Introduction
Oppositional Defiant Disorder is one of the most commonly diagnosed mental health conditions in children and adolescents. This site is designed for both families and professionals and is maintained by James Keim, MSW, LCSW, an author and psychotherapist who is focused on oppositional and conduct problems and Director of the Oppositional and Conduct Clinic at the Institute for the Advancement of Psychotherapy.
This site is focused on refinements of the diagnosis, Oppositional Defiant Disorder which are described below. It is assumed that you are already familiar with the concept of Oppositional Defiant Disorder, but if you are not, please visit the page ODD Defined and Refined.
The materials on this website are copyrighted by James Keim. Others are encouraged to use and quote these resources with appropriate attribution.
This site is focused on refinements of the diagnosis, Oppositional Defiant Disorder which are described below. It is assumed that you are already familiar with the concept of Oppositional Defiant Disorder, but if you are not, please visit the page ODD Defined and Refined.
The materials on this website are copyrighted by James Keim. Others are encouraged to use and quote these resources with appropriate attribution.
Oppositional Disorder of the Headstrong Variety (ODD-H)
Oppositional Tendencies (OT)
ODD-H or OT Complicated by Social Disruption
ODD-H and OT tend to occur in the context of normal nurturing, rules and consequences. Because these often require different interventions, they are differentiated as described below. These labels are meant only to guide intervention and, until research clarifies issues of etiology, should not be thought of as being anything more than practical treatment guides.
ODD-H describes problem behaviors that exist despite normal parenting, nurturing, and educational practices. Normal nurturing, rules and consequences are competently given, and other children in the family respond well, but the child in question develops very oppositional tendencies. Normal behavior modification techniques have been competently tried at home and school and have not worked.
OT decribes
ODD-H or OT Complicated by Social Disruption occurs in the context of disrupted nurturing, rules and consequences. For example, a chronic health problem with the child that requires frequent hospitalizations might also disrupt normal routines. In other situations, caretakers might be involved in a ongoing crisis that leads to inconsistent parenting. Type II describes a situation in which, sometimes for reasons beyond anyone's control, normal techniques have not yet been consistently used at home and school.
ODD-H describes problem behaviors that exist despite normal parenting, nurturing, and educational practices. Normal nurturing, rules and consequences are competently given, and other children in the family respond well, but the child in question develops very oppositional tendencies. Normal behavior modification techniques have been competently tried at home and school and have not worked.
OT decribes
ODD-H or OT Complicated by Social Disruption occurs in the context of disrupted nurturing, rules and consequences. For example, a chronic health problem with the child that requires frequent hospitalizations might also disrupt normal routines. In other situations, caretakers might be involved in a ongoing crisis that leads to inconsistent parenting. Type II describes a situation in which, sometimes for reasons beyond anyone's control, normal techniques have not yet been consistently used at home and school.
Rules for Working with ODD-H
Over 25 years of working with oppositional youth and their families and teachers has taught me some important lessons that I would like to share.
Rule One - Take Care of the Caretakers
The best predictor of success in helping children and adolescents past oppositional behavior is the endurance, optimism, and energy levels of the caretakers and teachers. Maintain these during therapy, and all will be on the road to success.
The best predictor of success in helping children and adolescents past oppositional behavior is the endurance, optimism, and energy levels of the caretakers and teachers. Maintain these during therapy, and all will be on the road to success.
Rule Two - Throw Out The "Book of Normal"
For me, the one of the defining characteristics of Type I Oppositional Behavior is that NORMAL RULES AND CONSEQUENCES DON"T WORK. Commonly, families bring in an oppositional boy or girl who actually has been receiving very good parenting with normal rules and consequences, and whose other siblings are doing quite well. The problems are occurring despite the family's and school's doing what is normal, and new approaches are called for.
For me, the one of the defining characteristics of Type I Oppositional Behavior is that NORMAL RULES AND CONSEQUENCES DON"T WORK. Commonly, families bring in an oppositional boy or girl who actually has been receiving very good parenting with normal rules and consequences, and whose other siblings are doing quite well. The problems are occurring despite the family's and school's doing what is normal, and new approaches are called for.
Rule Three - Customize a New Approach for Each Client
The nurturing, reinforcements and consequences that work for one oppositional child or adolescent do not work for the next. For reasons that are not well understood, oppositional cases require families to experiment with creating new and sometimes counter-intuitive approaches.
The nurturing, reinforcements and consequences that work for one oppositional child or adolescent do not work for the next. For reasons that are not well understood, oppositional cases require families to experiment with creating new and sometimes counter-intuitive approaches.
Rule Four - Learning and Communication Differences Should Influence Interventions
Learning and communication differences are often misinterpreted as stubbornness, and these misinterpretations can greatly feed the oppositional cycle. If ODD is suspected, always review a possible contribution of these differences in the way information is interpreted and expressed.
Learning and communication differences are often misinterpreted as stubbornness, and these misinterpretations can greatly feed the oppositional cycle. If ODD is suspected, always review a possible contribution of these differences in the way information is interpreted and expressed.
THIS WEBSITE IS CURRENTLY UNDER CONSTRUCTION, AND MORE "RULES" WILL BE POSTED SOON
