MGH Home SchoolPsychiatry Home Page
School-Based Interventions : Conduct Disorder/Oppositional Behavior
 
Interventions for Opposition

Accommodations
  1. Acknowledge the student's frustration about not making his/her goal and collaborate on solutions to achieve his/her goal the next time

    Example:
    "It's frustrating you didn't get enough points to earn your reward today, so let's think about what you can do differently tomorrow to reach your goal."
  2. Provide the student with choices for completing tasks

    Example:
    "You can start with the math problems on the board or with the problems on the next page of your book."
  3. Describe the student's alternatives and project the likely consequences with the student

    Example:
    Model a situation-alternatives-consequences approach ("You can decide whether to do your homework tonight. If you complete your homework, you can go on the school trip. If you choose not to do your homework, you will receive a lower overall grade, and won't be eligible for the school trip, which you said you're really excited about").
  4. Identify the student's good efforts even if results are ultimately unsuccessful

    Example:
    "You worked carefully, patiently, and just had this one step out of order--once you fix that, you have the rest figured out."
  5. Reinforce the student's collaborative or prosocial efforts

    Example:
    "Great job sharing the computer with others."
  6. Use "I need you to" rather than "You need to" statements

    Example:
    Avoid using "you" or statements that diminish the student's opportunities to participate in a solution or to fix misunderstandings. Instead use "I"-centered statements such as "I find it difficult to keep everybody's attention when there are other conversations going on in the classroom. That is why I need you to open your book and focus on today's lesson."
  7. Allow the student time to demonstrate compliance

    Example:
    Provide the student more time (30-60 seconds) to engage in the class assignment.
  8. Provide the student with an opportunity to describe his/her perception of events

    Example:
    Allow the student to briefly (three sentences) describe what led to his/her choice, and identify good intentions (perhaps gone awry).
  9. Devise consistent cues or language to redirect the student

    Example:
    Outside of class, with the student, identify nonemotional, non-provocative statements that the teacher can use to redirect the student (the teacher could say "reading time" to signal the student to stop current dialogue, or "eyes on board" to re-direct the student to instruction).
  10. Allow the student to fix problems rather than to affix blame

    Example:
    During conflicts, direct the student's attention to fixing the problem rather than focusing on who is most responsible ("The paper got torn. Can you help tape it together and write answers as [victim name] dictates to you?").
  11. Reward appropriate behaviors at multiple intervals during the day

    Example:
    Recognize and reinforce appropriate behaviors ("Great morning, everyone helped each other to finish this assignment early, now we can go to recess five minutes earlier") and acknowledge a correct answer ("You are right, 2 x 5 is 10.") Aim for three positive interactions with the student for each negative interaction.
  12. Address the student's distortions or lies apart from other students. With the student, examine how things would be different if the lie were true.

    Example:
    With the student, understand the purpose of lying by examining how the situation would play out if the lie were true, allowing a different course of action to accomplish the same end ("if you really had a horse at your house, classmates might want to get together after school -- I notice that classmates like to play basketball with you. I wonder if you might want to play ball with them after school."
  13. Involve the student in reciprocal activities that encourage feelings of belonging and support self-worth

    Example:
    Provide one-to-one chats, daily greetings, reciprocal smiles, interactive tasks or activities (cleaning the classroom together, five minutes of computer/calculation game), or other subtle personal affirmations.
  14. Designate a time and place for working through conflicts

    Example:
    Establish with the student and staff a place in the classroom (confidential and quiet) where negotiation of conflicts can occur.
  15. Identify a "time-out" area where the student can go to regroup when disruptive or uncooperative

    Example:
    Designate an area or room for the student to go to where he/she can regroup, fill out an action plan form and return ready to resume classroom tasks. top

Specialized Instruction

  • Role play alternative responses and plan for "next time"

    Example:
    Model appropriate responses to conflicts ("instead of saying 'I can't do that,' what would happen if you said 'can you show me that once more?'").
  • Have the student visualize an appropriate response to a provocation

    Example:
    Have the student play out in his/her mind (visually) how events will unfold if he/she makes certain responses to provocation.
  • Help the student identify underlying feelings of anger and anxiety and plan for appropriate resolution of these feelings. Employ active listening skills.

    Example:
    Read with the student children's literature that explores oppositional feelings and suggests management strategies ("Hands are Not for Hitting" by Martine Agassi Ph.D or "The Teenagers' Guide to School Outside the Box" by Rebecca Greene, Elizabeth Verdick, ed.). Use active listening statements to paraphrase student comments ("so from your point of view, the situation looks like this...").
  • Have the student use appropriate, socially acceptable methods of dealing with triggers and targets for angry or antisocial outbursts

    Example:
    Use "I" statements, walk away, use humor, take a personal time-out. Role-play the use of these prosocial methods.
  • Ask the student to draw the cycle of negative behavior and the resulting consequences, and list strategies for breaking the cycle

    Example:
    Draw the negative behavior or event. Draw the consequences: student reacts negatively, adult criticizes student, student escalates the negative reaction. Draw/describe possible strategies: count to 10, engage in positive self-talk, write instead of verbalize reaction, take a short mental timeout.
  • Have the student verbalize an understanding of empathy and how it can reduce conflict

    Example:
    Read a story with the student involving conflict (e.g., "Nothing's Fair in Fifth Grade" by Barthe Declements) and discuss with the student how empathy, communication, and awareness of another's point of view can prevent or reduce conflicts.
  • Develop and role-play various methods of resolving a conflict fairly and positively

    Example:
    Teach a conflict resolution process for older students to use such as: 1) find a private place to talk, 2) discuss the problem without judging 3) brainstorm possible solutions, 4) agree on a solution that works for both and 5) try the solution and agree to renegotiate if it is not effective.
  • Help the student understand how behavior affects relationships with peers

    Example:
    Use children's literature to explore the causes for and effects of behavior upon interpersonal relationships ("Don't Pop Your Cork on Mondays" by Adolph J. Moser and Dav Pilkey or "Don't Feed the Monster on Tuesdays!" by Adolph J. Moser). top

Behavioral Planning

  • Identify limits of acceptable behavior in class and activities

    Example:
    Clarify classroom expectations ("students will complete 15 minutes of class work, raise hands if assistance is needed, and speak softly and slowly").
  • Prevent other students from reinforcing inappropriate student behaviors

    Example:
    Remove the student's audience or the student if behavior escalates.
  • Engage staff in supporting acceptable behaviors and consistent responses

    Example:
    Enlist multiple staff (teacher, aide, coach, recess monitor) in planning and implementing consistent responses to student inappropriate behaviors.
  • Enlist friends or other family members to help the student succeed at school

    Example:
    If the student has trouble getting to school on time, encourage the student to be accompanied by a peer or family member to get to school on time.
  • Identify where the school may contact parents if the student does not arrive at school on time

    Example:
    Establish a protocol with the family so that there is a clear procedure for who will be contacted, and which parent will leave work if the student fails to arrive on time.
  • If the student consistently does not arrive on time for school, have parents notify the school when the student leaves the house

    Example:
    Have a parent phone a message to the school clarifying when the student left for school so the school has a reasonable expectation for when the student should arrive, and school staff are positioned to have facts to address with the student. top
 
   
 
    ©2010 Massachusetts General Hospital, School Psychiatry Program and MADI Resource Center
    Copyright | Disclaimer | Privacy Policy | Department of Psychiatry  | Site Map