Oppositional Defiant Disorder is a mental health diagnostic term that can be applied by a mental health professional to describe some severely misbehaved youth and children. Although this youngster may be a real handful to manage, this diagnosis is an infinitely more hopeful and workable one than Conduct Disorder, which can appear similar.

In our Breakthrough Strategies to Teach and Counsel Troubled Youth workshop, even many mental health professionals confuse the differences between oppositional defiant disorder (ODD) and conduct disorder (CD). Although there are similarities between these two types of seriously misbehaved youth, some of the ways you work with these kids differ dramatically. In fact, many methods that are essential to work with ODDs are not just ineffective, but dangerous with CDs.

We covered CDs and ODDs in your first ezine issues but here is a very quick recap in case your forgot. ODDs probably have a conscience and remorse, but neither of these seem to be much in evidence. CDs are considered much more severely disturbed, and much more likely to engage in extremely dangerous and/or problematic behavior. By definition, CDs lack meaningful relationship capacity.

Here’s a pop quiz to test your knowledge. Don’t worry, the answers are below.

These questions capture some of the most common misconceptions and questions we constantly hear in class about these two types of hard-to-manage youth. However, the brief answers provided here are absolutely no substitute for mastering how to effectively and safely work with severely acting-out youth and children, so if you want more information, be sure to go to where you can get fast answers: our web site (link is above and below.)

Here’s the quiz:

1. Animal abuse is particularly characteristic of…ODDs or CDs?

2. Evoking remorse is a strategy that should only be used with…ODDs or CDs?

3. There has been a big increase in the number of kids diagnosed as…ODD or CD?

4. ODD leads to CD…or does CD lead to ODD?

ANSWERS:

1. Animal abuse isn’t a litmus test for CD, but some mental health experts believe it almost could be. Animal abuse is tightly correlated with CD.

2. Most mental health experts, though not all, believe that the heart of being a CD is having no heart or conscience. Therefore, evoking remorse in a CD won’t work. Getting that conscience “in gear” is often central to working with ODDs.

3. There has been a big increase in all manner of severe emotional problems over the last few years, especially in younger children. No study has yet revealed the explanation for this general increase but CDs and ODDs are part of this trend. CDs are especially increasing in number, so it is more important than ever to understand this problem and to learn basic mental health terms and concepts even if you are a teacher, after-school program worker, principal, court worker or other professional or para-professional who didn’t really sign up to work with the most seriously disturbed youth and children.

4. ODD does not morph into CD, nor does CD change into ODD. Sometimes a child will be diagnosed as ODD but the therapist may really suspect CD. Because CD is such a serious diagnosis, clinicians are often very deliberate and slow to formally apply that label. This is an appropriate amount of care, but to the non-clinician, it can appear that the child must have changed from ODD to CD, when what really happened is that the clinician was finally able to make a definite determination of CD.

Here’s some key strategies to use with ODDs. Remember: Some of these won’t work with CDs:

* Skill Training: Teach the youth to properly manage his or her fist, mouth and actions. This is critical– especially if the child doesn’t get this training at home: kids can not use skills they haven’t been taught.

* Relationship-Based Approaches: Developing a bond with this child can yield results.

* Activate the Conscience: It is critical to evoke remorse and regret for problem behaviors.

* Consequences Count: They are just one part of the solution but shouldn’t be overlooked. Offer consequences as soon as possible. Be careful about second chances or lightening the consequence.

* Problem Peers: ODDs get into plenty of trouble on their own and need no help from CDs to engage in misbehavior. Keep ODDs tracked to positive peers. Limit their contact with CDs.

* Observe for CD: If you are not a mental health professional, consult one if you feel that your ODD child is so seriously and extremely misbehaved that he or she should be examined for a possible CD diagnosis.

LEARN MORE: You’ve just read only a small portion of the information that youth professionals need to safely and successfully work with oppositional-defiant youth. Come to our workshop or visit our web site to get more of the key information and strategies you must have to work with one the most difficult-of-all youth.

You may also want to visit our web site’s Solution Center for a more extensive version of this article.