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Rule Breaking, Defiance, & Acting Out

Created on August 5, 2017. Last updated on March 29th, 2021 at 06:01 pm

Take me to the effective therapies for disruptive behavior problems

Rule breaking and “acting out” are some of the signs of child and adolescent disruptive behavior problems.

What are Disruptive Behavior Problems?

Children and teens with disruptive behavior problems may act in ways that are upsetting or troubling. This can include stealing, fighting, not doing what has been asked of them, or lying. These problems may also get in the way with a child’s ability to learn or interact with the people around them.

Parents often become worried about these problems, because they can upset family life. These behaviors can also lead to problems at school, and even cause trouble with the police.

Oppositional defiant disorder (ODD) and conduct disorder (CD) are the two main disruptive behavior disorders and cover many problem behaviors.

Effective Therapies for Disruptive Behavior Problems

Parent behavior therapy with child participation and group parent behavior therapy are two effective treatments for disruptive behavior problems in children. For adolescents struggling with these problems, a combination of strategies from behavioral therapy, CBT, and family therapy and particular forms of CBT alone have been shown to be effective.

Listed in the chart below are many treatments for each of these disorders. Although the therapies listed within each treatment have been scientifically evaluated for their effectiveness in treating disruptive behavior disorders, they can often be used to treat individual problem behaviors (e.g., aggression, disregard for rules, etc.).

 

Tested Therapies for Adolescents
Level 1: Works Well Combined Behavioral Therapy + CBT + Family Therapy Examples:

Multisystemic Therapy (targeting youth involved in juvenile justice system)

Treatment Foster Care Oregon (TFCO); formerly Multidimensional Treatment Foster Care (MTFC) (targeting youth involved in juvenile justice system)

Level 2: Works  

CBT

 

Examples:

Aggression Replacement Training + Positive Peer Culture (Equipping Youth to Help One Another) (targeting youth involved in juvenile justice system)

Solution-Focused Group Program (targeting youth involved in juvenile justice system)

Level 2: Works Combined Behavioral Therapy + CBT + Family Therapy Examples:

Functional Family Therapy (targeting youth involved in juvenile justice system)

Multisystemic Therapy

Level 3: Might Work Behavioral Therapy or Parenting Skills Examples:

Familias Unidas

Non-Violent Resistence

Level 3: Might Work CBT Examples:

Cognitive Mediation (targeting youth involved in juvenile justice system)

Level 3: Might Work Combined Behavioral Therapy + CBT Examples:

Rational-Emotive Behavior Therapy

Support to Reunite, Involve, and Value Each Other

Level 4: Experimental Behavioral Therapy or Parenting Skills Examples:

Behavior Management Training + Problem-Solving Communication Training

Parenting with Love and Limits

Triple P Teen (Self-Directed Enhanced with Phone Consultations)

Level 4: Experimental CBT Examples:

Aggression Replacement Training (Learned Resourcefulness) (targeting school/classroom disruption)

Anger Management + Think Good, Feel Good (targeting school/classroom disruption)

Assertive Training (targeting school/classroom disruption)

Cognitive-Behavioral Therapy

Cognitive Training + Phone Coaching / RealVictory Program (targeting youth involved in juvenile justice system)

Juvenile Cognitive Intervention (targeting youth involved in juvenile justice system)

Juvenile Probation Services Intervention (targeting youth involved in juvenile justice system)

Life Skills (Psychoeducation) (targeting youth involved in juvenile justice system)

Mindfields (targeting youth involved in juvenile justice system)

Multi-Family Group Counseling (targeting school/classroom disruption)

Rational-Emotive Mental Health Program

Level 4: Experimental Family Therapy Example:

Brief Strategic Family Therapy

Level 4: Experimental Mentoring Example:

Monitored Youth Mentoring Program (targeting school/classroom disruption)

Level 4: Experimental Combined Behavioral Therapy + CBT Examples:

Anger Control Training with Contingency Management

Anger Management for Female Juvenile Offenders (targeting youth involved in juvenile justice system)

Dialectical Behavior Therapy

Dialectical Behavior Therapy – Corrections Modified (targeting youth involved in juvenile justice system)

Dialectical Behavior Therapy – Skills Training Only

Motivational Interviewing + Solution-Focused Counseling + Behavioral Shaping

Parent Management + Problem-Solving + Cognitive Behavioral Therapy

Level 4: Experimental Combined CBT + Mindfulness Example:

Meditation on the Soles of the Feet

Level 4: Experimental Combined Behavioral Therapy + Attachment-Based Therapy Examples:

Connect Program

Multiple-Family Group Intervention (targeting youth involved in juvenile justice system)

Level 4: Experimental Combined Family Therapy + Emotionally Focused Approaches Example:

Family-Centered Treatment (targeting youth involved in juvenile justice system)

Level 4: Experimental Combined Behavioral Therapy + CBT + Family Therapy Examples:

