A transactional model of oppositional behavior: underpinnings of the Collaborative Problem Solving approach.

Oppositional defiant disorder (ODD) refers to a recurrent pattern of developmentally inappropriate levels of negativistic, defiant, disobedient, and hostile behavior toward authority figures. ODD is one of the most common (and debilitating) comorbid disorders within Tourette's disorder (TD). Diverse psychosocial treatment approaches have been applied to children's ODD-related behaviors. In this paper, the authors articulate a transactional developmental conceptualization of oppositional behavior and describe a cognitive-behavioral model of intervention-called collaborative problem solving (CPS)-emanating from this conceptualization. The specific goals of the CPS approach are to help adults (1). understand the specific adult and child characteristics contributing to the development of a child's oppositional behavior; (2). become cognizant of three basic strategies for handling unmet expectations, including (a). imposition of adult will, (b). CPS, and (c). removing the expectation; (3). recognize the impact of each of these three approaches on parent-child interactions; and (4). become proficient, along with their children, at CPS as a means of resolving disagreements and defusing potentially conflictual situations so as to reduce oppositional episodes and improve parent-child compatibility. Summary data from an initial study documenting the effectiveness of the CPS approach (in comparison to the standard of care) are also presented.