A total of 12% of young children with obsessive compulsive disorder (OCD) present with comorbid oppositional defiant disorder (ODD), yet empirically based treatment packages are designed for implementation with monodiagnostic cases. The current case illustrates treatment of both disorders using concurrent exposure with response prevention and behavioral parent training. A 6-year-old male child is presented with significant obsessions and compulsions. To accommodate his OCD, his parents set limits inconsistently and used consequences infrequently. In addition, the child often was aggressive and defied adults. Treatment focused on training the child’s mother to differentiate anxiety-related behavior from oppositional behavior. The mother was also trained to conduct exposure and response prevention for compulsive behaviors and to increase positive parental attention, use a token economy for compliance, and implement time-out for aggressive behavior.
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