So My Kid has Oppositional Defiant Disorder (ODD): Now What?
Maybe you've gone to a psychologist, therapist or social worker and they've given you the diagnosis. Maybe you've Web-MD'ed it and think your child has ODD. Regardless, I'm here to give you the next steps toward your child's healing:
1. Find a child therapist who can provide a more comprehensive assessment.
ODD is not a diagnosis that has much meaning. Ok, so your child is defiant and oppositional. I'm sure you didn't require a professional to tell you that!
A good child therapist will work with great meticulousness to understand and show you why your child is behaving this way. The underlying causes of the defiance are going to bring you toward real solutions. If your child has had an evaluation and the result was, "Well, your child has ODD," you will need a much more comprehensive assessment. You need to understand the meaning and motivation of the defiance in order to find a better balance.
I suggest scheduling consultations with at least 3 therapists before making a final decision on who will do the assessment. Finding a good therapist is sort of like buying new shoes; You don't order them sight unseen and expect a perfect fit! You are looking for a good fit: Does this therapist have experience with families like mine? Do I have the sense that this person can help my child? Does it feel "right" being in their office? Do I like their smile? Trust your gut!
A good child therapist will work extensively with you, the parents, on collecting lots of crucial background information, and they will usually require or strongly suggest that you be involved in sessions ongoing. It is normal to start therapy with many sessions just meeting one-on-one, therapist and parent, before your child even enters the therapy office. A comprehensive assessment will show you why your child struggles with defiance, and it will offer recommendations for next steps.
2. Decide on the type of therapy your child needs.
The assessing therapist may have strong opinions on this, but you, as the parent, need to make an informed decision. Instead of listing different types of therapies (there are many!), I want to give you some questions to ask your child's therapist:
What is the goal of this form of therapy?
How does this therapy accomplish the goal? Can you give me a specific example of how it works?
What can't this form of therapy accomplish?
Will my child be able to benefit from this type of therapy given her developmental level, cognitive ability, and language skills?
Is this therapy evidence-based? (You can check the California Evidence-Based Clearinghouse of Child Welfare- anything with a score of 1, 2, or 3 is generally accepted as evidence-based)
What is your level of training in this model of therapy?
3. Remain a strong, solid support for your child by focusing on your own self-care and receiving support from your community.
Self-care is something a lot of therapists will drone on and on about (myself included). It basically means making yourself a priority and taking care of yourself. There are many dimensions to this, including physical, emotional, social, and spiritual. When your child is struggling, it is easy to put your own needs on the back-burner, so you have the time and energy to deal with the latest crisis. However, your child needs the absolute strongest, healthiest version of you to get through this tough time! The strongest, healthiest version of you requires self-care on a daily basis as well as receiving support from others. Humans are social mammals; we don’t thrive on our own. We require support from other humans. Here are a few examples of supportive activities:
Journaling
Reading affirmations (positive self-statements)
Taking a walk in nature
Accepting a meal train from friends
Asking your employer for a reduction in your work hours or increased flexibility
Gardening
Exercise: dance, yoga, running, sports
Artistic activities
Confiding in a trusted friend
Finding your own therapist or joining support group
Turning off all electronics for a designated time frame
Taking a hot bath with candles
Listening to music or podcasts on a long walk
Danielle Maxon is a Licensed Clinical Social Worker in the State of North Carolina. She has over a decade of clinical experience working with children and families.
In August of 2015 she created her private practice, Under Wing Therapeutic Services, PLLC, which offers attachment-based therapy for parents and children. Danielle specializes in working with gifted, twice-exceptional, and neurodivergent families.