title: Treating oppositional defiant disorder in primary care: a comparison of three models.
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.
authors.affiliation: Department of Child and Adolescent Psychiatry (#10), Children's Memorial Hospital, Chicago, IL 60614, USA. jlavigne@childrensmemorial.org
authors.forename: John V
authors.initials: JV
authors.lastname: Lavigne
authors.forename: Susan A
authors.initials: SA
authors.lastname: Lebailly
authors.forename: Karen R
authors.initials: KR
authors.lastname: Gouze
authors.forename: Colleen
authors.initials: C
authors.lastname: Cicchetti
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pochyly
authors.forename: Richard
authors.initials: R
authors.lastname: Arend
authors.forename: Bryn W
authors.initials: BW
authors.lastname: Jessup
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Binns
mesh_terms: 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