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ow to Manage Oppositional Defiant Disorder
How to Manage Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a mental health condition affecting children and adolescents. There is a persistent pattern of angry or irritable mood, argumentative or defiant behavior, and vindictiveness toward authority figures. Children and adolescents with ODD often rebel, are stubborn, argue with adults, and refuse to obey. They may also intentionally annoy or upset others, blame others for their mistakes or misbehavior, and say mean or hateful things when upset. 

Problems from ODD

ODD can cause severe problems with family life, social activities, school, and work. It can also increase the risk of developing other mental health disorders, such as conduct disorder, attention-deficit/hyperactivity disorder (ADHD), substance use disorder, or depression. 

The Causes

The exact cause of ODD is not known. Genetic, biological, and environmental factors may play a role. Some possible risk factors include:

  • A family history of ODD or other mental health disorders
  • A temperamental or difficult personality
  • Having problems with brain development or functioning
  • Experiencing stress, trauma, abuse, neglect, or instability in early childhood
  • Poor parenting practices, such as lack of supervision, inconsistent or harsh discipline, or low warmth and involvement
  • Having difficulties in school, such as learning disabilities, bullying, or peer rejection

Psychological Exam

A mental health professional will conduct a comprehensive psychological evaluation to diagnose ODD. The review will assess the child’s overall health, behavior in multiple settings, and other possible mental health problems. The diagnosis of ODD comes from the presence of at least four symptoms from any of the following categories for at least six months: 

  • Angry or irritable mood: often loses temper, is frequently touchy or easily annoyed by others, is often angry or resentful
  • Argumentative or defiant behavior: often argues with adults or people in authority, actively defies or refuses to follow adults’ or rules, annoys or upsets people on purpose, blames others for their own mistakes or misbehavior
  • Vindictiveness: says mean and hateful things when upset, tries to hurt the feelings of others, and seeks revenge.

The Symptoms

The severity of ODD can be mild (symptoms occur only in one setting), moderate (symptoms occur in at least two sets), or severe (symptoms occur in three or more settings). 


Treatment of ODD involves different psychotherapies and parental training to help the child and the family learn skills to manage the child’s behavior and emotions. Some of the standard treatment options include:   

  • Parental training: teaches parents how to set clear rules and expectations, provide consistent and positive reinforcement, use effective discipline strategies, and improve communication and problem-solving skills
  • Parent-child interaction therapy (PCIT) provides parents with live coaching on interacting with their children in a positive and supportive way.
  • Family counseling: helps the family and the child cope with stress, express feelings more healthily, and improve relationships
  • Cognitive behavioral therapy (CBT) helps the child identify and change negative thoughts and behaviors that contribute to ODD symptoms.
  • Social skills training: helps the child improve social interactions and communication skills


In some cases, prescriptions treat co-occurring conditions that affect ODD symptoms, such as ADHD, anxiety, or depression. However, medication alone is not sufficient to treat ODD. In some cases, behavioral therapy or psychotherapy is necessary.ODD can be a challenging condition for both children and parents. However, with proper diagnosis and treatment, it is possible to reduce ODD symptoms and improve the quality of life for the whole family. Since it usually stems from a much deeper problem, finding a family or Christian counselor may help you identify the root. Contact Triangle Learning Center or Focus on the Family for family counseling recommendations.