ADHD & ODD: Confronting the Challenges of Disruptive Behavior

By CHRISTOPHER K. PETERS, MD
University of Louisville | September 9, 2009

Dr Peters is director of training in child and adolescent psychiatry and assistant professor in the division of child and adolescent psychiatry at the University of Louisville.

TREATMENT OUTCOMES IN 3 CASES
In Case 1, adequately treating TJ's ADHD did very little to mitigate the indulgent strategies that his mother used to assuage her own guilt and coercively minimize acute problems. She did not realize that she was impeding TJ's development of self-regulation. Through PMT and individual therapy to help her see the role her own thoughts and emotions played in maintaining her son's behavior, TJ's mother was able to make strides in creating more appropriate limits and boundaries. Although TJ continues to have challenges, he is showing progress.

In Case 2, AT's parents had been struggling with a lack of confidence in their parenting methods, and they responded well to PMT.

In Case 3, JS engaged well with the therapist and began to try out new ways of self-managing his anger and frustration. He also benefited from his mother's response to her own treatment for ADHD.

Although not every case is a success story, with better understanding of the interactional components of ODD, primary care pediatricians can provide more appropriate interventions and will be more likely to elicit the needed change. While the major goal of working with disruptive patients is to enhance their own self-confidence in managing impulses and negative emotions, this cannot occur without working with the context within which these children live—that is, their families.

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ADHD & ODD: Confronting the Challenges of Disruptive Behavior

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