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Abstract:
This study examined the efficacy of Collaborative & Proactive Solutions
(CPS) in treating oppositional defiant disorder (ODD) in youth by
comparing this novel treatment to Parent Management Training (PMT), a
well-established treatment, and a waitlist control (WLC) group. One
hundred thirty-four youth (ages 7-14, 61.9% male, 83.6% White) who
fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th
ed.) criteria for ODD were randomized to CPS, PMT, or WLC groups. ODD
was assessed with semistructured diagnostic interviews, clinical global
severity and improvement ratings, and parent report measures.
Assessments were completed pretreatment, posttreatment, and at 6 months
following treatment. Responder and remitter analyses were undertaken
using intent-to-treat mixed-models analyses. Chronological age, gender,
and socioeconomic status as well as the presence of comorbid attention
deficit/hyperactivity and anxiety disorders were examined as predictors
of treatment outcome. Both treatment conditions were superior to the WLC
condition but did not differ from one another in either our responder or
remitter analyses. Approximately 50% of youth in both active treatments
were diagnosis free and were judged to be much or very much improved at
posttreatment, compared to 0% in the waitlist condition. Younger age and
presence of an anxiety disorder predicted better treatment outcomes for
both PMT and CPS. Treatment gains were maintained at 6-month follow-up.
CPS proved to be equivalent to PMT and can be considered an
evidence-based, alternative treatment for youth with ODD and their
families.
