Choosing psychosocial interventions for the treatment of symptoms of oppositional defiant disorder and/or conduct disorder in children or adolescents*

ODD/CD: oppositional defiant disorder and/or conduct disorder.

* Our preference is to treat all individuals with syndromal or subsyndromal symptoms of ODD/CD with an evidence-based psychosocial intervention as first-line treatment. If the child has significant aggression or irritability that requires immediate attention, we typically treat with a combination of psychosocial intervention and pharmacologic management. If comorbid disorders such as attention deficit hyperactivity disorder or major depression are contributing, we treat with an evidence-based treatment for that disorder in addition to psychosocial treatment for ODD/CD.

¶ Behavioral parent management training includes teaching parent skills and techniques such as labeled praise, positive attention, and consequences. Refer to UpToDate content for further discussion on behavioral parent management training.

Δ We consider mild symptoms to cause no more than minimal disruption in interpersonal, family, and academic functioning.

◊ Cognitive-behavioral skills training for youth includes teaching a variety of cognitive or behavioral skills to children or adolescents. Refer to UpToDate content for further discussion.

§ Multisystemic therapy is an intensive form of systemic therapy developed for older youth with more severe forms of oppositional or conduct behaviors. It often includes a family therapy component. Refer to UpToDate content for further discussion.