Occasional defiant behavior is commonplace in children and teens. But when such behavior occurs to a degree that is frequent, developmentally inappropriate, and leads to functional impairment in major life activities or harm to affected youth, a child or teen may have Oppositional Defiant Disorder (ODD). Defiant behavior is among the leading reasons for referral of children and teens to child mental health professionals and is a major cause of parental distress in raising children. This workshop will first discuss the nature of ODD as a two-dimensional condition (emotional dysregulation, social conflict) that arises both directly and indirectly out of the interplay of four major factors. The four factors are described in some detail along with the reciprocal nature of parent-child interactions involving noncompliance and defiance and the important role played by negative reinforcement in generating, sustaining, and even escalating the frequency and severity of such interactions through a process of family social coercion. The implications of this model for the management of child defiant behavior and parent-child conflicts will be discussed.
The workshop will then cover Dr. Barkley’s two parent training programs for managing ODD, Defiant Children which applies to children 2-12 years of age, and Defiant Teens, which is better suited to youth 14 years of age or older. He will discuss each of the steps or methods involved in these two family training programs, how they are to be implemented, and what are the most common problems likely to be encountered in training families in these methods. Participants will be provided with a copy of the two published training manuals for use as handouts to this workshop. These manuals contain information about ODD and especially step-by-step instructions on how clinicians are to implement each session of the program. Handouts given to parents as part of this program are also included in these manuals and can be photocopied for use with families in the professional’s clinical practice.
After completing this lecture, professionals will be able to:
• Understand the nature of defiant, oppositional, or noncompliant behavior in children and teens
• Describe the four major factors that contribute to such behavior, known as the four-factor model of defiant behavior
• Appreciate the implications of this model for evaluating children with this behavior pattern.
• State the treatment implications that arise from an understanding of this model
• Understand each of the steps in each program (Defiant Children,DefiantTeens), how they are to be implemented, and issues that may arise in doing so with particular families.
This workshop is adapted from Dr. Barkley’s books, Defiant Children: A Clinician’s Manual for Assessment and Parent Training. New York: Guilford Press, 2012; and Defiant Teens: A Clinicians Manual for Family Training (2nd ed.), NY: Guilford Press, 2013.