Rule Breaking, Defiance, & Acting Out
Created on August 5, 2017. Last updated on July 12th, 2023 at 09:54 am
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.).
| Level 1: Works Well | Combined Behavioral Therapy + CBT + Family Therapy | Examples:
Functional Family Therapy (targeting youth involved in juvenile justice system) Multisystemic Therapy (targeting youth involved in juvenile justice system) Treatment Foster Care Oregon (formerly Multidimensional Treatment Foster Care) (targeting youth involved in juvenile justice system) |
| Level 2: Works |
|
Examples:
Aggression Replacement Training + Positive Peer Culture (Equipping Youth to Help One Another) (targeting youth involved in juvenile justice system) Preventing HIV/AIDS Among Teens (targeting youth involved in juvenile justice system) Social Cognitive Intervention (targeting disruptive behavior in youth not involved in juvenile justice system) Solution-Focused Group Program (targeting youth involved in juvenile justice system) |
| Level 2: Works | Combined Behavior Therapy + Attachment-Based Approach | Example:
Connect Program (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 2: Works | Combined Behavioral Therapy + CBT + Family Therapy | Examples:
Multisystemic Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 2: Works | Combined CBT + African Cultural Reflective Identity and Life Skill Development + Case Management + Peer Mentoring | Example:
Redemption Reintegration Services (targeting youth involved in juvenile justice system) |
| Level 3: Might Work | Behavioral Therapy or Parenting Skills | Examples:
Parenting Toolkit (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 3: Might Work | CBT | Examples:
Cognitive Behavior Therapy + Phone Coaching (RealVictory Program) (targeting youth involved in juvenile justice system) Cognitive Mediation (targeting youth involved in juvenile justice system) |
| Level 3: Might Work | Combined Behavioral Therapy + CBT | Examples:
Rational-Emotive Behavior Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) Support to Reunite, Involve, and Value Each Other (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 3: Might Work | Combined Behavior Therapy + Family Therapy | Example:
Familias Unidas (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 3: Might Work | Combined Family Therapy + Emotionally Focused Approach | Example:
Family Centered Treatment (targeting youth involved in juvenile justice system) |
| Level 3: Might Work | Combined Behavior Therapy + CBT + Family Therapy | Examples:
Functional Family Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) Non-Violent Resistance (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 3: Might Work | IPT | Example:
Group Interpersonal Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 4: Experimental | Art Therapy | Example:
Integrated Arts Therapy Program (targeting youth involved in juvenile justice system) |
| Level 4: Experimental | Behavioral Therapy or Parenting Skills | Examples:
Behavior Management Training + Problem-Solving Communication Training (targeting disruptive behavior in youth not involved in juvenile justice system) Parenting with Love and Limits (targeting disruptive behavior in youth not involved in juvenile justice system) Parenting Skills Group (targeting school/classroom disruption) Triple P Teen (targeting disruptive behavior in youth not involved in juvenile justice system) Triple P Teen: Self-Directed Enhanced with Phone Consultations (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 4: Experimental | Bibliotherapy | Example:
Bibliotherapy (targeting school/classroom disruption) |
| Level 4: Experimental | CBT | Examples:
Aggression Replacement Training (Learned Resourcefulness) (targeting school/classroom disruption) Anger Coping Program (targeting school/classroom disruption) Anger Management Education Program (targeting disruptive behavior in youth not involved in juvenile justice system) Anger Management + Think Good, Feel Good (targeting school/classroom disruption) Assertive Training (targeting school/classroom disruption) Brief Acceptance and Commitment Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) Cognitive-Behavior Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) Cognitive-Behavior Therapy (targeting youth involved in juvenile justice system) Girls Only Active Learning (targeting youth involved in juvenile justice system) Graduated Successful Community Opportunity Growth (targeting youth involved in juvenile justice system) Hostile Attribution Bias Modification (targeting school/classroom disruption) 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) Problem-Solving Intervention (targeting school/classroom disruption) Rational-Emotive and Cognitive Behavior Education (targeting disruptive behavior in youth not involved in juvenile justice system) Rational-Emotive Mental Health Program (targeting disruptive behavior in youth not involved in juvenile justice system) Responsive-Aggression Regulation Therapy (targeting youth involved in juvenile justice system) SafERteens: Delivered by Therapists Remotely (targeting disruptive behavior in youth not involved in juvenile justice system) Violence Prevention Program (targeting youth involved in juvenile justice system) Williams Lifeskills Training (targeting youth involved in juvenile justice system) |
| Level 4: Experimental | Family Therapy | Example:
