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.).
| 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 |
|
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.
| 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:
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
