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Oppositional and Defiant Behavior in Children and Teens

One of the most frustrating and challenging experiences for parents is trying to manage the behavior of a child who misbehaves frequently. Sometimes, a child seems incapable or completely unwilling to follow rules, cooperate with adults, or accept any sort of discipline or structure. Other times, a child may go for long periods without an episode of oppositional behavior, and then, either due to a small trigger or for no apparent reason, break significant rules, use abusive language with others, or in some way act out.

What Causes Oppositional and Defiant Behavior?

There is no single factor used to predict whether a child will develop oppositional behavior, and many different factors may contribute to children acting out. Children who have a history of abuse, neglect, or trauma may exhibit oppositional behavior as a response to their experiences. Experiencing any kind of traumatic event increases a child's likelihood of acting out, as they must cope with challenging feelings, thoughts, and memories. In some children a chemical issue may be present; women who abuse drugs or alcohol during pregnancy increase the odds of oppositional behavior in their children. For others, oppositional behavior may be the symptom of an underlying mental health condition. Oppositional behavior may also develop when parents do not succeed in teaching boundaries or other social skills. In some cases there is no identifiable root for a child's oppositional behavior, and this may make treatment more difficult.

Is all Rebellious Behavior Considered Oppositional and Defiant?

It is important to remember that at certain ages, children may be naturally quite rebellious. During adolescence there may be frequent bouts of anger and misbehavior; toddlers also go through a phase of exerting their individuality by being contrary and refusing to follow rules at times. This may be part of a normal individuation process. These behaviors are not diagnosable, although they may be frustrating and certainly require some parental skills with boundaries, compassion, patience, discipline, and communication skills.

Do Defiant Children Feel Remorse?

Often, oppositional children show remorse at least sometimes, and may make promises, ask forgiveness, and seem to try to do better. Some such promises may be manipulative, and some may be sincere. Even so, many children seem to revert to their difficult ways again and again. And, often, oppositional children do not show remorse or promise to do better. Some children seem to have no regard for the consequences of their behavior for themselves or for other people. They may be emotionally numb and quite unhappy. Defiant behaviors are potentially devastating in school, and can be very frustrating at home. Sometimes, infractions of the law can even occur. Left unaddressed, oppositional behavior can escalate into adulthood, where such actions can lead to lasting consequences socially, legally, occupationally, and psychologically. 

Is Oppositional and Defiant Behavior a Mental Diagnosis?

Children who act out often and in a way that disrupts normal functioning may qualify for certain mental health diagnoses, according to the Diagnostic and Statistical Manual (DSM). These diagnoses include: oppositional defiant disorder (ODD) and/or conduct disorder.

Therapy for Oppositional Behavior

Treating a child who exhibits oppositional behavior--especially one who is diagnosed with oppositional defiant disorder--requires addressing all of the factors that are contributing to the child's misbehavior. Most children who exhibit oppositional behavior on an ongoing basis have a difficult time with emotional expression and benefit from learning about emotions. This empowers the child to understand their emotional response and teaches them how to verbally express their feelings rather than relying solely on physical outbursts.

 

Additionally, children who struggle with emotional regulation also usually have trouble controlling their anger. Therefore, anger management therapy can be another useful treatment for these children. Some of the strategies that are taught in anger management, whether in group sessions or individually, include relaxation, goal setting, problem solving, identifying triggers, and recognition of consequences. Individual therapy is another helpful tool for children who cannot maintain control over their behavior. Therapists may use behavior modification techniques, such as rewards and consequences, or may employ play therapy, family therapy, or other techniques depending on their philosophy and the needs of the particular child. They can learn behavior modification and communication skills that allow them to better interact with peers, family members, and authority figures. Children who work individually with a trained therapist also have the opportunity to more deeply explore personal issues that may be contributing to their defiant behavior. 

 

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When a child struggles with oppositional behavior, it can affect the entire family. Therefore, it is critical that the family seek help as well. Family therapy or marriage therapy can be a valuable resource for those people most closely impacted by the defiant behavior. Oppositional behavior can cause stress that has negative consequences on relationships between intimate partners, parents, and siblings. In order to effectively manage oppositional behavior, the entire family must learn healthy and adaptive ways to cope with their own feelings so that they may better support the child they love.

Art and Play Therapy for an Oppositional Foster Child - Case Study

Gerald, 12, is brought to therapy by a foster parent. He is sweet and cooperative much of the time, but just as often he talks back rudely, purposefully breaks rules, sneaks out of the house, speaks angrily to everyone around him, and never takes responsibility for his chores, his words, or his actions generally. His foster mother reports Gerald was neglected by his mother and has been in several foster homes. His current foster family would like to adopt him, but they are worried they will not be able to manage his behavior, which seems to be getting worse. The therapist begins by engaging in play with Gerald--art projects, games, and toy army battles. As the therapist develops a relationship with Gerald, the foster parents are brought into some of the sessions. Gerald is encouraged to write, draw and talk about his experiences in other foster homes, and he is encouraged to communicate these experiences through various means of performance--puppet shows, a play involving everyone in the room, a story with the army men. Soon, Gerald begins to show real trust for his foster parents, his anger becomes more manageable, and his behavior, while far from perfect, improves enough to make adoption possible.

Wild High School Senior - Case Study

Alice, 17, is staying out beyond curfew, cutting school, eating junk food all day, drinking alcohol on weekends, and cursing at her parents if they try to talk to her about any of this. This has gone on all senior year--8 months so far. The parents are at wit’s end, and seek therapy, but Alice will not go. The therapist talks to the parents about their options, all of which seem terrible; do they emancipate her, or continue trying to help her? The therapist explores the couple’s relationship, history, and parenting style, and continues to work with the parents, helping them to manage their own stress, and address some long standing intimacy issues. The parents are amazed to report after a couple of months that Alice is doing better, staying home more. She agrees to enter therapy, and this begins a conversation in which her parents become aware of the many ways they have sent mixed messages to Alice, and Alice becomes aware of the pain she is causing in her family. Her behaviors begin to subside.

 

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Last updated: 09-30-2014

     

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