Brief Strategic Family Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 4: Experimental | Mentoring | Example:
Monitored Youth Mentoring Program (targeting school/classroom disruption) |
| Level 4: Experimental | Mindfulness | Example:
Mindfulness Training Program (targeting school/classroom disruption) |
| Level 4: Experimental | Combined Behavioral Therapy + Attachment-Based Approach | Example:
Multiple-Family Group Intervention (targeting youth involved in juvenile justice system)
|
| Level 4: Experimental | Combined Behavioral Therapy + CBT | Examples:
Anger Control Training with Contingency Management (targeting disruptive behavior in youth not involved in juvenile justice system) Anger Management for Female Juvenile Offenders (targeting youth involved in juvenile justice system) Dialectical Behavior Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) Dialectical Behavior Therapy – Corrections Modified (targeting youth involved in juvenile justice system) Dialectical Behavior Therapy – Skills Training Only (targeting disruptive behavior in youth not involved in juvenile justice system) Juvenile Justice Anger Management (targeting youth involved in juvenile justice system) Motivational Interviewing + Solution-Focused Counseling + Behavioral Shaping (targeting disruptive behavior in youth not involved in juvenile justice system) Multimodal Treatment Program (targeting disruptive behavior in youth not involved in juvenile justice system) Parent Management + Problem-Solving + Cognitive Behavioral Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 4: Experimental | Combined CBT + Mindfulness | Example:
Meditation on the Soles of the Feet (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 4: Experimental | Combined Behavioral Therapy + CBT + Family Therapy | Examples:
Family-Centered, Feedback-Informed Treatment Program (targeting disruptive behavior in youth not involved in juvenile justice system) Family TIES (targeting youth involved in juvenile justice system) Functional Family Therapy + Intensive Supervision, Psychiatric Support, and Family Mentoring (targeting youth involved in juvenile justice system) Integrated Families and Systems Treatment (targeting disruptive behavior in youth not involved in juvenile justice system) Multidimensional Family Therapy – Outpatient (targeting disruptive behavior in youth not involved in juvenile justice system) Multisystemic Therapy – Emerging Adults (targeting youth involved in juvenile justice system) Treatment Foster Care Oregon (formerly Multidimensional Treatment Foster Care) + 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 | Animal Assisted Therapy | Example:
Teacher’s Pet: Dogs and Kids Learning Together (targeting youth involved in juvenile justice system) |
| Level 5: Tested and Does Not Work | Behavioral Therapy or Parenting Skills | Examples:
Contingency Management (targeting disruptive behavior in youth not involved in juvenile justice system) Family Check-Up (targeting disruptive behavior in youth not involved in juvenile justice system) Parenting with Love and Limits (targeting youth involved in juvenile justice system) Positive Family Support-Family Check-Up (formerly Adolescent Transitions Program) (targeting disruptive behavior in youth not involved in juvenile justice system) Relaxation Breathing Exercise (targeting youth involved in juvenile justice system) |
| Level 5: Tested and Does Not Work | CBT | Examples:
Aggression Replacement Training (targeting youth involved in juvenile justice system) Changing Lives Programs (targeting school/classroom disruption) Engage in Education – London (targeting school/classroom disruption) Motivational Interviewing (Personal Aspiration and Concerns) (targeting youth involved in juvenile justice system) New Perspectives Aftercare Program (targeting youth involved in juvenile justice system) New Perspectives Aftercare Program (targeting disruptive behavior in youth not involved in juvenile justice system) Positive Life Changes (targeting disruptive behavior in youth not involved in juvenile justice system) SafERteens: Delivered by Therapists in Person (targeting disruptive behavior in youth not involved in juvenile justice system) SafERteens: Delivered by Computer (targeting disruptive behavior in youth not involved in juvenile justice system) Think Cool Act Cool Emotion Regulation Training (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 5: Tested and Does Not Work | Psychodynamic | Example:
Human Relations Training (targeting disruptive behavior in youth not involved in juvenile justice system) |
| 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 (targeting disruptive behavior in youth not involved in juvenile justice system) |
| Level 5: Tested and Does Not Work | Combined Behavior Therapy + CBT + Family Therapy | Examples:
Functional Family Therapy – Gang (targeting youth involved in juvenile justice system) Usual Care Family Therapy (targeting disruptive behavior in youth not involved in juvenile justice system) |
| 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.
| 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
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Examples:
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., & Jaramillo, J. (2023). Evidence-based update of psychosocial treatments for adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 52(4), 447-474. https://doi.org/10.1080/15374416.2022.2145566
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
