Treating oppositional defiant disorder in primary care: A comparison of three models

John V. Lavigne*, Susan A. LeBailly, Karen R. Gouze, Colleen Cicchetti, Jonathan Pochyly, Richard Arend, Bryn W. Jessup, Helen J. Binns

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)449-461
Number of pages13
JournalJournal of pediatric psychology
Issue number5
StatePublished - Jun 2008


  • Oppositional defiant disorder
  • Parent training
  • Primary care

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Pediatrics, Perinatology, and Child Health


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