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Journal of Pediatric Psychology Advance Access originally published online on October 23, 2007
Journal of Pediatric Psychology 2008 33(5):449-461; doi:10.1093/jpepsy/jsm074
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Treating Oppositional Defiant Disorder in Primary Care: A Comparison of Three Models

John V. Lavigne, PhD1,2,3, Susan A. LeBailly, PhD1,3, Karen R. Gouze, PhD1,2, Colleen Cicchetti, PhD1,2, Jonathan Pochyly, PhD1,2, Richard Arend, PhD1,2, Bryn W. Jessup, PhD2 and Helen J. Binns, MD1,2,3

1Children's Memorial Hospital, 2Feinberg School of Medicine, Northwestern University, and 3Mary Ann and J. Milburn Smith, Child Health Research Program, Children's Memorial Research Center

All correspondence concerning this article should be addressed to John V. Lavigne, Department of Child and Adolescent Psychiatry (#10), Children's; Memorial Hospital, 2300 Children's; Plaza, Chicago, IL 60614. E-mail: jlavigne{at}childrensmemorial.org.


  Abstract

Objective To determine if a nurse-led or psychologist-led parent-training program was more successful than a minimal intervention in treating early childhood Oppositional Defiant Disorder (ODD) in pediatric primary care. Methods Twenty-four practices were randomized to conditions in which parents of 117, 3- to 6.11-year-olds with ODD received the 12-session Webster-Stratton Incredible Years program led by primary care nurses or clinical psychologists, or to a minimal intervention group in which parents received only the companion book to the treatment program. Results There was improvement across posttreatment and 12-month follow-up for all groups, but no overall treatment group effects. There was a dose effect, with a reliable, clinically significant gain after seven sessions on the Eyberg intensity scale, and nine sessions on the Child Behavior Checklist externalizing scale. Conclusions There is little advantage to the therapist-led treatment over bibliotherapy unless parents attend a significant number of sessions.

Key words: oppositional defiant disorder; parent training; primary care.

Received May 9, 2007; revision received July 13, 2007; accepted August 11, 2007


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