelation led Jenna enroll Elise for a special education. Jenna confesses that she lived in fear that her daughter would do something worse than the impulsive behavior she had expressed.
The method for treating opposition defiant disorders depend on the factors such as the age of the child with ODD disorder, the seriousness or severity of the symptoms, and the ability of the child to cope with given therapies (webmd.com). There are two major methods used in treating children with ODD: behavioral therapy and medication.
Behavioral therapy is also referred to as psychosocial management or psychotherapy and it involves the utilization of learning theory (Ghosh et al., n.d). Behavioral therapy focuses on assessing functional behavior through the use of a research-validated method called functional behavior analysis. Psychosocial management can further be divided into cognitive behavioral therapy (CBT), a brief strategic family therapy, functional family therapy, parenting/school-based training, and parental management training (PMT) (Ghosh et al., n.d).
The PMT combines differential reinforcement strategies and spending of quality time with the child with ODD with the aim of directing the motivation of the child. The approach concentrates on utilizing the parental skills to shape the behavior of the ODD child. The method is considered very effective with younger children but can also be used with adolescence by applying positive parenting practices model (Triple P) (Ghosh et al., n.d).
Another sub-component of psychotherapy in treating ODD is functional family therapy which is based on the argument that problem behavior has a functional role to play in the family equilibrium. Therefore, modifying the functioning of the family can result in the change of the behavior problem (Ghosh et al., n.d). The same principle that the functional therapy is founded also forms the basis on which strategic family functioning hinges. However, the intervention process is different between the two approaches.
Multisystemic therapy seeks to holistically address problem behavior in children by integrating individual, school, family, and social interventions. The approach aims at addressing all the factors that are responsible for the behavior problem in the child with ODD. In adolescents with ODD, using CBT in different formats is effective. In such cases, anger-coping programs top the list and Coping Power program augments the anger-coping program with the parent component. In children with ODD, the CBT model used incorporates perspective-taking and problem-solving skills training (Ghosh et al., n.d).
Ghosh et al. (2017) note that recent research identifies two methods of treating disruptive behaviors as most effective. The models identified include Treatment Forster Care Oregon (which was originally known as multidimensional treatment foster care) and multisystemic therapy. Gosh et al. (2017) assert that the two approaches are established as the most effective based on many studies conducted that yielded consistent results. Furthermore, the researchers established that anger-control training, which is another CBT-based model, could be used in treating ODD children but its efficacy is questionable as pointed out by latest reviews (Ghosh et al., n.d).
While psychological approaches are the first intervention lines for treating the aggressive and vindictive behaviors in children and young adults, pharmacotherapy can be used too. Psychological interventions are preferred since they do not have side effects. Failure of psychotherapy to manage aggressive behavior in children and younger adults calls for the use of pharmacotherapy to augment psychotherapy. The first option in pharmacotherapy is the treating of comorbid disorders. Should the first option fail, an atypical antipsychotic is added. In some cases, the people with ODD conditions fail to respond to medications. In such circumstances, the medications are usually changed. Some of the medications used in treating ODD include methylphenidate, atomoxetine, chlorinide, and guanfacine (Ghosh et al., n.d).
Of the two methods of treating oppositional defiant disorder, psychotherapy is the better approach since, as pointed out by Ghosh et al., (2017), it does not have side effects.
To sum up, ODD is a medical condition among children where children and young people express aggressive behavior, disobedience and vindictiveness to people with authority. Some of the characteristics of children with ODD include biological factors (associated with brain injuries), genetic factors (coming from families with members suffering from mental illnesses such as personality disorders, anxiety disorders, and mood disorders) and environmental factors. Symptoms of ODD include using obscene language and swearing, seeking revenge and spiteful, making deliberate efforts to upset others, openly and actively disobeying the elder people and the authorities. There are two approaches of treating ODD: psychotherapy and pharmacotherapy. Psychotherapy is the first intervention in treating ODD and has various components such as brief strategic family therapy, cognitive behavior therapy, social awareness and supervision, peer-intermediated interventions and peer-group supports, and parental management trainings. Pharmacotherapy or medication approach is introduced if psychotherapy alone fails. Various medications are used but methylphenidate is the best medication.
Works Cited
"Oppositional Defiant Disorder." WebMD, www.webmd.com/mental-health/oppositional-defiant-disorder#2.
Ghosh, Abhishek, Anirban Ray, and Aniruddha Basu. "Oppositional defiant disorder: current insight." Psychology research and behavior management 10 (2017): 353. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716335/
WINTER, KATY. "Mother's Horror As Three-year-old Daughter Self-harms." Mail Online, 17 Dec. 2013, www.dailymail.co.uk/femail/article-2525129/Mothers-horror-toddler-daughter-begins-self-harm.html.
