Defiance

What is defiance?

In it's basic form, "Oppositional Defiance Disorder" has specific criteria, according to the DSM-IV, the official book of all mental illnesses. The defiance must interfere with your child's ability to function, first of all, either in school, home, or the community. Secondly, the defiance isn't happening just because of another problem, such as depression, anxiety, or the more serious (and scary) Conduct Disorder. Third, your child's problem behaviors have been happening for at least six months. In these last six months, at least FOUR of the following eight problems have been happening most every day, or almost all the time:

  • Losing temper
  • Arguing with adults
  • Refusing to follow the rules
  • Deliberately annoying people
  • Blaming others
  • Easily annoyed
  • Angry and resentful
  • Spiteful or even revengeful

If your child meets at least four of this criteria, and the rest described above, then he or she technically meets the definition of Oppositionally Defiant. Congratulations - you've got yourself a serious problem, but there's good news: it's treatable. Keep reading.

Is my child defiant?

As parents, we know that kids argue, and they disagree with the rules, and they have bad days every now and then. That's normal. What's not normal is your child arguing, disagreeing, and losing his or her temper virtually all the time. If your child's bad behavior is starting to have a serious effect on school life, your home, the community, friends, family and extended family members, it's quite possible there is significant defiance. Ward will speak with you anytime about what is normal behavior for a child of the same age, and what is not normal, and is no longer acceptable. Ward does not stand for children who break the rules, argue with their parents, fail in school, or hurt others. He works directly with the parents, the school, the police, and anyone else who might be a resource, in order to get things back to normal.

How is it treated?

Ward Halverson is a local expert on treating children with Oppositional Defiance Disorder. If your child struggles with this disorder, you will be in the right hands, and the typical treatment begins with a careful assessment.

Assessment requires that Ward, first of all, take a psychological history and develop a family genogram. That's a sort of picture of the family, like a family tree, that helps put relationships and resources into perspective. All this information is shared with you at any time and the assessment usually takes place in the office.

Afterward, Ward asks questions and listens to you describe what is going on with your child. This is known as the presenting problem. Ward will be most interested in exceptions to the problem, or times when your child is not defiant, and why that may be. He will also ask you a lot about your parenting style, starting way back when your child was a baby. He will ask about school, typical family schedules and routines, and ways that conflict is managed. Ward will try to rule out another mental illness first, in order to focus the right amount of energy and direction on treating the defiance. Other questions will help to fill in the background necessary to get started. This initial assessment might take about 30 minutes.

The next step is to lay out a treatment plan. This might take a couple of sessions. There are several effective and research-proven ways to treat defiance, but - far and above - the best technique of all is known as Parent Management Training, combined with a Behavioral Modification Plan. Although each family is treated uniquely, there are certain qualities to this approach that are the same. With Parent Management Training, most of the energy and work with Ward is directed at the parents. This means he will help you find new ways to manage your child. He will quickly determine your personal strengths, and then help you apply those to the situation. Ward will explain (in his military jargon style) that you are "the tip of the spear" in "the battle that's coming up," but you are not alone. Rather, the entire community stands with you in the difficult process necessary to turn your child around. This includes the local school, the police, the PINS unit and Probation, your extended family, and Ward himself.

In fact, once you "go to Level III" and begin the serious work involved, Ward may ask you to call him every night for a daily check-up. The Behavioral Modification Plan will outline the rules of your home. You will design that yourself, with Ward's help and support. It will also include the rewards your child can earn for following the rules, and the consequences associated with breaking the rules. In those consequences, there will be specific steps to follow to make sure your child is held accountable, learns from mistakes, and is ultimately successful.

Ward will never give up on you, especially during the most difficult and trying times.

Eventually, there will be great progress, and your child will understand that following the rules is a necessary part of life. At this point, Ward will lower the intensity of treatment. You will only come into the office when necessary and only call under certain conditions. After a continued period of success, Ward will "close your case," and terminate officially, but it's important to understand that his services will remain available to you permanently.

How long does it take?

Typical treatment of moderate to severe defiance requires four to five months. Several visits are usually necessary to get background and rule out other concerns, explain the process, answer questions, and get ready. At least one visit is necessary to develop and practice the Behavioral Modification Plan. The intensive treatment that follows usually involves two or three weeks in itself. The "maintenance phase" afterward can last from a month or two to six months, although most families are very happy with the results within six weeks, and termination, the final phase, is just one visit.

What's involved?

The most important thing to understand is that you, the parent, will be asked to do much of the work. You will be asked to look very closely at your management techniques, as well as your frustration tolerance, anger control, and the way you were raised. Ward will probably make the assumption that whatever management is being used right now, at home and elsewhere, isn't working. The nice part is that you can stop doing what doesn't work. Ward will talk with you about completely different ways to deal with your child's defiance, many of which will genuinely surprise you. Over time, you'll start using these techniques at home, you'll see them work, and you'll be ready to try more.

What are your success rates?

This exact treatment, as described above, succeeds 85 - 90% of the time.

Are you serious?

No kidding - Ward is very good at this. He points out again, however, that much of the work depends on the parent's (or parents') willingness to make major changes in the household, work with local authorities, and connect with the school. Even though Ward is deeply involved in the process and sets up all the major interventions, the parent remains "the tip of the spear" and success is ultimately determined there, not just in Ward's office.

How do I get started?

Call Ward Halverson, Child & Family Therapist, at 868-1000. Set up your initial appointment and get ready to change your life, and your child's.