Treating oppositional defiant disorder in primary care: a comparison of three models.
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.
Lavigne
John V
JV
Department of Child and Adolescent Psychiatry (#10), Children's Memorial Hospital, Chicago, IL 60614, USA. jlavigne@childrensmemorial.org
Lebailly
Susan A
SA
Gouze
Karen R
KR
Cicchetti
Colleen
C
Pochyly
Jonathan
J
Arend
Richard
R
Jessup
Bryn W
BW
Binns
Helen J
HJ
D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy; D001638:Bibliotherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004493:Education; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010287:Parent-Child Relations; D010552:Personality Assessment; D011320:Primary Health Care; D012017:Referral and Consultation