When someone has oppositional defiant disorder (ODD), conduct disorder, intermittent explosive disorder or another type of disruptive behavior disorder, they will require mental health treatment from an experienced professional. With a concerted effort from therapists, educators, psychiatrists and parents, someone with a disruptive behavior disorder can achieve symptom reduction and relief.
Fortunately, there are a variety of strategies and therapies which focus on the client, parents and school that can improve the life of someone with a disruptive behavior disorder. By experimenting with a combination of the following treatments, a person with a disruptive behavior disorder may find the stability they seek.
Client-focused treatments modify the signs and symptoms of a disruptive behavior disorder by directly addressing the person with the disorder. The goal is to foster more appropriate actions in the individual. In client-focused treatments, the person meets with a therapist individually or in a group therapy setting to learn needed skills. Some coping skills taught in client-focused treatments may include relaxation and anger management skills, among others.
Cognitive Behavioral Therapy
More commonly known as child behavior therapy when used to address disruptive behavior disorders, cognitive behavioral therapy (CBT) is one of the most common client-focused interventions used to treat behavioral health conditions. To improve client behaviors, a CBT therapist will use techniques like:
- Modeling: Displaying the type of actions they would like the client to mirror
- Role-play: Helping clients develop communication and coping skills by playing the part of other people in therapy sessions
- Behavior charts: Identifying desired behaviors and rewarding the occurrence of these behaviors visually with a chart to improve the child’s chances of practicing these behaviors
Younger children with disruptive behavior disorders may benefit from play therapy. During play therapy, children play with toys like puppets, sand trays, dolls and blocks to express ideas they may have trouble explaining with words.
In play therapy, the role of the therapist is to:
- Provide the child with positivity and warmth
- Help the child communicate and process their thoughts and feelings
- Offer safety and encouragement
The goal of the relationship between the therapist and the child is to improve and decrease unwanted behaviors and symptoms.
Since disruptive behavior disorders frequently begin during childhood, people with these conditions spend a significant amount of time in school. By utilizing school-focused treatments, school personnel can help decrease disruptive behaviors.
School-focused treatments will use many of the same techniques used in client-focused treatments. However, they are applied to a classroom setting instead of on an individual basis.
Teachers and other school staff typically use three primary interventions as part of school-wide positive behavioral supports:
- Classroom Management: Teachers aim to create a classroom environment based on rewards, support and understanding while promoting emotional awareness and social skills. With effective classroom management, teachers respond to aggression or acting out in ways that diffuse, rather than escalate, the situation.
- Tutoring: Students with behavioral disorders tend to struggle academically, which could result in less interest in school and increased acting out. By using tutoring, the client can improve their grades and self-esteem.
- School-Wide Behavior Plans: Beyond the classroom, school-wide plans can establish consistency for the child. These plans should include clear consequences for unwanted behaviors, clear rewards for desired behaviors and carefully planned team responses for students with more problematic needs.
Along with client-focused and school-focused treatments, parent-focused treatments round out comprehensive therapeutic approaches for someone with a disruptive behavior disorder. Parent-focused treatments work to teach parents useful skills and techniques to manage the behaviors of their child.
Parent-focused treatment may occur in the home or a therapist’s office. They may involve the entire family or the parents only. Disruptive behavior disorder treatments for parents may include:
- Psychoeducation: Parents learn about disruptive disorders and effective behavioral modification techniques to help their child.
- Parent Training: Teaches parents short-term skills to improve the child’s behavior like providing positive attending and attention, ignoring unwanted behaviors, and delivering fair rewards and punishments.
- Parent-Child Interaction Therapy (PCIT): PCIT is an innovative therapeutic approach that combines psychoeducation, parent training and other treatment strategies. During treatment, a therapist observes the interactions between client and parent while offering suggestions and encouragement to the parent through an earpiece without the child’s knowledge.
Parent-focused treatments can also help parents recognize the emotional impact of having a child with a behavior disorder and learn how their moods and actions affect their child’s behaviors. By identifying and regulating their own emotions, parents can create a more stable and supportive home environment for their family.
Although they are not usually used for disruptive behavior disorders, medications may be helpful for instances when symptoms remain despite therapy. Some medication options for disruptive behavior disorders include:
- Stimulants: Psychiatrists and primary care doctors frequently use stimulant medications to treat attention-deficit/hyperactivity disorder (ADHD) in children and adults. There is some indication that these could help with disruptive behaviors as well. Some stimulant medications for disruptive behavior disorders include Adderall, Concerta, Focalin, Metadate and Ritalin.
- Nonstimulant ADHD medications: Nonstimulant medications like Strattera and Intuniv, which are mostly used for ADHD symptoms, may also be prescribed for behaviors linked to ODD, conduct disorder and intermittent explosive disorder.