Integrated Families and Systems Treatment

Treatment Foster Care Oregon (TFCO); formerly Multidimensional Treatment Foster Care (MTFC) + Trauma-Focused CBT (targeting youth involved in juvenile justice system)

Level 4: Experimental Combined Behavioral Therapy + CBT + Wrap-around Example:

Parenting with Love and Limits—Re-entry (targeting youth involved in juvenile justice system)

Level 5: Tested and Does Not Work Behavioral Therapy or Parenting Skills Examples:

Positive Family Support-Family Check-Up (formerly Adolescent Transitions Program)

Contingency Management

Relaxation Breathing Exercise

Level 5: Tested and Does Not Work CBT Examples:

Motivational Interviewing (Personal Aspiration and Concerns) (targeting juvenile justice system)

Positive Life Changes

SafERteens

Level 5: Tested and Does Not Work Psychodynamic Example:

Human Relations Training

Level 5: Tested and Does Not Work Combined Behavioral Therapy + CBT Examples:

Aggression Replacement Training + Token Economy (targeting youth involved in juvenile justice system)

Anger Control Training with Behavior Management

Level 5: Tested and Does Not Work Combined Humanistic + Bibliotherapy +Psychodynamic + CBT Example:

Counseling Intervention (targeting school/classroom disruption)

 

To find out more about how these treatment levels are defined, click here.

 

Tested Therapies for Children
Level 1: Works Well Group parent behavior therapy Examples:

Incredible Years Basic

Parent Management Training Oregon (PMTO)

Communication Method program (COMET)

Triple P (Level 4)

Level 1: Works Well  

Individual parent behavior therapy with child participation

 

Examples:

Behavioral parent training

Parent Management Training Oregon (PMTO)

Oregon Social Learning Center program (OSLC)

Social learning parent training (Hanf model)

Abbreviated Parent-Child Interaction Therapy (PCIT)

Parent Management Training

Standard Behavioral Family Intervention (Triple P Precursor)

Level 2: Works Group parent behavior therapy + group child behavior therapy Examples:

Stop Now and Plan (SNAP) Under 12 Outreach Program

Incredible Years Basic + Dinosaur School

Level 2: Works Group parent behavior therapy with child participation + Family problem solving training Example:

Multiple Family Group

Level 2: Works Group parent behavior therapy with child participation Example:

Group Parent-Child Interaction Therapy (PCIT)

Level 2: Works Individual parent behavior therapy Example:

Brief Parent Management Training Oregon (PMTO)

Level 2: Works Individual parent behavior therapy with child participation + individual child behavior therapy with parent participation + teacher training Example:

First Step to Success

Level 2: Works Self-directed parent behavior therapy Examples:

Every Parent

Communication Method program (COMET)

Therapy program for children with hyperkinetic and oppositional problem behavior (THOP)

1-2-3 Magic

Individually administered videotape modeling parent training program (IVM; Incredible Years Precursor)

Incredible Years Precursor

Self-Directed Behavioral Family Intervention

Level 2: Works Group child behavior therapy Example:

Incredible Years Dinosaur School

Level 2: Works Group child behavior therapy + teacher training Example:

Incredible Years Dinosaur School + Teacher Training

Level 2: Works Individual child behavior therapy Example:

Problem Solving Skills Training

Level 2: Works Individual child behavior therapy with parent participation Example:

Problem Solving Skills Training with in vivo practice

Level 2: Works Group parent-focused therapy Example:

Tuning Into Kids

Level 2: Works Group child-centered play therapy Example:

Group Activity Play Therapy

Level 2: Works Individual child-centered play therapy Example:

Alderian Play therapy

Level 3: Might Work Group parent behavior therapy + individual parent behavior therapy with child participation + group child behavior therapy + individual child behavior therapy Example:

Project TEAM

Level 3: Might Work Group parent behavior therapy + group parent-focused therapy Example:

Rational Positive Parenting Program

Level 3: Might Work Group parent behavior therapy + teacher training + group child behavior therapy Example:

Incredible Years Basic plus Teacher Training plus Dinosaur School

Level 3: Might Work Group parent behavior therapy + teacher training Example:

Incredible Years Basic plus Teacher Training

Level 3: Might Work Individual parent behavior therapy with child participation + addressing parental mental health needs Example:

Enhanced Behavioral Family Intervention

Level 3: Might Work Teacher training Example:

Incredible Years Teacher Training

Level 4: Experimental Family problem-solving training Example:

Collaborative & Proactive Solutions

 

To find out more about how these treatment levels are defined, click here.

Source(s): McCart, M. R., & Sheidow, A. J. (2016). Evidence-based psychosocial treatments for adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 45(5), 529-563. https://doi.org/10.1080/15374416.2016.1146990

Kaminski, J. & Claussen, A. (2017). Evidence based update for psychosocial treatments for disruptive behaviors in children. Journal of Clinical Child and Adolescent Psychology, 46(4), 477-499. https://doi.org/10.1080/15374416.2017.1310044

Partner Sites:

Evidence-based Services Committee of Hawaii