Building a conceptual bridge between behavioral, cognitive -behavioral, and self -psychology models of oppositional defiant disorder

Research has demonstrated that the current behavioral and cognitive-behavioral interventions used to treat Oppositional Defiant Disorder (ODD) lack long-term clinically significant results. This dissertation explores whether Kohut's psychoanalytic self-psychology model can offer itself as a theory that might address this limitation. According to self-psychology theory, when caregivers fail to provide empathy to their children it significantly interferes with their children's ability to develop intrapsychic structures that promote emotional and behavioral well-being. As a result, these children feel devalued, unprotected, and disconnected from their caregivers. The sense of self in these children begins to fragment, leaving them with poor self-esteem. In turn, this low self-esteem causes these children to behave in oppositional ways.;A treatment approach was designed that incorporated the current treatments for ODD with an additional empathy training component for parents. This empathy training procedure seeks to help parents meet their children's selfobject needs by making children feel more valued, comforted, and connected to their caregivers. Improving parents' ability to meet these selfobject needs is presumed to help increase their children's self-esteem. It is thought that as children's self-esteem increases, their fragmented sense of self becomes more cohesive and vital, creating an internal motivation to please their parents. As a result of this empathic attunement between parents and their children, the children's defiant behaviors are thought to subside. A pilot study evaluating the effectiveness of this integrative model was discussed.