Oppositional Defiant Disorder Specialists: Online & In-Person Treatment

Oppositional Defiant Disorder (ODD) is a mental health condition defined by a pattern of angry or irritable mood, argumentative or defiant behavior, and vindictiveness. Symptoms must exist for 6 or more months, for a diagnosis to be made. Symptoms can affect a child’s social life, school life and home life. This condition is typically diagnosed in childhood, but sometimes in adolescents. ODD often precedes the development of conduct disorder. Rittenhouse Psychiatric Associates has child and adolescent mental health specialists, who are able to evaluate children and adolescents for this condition, and discuss treatment options with both the child, and their families.

What is Oppositional Defiant Disorder (ODD)?

Oppositional Defiant Disorder (ODD) has an estimated prevalence between 1 and 10% of children and adolescents in the US. It may be more prevalent in men than women, particularly before adolescents. Evaluation and treatment by a mental health professional is important, not only because of the distressing symptoms that a child or adolescent experiences, but also because there’s a high comorbidity of ODD with other very treatable mental health conditions. In order to adequately treat ODD, other mental health conditions need to also be diagnosed and managed by a skilled mental health professional.

Oppositional Defiant Disorder has high comorbidity with:

• Impulse Control Disorders
• Attention Deficit Hyperactivity Disorder (ADHD)
• Intermittent Explosive Disorder
• Substance Use Disorders
• Major Depressive Disorder
• Disruptive Mood Dysregulation
• Bipolar disorder
• Anxiety Disorders

ODD Symptoms

Symptoms of Oppositional Defiant Disorder, can be broken down into three categories.

1. Angry/ irritable mood: Characterized by frequent loss of temper, being easily annoyed or sensitive, frequently being angry or resentful.
2. Argumentative/ defiant behavior: Characterized by frequent arguing with authority figures (such as adults), refusal to comply (or frequently defies) requests from authority figures. Frequent rule breaking.
3. Vindictiveness: Acts out of spite, or in a manner that is vindictive.

ODD in Children & Adolescents

Children and adolescents with Oppositional Defiant Disorder, are distressed by their condition. Unfortunately, some individuals may label a child with ODD as “a problem child,” or feel that they are purposefully rule breaking or engaging in other problematic behavior. However, this condition causes children and adolescents to feel a great deal of distress, and frequently has a negative impact on self-confidence, friends, academic achievement and relationships both within, and outside of, the family. With ODD being co-morbid with several conditions such as ADHD, anxiety and depression, it’s important to label the symptoms as an illness (and to seek treatment) – as opposed to further ostracizing the child.

Untreated ODD and Conduct Disorder

Oppositional Defiant Disorder, particularly untreated ODD, can lead to a higher risk of a diagnosis of Conduct Disorder later in life. Conduct Disorder is characterised by a persistent pattern of behaviors,that violate the basic rights of others, or defy societal norms.

Symptoms of Conduct Disorder may include:

1. Aggression to People and Animals (Bullying, use of weapons, sexual misconduct)
2. Destruction of Property (fire-setting, other destruction)
3. Deceitfulness or Theft
4. Serious Violations of Rules (Truancy, running away from home)

Therefore, if symptoms are not properly diagnosed and treated, as an individual ages, the behaviors that may result from these conditions can result in severe personal, occupational, legal and financial implications.

ODD Services Offered at Rittenhouse Psychiatric Associates

Rittenhouse Psychiatric Associates offers evaluations by Child and Adolescent Board Certified Psychiatrists and Psychiatric Nurse Practitioners, who can evaluate your child for Oppositional Defiant Disorder, co-occurring psychiatric conditions that may be clouding the picture, and treat these conditions with medication management and/or psychotherapy. If services are not offered by our clinicians, they can also make appropriate recommendations for referrals, and coordinate care with those providers. They will also coordinate care with your pediatrician and school. They can also help to write and implement IEP / 504 plans, to increase a child’s likelihood of success.

Diagnostic & Specialized Services

Mental Health Evaluation Services

Psychiatric assessments to diagnose your child’s condition, formulate a plan for both treatment and accommodations at school, and collaboration with school, pediatricians and other providers to increase the likelihood of success.

Specialized Therapeutic Services

Providers may additionally utilize family therapy, Cognitive Behavioral Therapy (CBT), parent coaching and education, motivational interviewing, and other types of therapy, in conjunction with medication management, for the treatment of ODD.

Medication Management in ODD Treatment

Types of Medications

As listed above, Oppositional Defiant Disorder co-occurs at high frequencies with other mental health conditions (such as anxiety, depression, bipolar disorder, ADHD and substance use disorders).

The providers at Rittenhouse Psychiatric Associates are able to not only treat ODD, but also co-existing mental illness with appropriate medications, whether they be SSRIs or other anti-depressants for anxiety or depression, mood stabilizing medications or neuroleptics for bipolar disorder, or ADHD medications such as stimulants (when appropriate) or non-controlled options for ADHD.

ODD Resources

American Academy of Child and Adolescent Psychiatry: Oppositional Defiant Disorder Resource Center.