- Anticonvulsants: Medications like Depakote are typically used to limit seizures, but some professionals also prescribe these to address the aggression characteristic of disruptive behavior disorders.
- Antipsychotics: This class of medicines can help reduce symptoms of disruptive behavior disorders. Using an antipsychotic medication does not mean someone has hallucinations or delusions. Antipsychotics available include options like Abilify, Risperdal and Geodon.
Additionally, a prescriber may recommend medications to treat conditions that commonly co-occur with disruptive behavior disorders, like depression. By addressing these other conditions through medication, symptoms like defiance, anger and aggression can improve.
Additional Tips for Parents
Being a parent is often challenging, but being the parent of a child with a disruptive behavior disorder can be much more complex and frustrating.
To help reduce stress and improve outcomes, parents should:
- Encourage positive behaviors. It’s easy to dwell on all the negatives and unwanted behaviors a child commits. By staying optimistic and encouraging more desirable behaviors, a parent can shift the focus from negative to positive.
- Be clear and consistent. If a parent gives clear expectations while staying consistent with punishments and rewards, a child will have a more stable environment, which tends to result in better behaviors.
- Plan and prepare. Rather than parenting reactively, take time to consider what behaviors your child is likely to engage in and discuss the consequences with those behaviors with them.
- Practice self-care. A parent’s ability to parent effectively decreases when their emotions are high. Using self-care skills can help parents stay calm and level headed.
Additional Disruptive Behavior Disorders Resources and Support
In many cases, no single type of treatment can completely resolve all symptoms of disruptive behavior disorders. Those in need of additional help can connect with resources and supports for disruptive behavior disorders, like:
- Support groups for ODD
- ODD support groups for friends and family
- Conduct disorder forum for parents
- Anger management skills for young men and young women
Professional interventions will always be critical in treating disruptive behaviors. However, adding community or online supports can complement the benefits of other treatments.
Treating Disruptive Behavior Disorder and Co-Occurring Conditions
Managing symptoms of a disruptive behavior disorder and co-occurring condition is a serious undertaking, but concerted efforts from the affected individual, their family, school and mental health professionals can make a positive impact.
Disruptive behavior disorders commonly co-occur with:
To improve symptoms of disruptive behavior disorder and their co-occurring conditions, all conditions must be addressed at the same time, rather than only picking one symptom or one condition to treat. This system is the best path to recovery.
If you are a parent of a child with substance abuse issues in addition to disruptive behavior disorders, or if you have symptoms of addiction and disruptive behaviors, reach out to The Recovery Village. When you do, you will connect to a representative who can provide more information about helpful treatment options available.
Agency for Healthcare Research and Quality. “Treating Disruptive Behavior Disorders in Children and Teens.” August 31, 2016. Accessed on March 30, 2019. American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” 2013. Boston Children’s Hospital. “Treatments for Disruptive Behavior Disorders in Children.” (n.d.) Accessed on March 30, 2019. CHADD. “Disruptive Behavior Disorders.” Accessed on March 30, 2019. HealthyChildren.org. “Disruptive Behavior Disorders.” November 21, 2015. Accessed on March 30, 2019. Kaminski J.W. and Claussen A.H. “Evidence Base Update for Psychosocial Treatments for Disruptive Behaviors in Children.” Journal of Clinical Child & Adolescent Psychology. May 1, 2017. Accessed on March 30, 2019. Parekh, Ranna. “What are Disruptive, Impulse-Control and Conduct Disorders?” American Psychiatric Association, January 2018. Accessed on March 30, 2019. Substance Abuse and Mental Health Services Administration. “Characteristics and Needs of Children with Disruptive Behavior Disorders and Their Families.” 2011. Accessed on March 30, 2019.
Agency for Healthcare Research and Quality. “Treating Disruptive Behavior Disorders in Children and Teens.” August 31, 2016. Accessed on March 30, 2019.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” 2013.
Boston Children’s Hospital. “Treatments for Disruptive Behavior Disorders in Children.” (n.d.) Accessed on March 30, 2019.
CHADD. “Disruptive Behavior Disorders.” Accessed on March 30, 2019.
HealthyChildren.org. “Disruptive Behavior Disorders.” November 21, 2015. Accessed on March 30, 2019.
Kaminski J.W. and Claussen A.H. “Evidence Base Update for Psychosocial Treatments for Disruptive Behaviors in Children.” Journal of Clinical Child & Adolescent Psychology. May 1, 2017. Accessed on March 30, 2019.
Parekh, Ranna. “What are Disruptive, Impulse-Control and Conduct Disorders?” American Psychiatric Association, January 2018. Accessed on March 30, 2019.
Substance Abuse and Mental Health Services Administration. “Characteristics and Needs of Children with Disruptive Behavior Disorders and Their Families.” 2011. Accessed on March 30, 2019.