The Efficacy Of Cognitive Behavior Therapy On Oppositional Defiant Disorder Among Children In Selected Primary Schools In Nairobi County, Kenya

The rise in defiance cases among children in schools in Kenya calls for the need for proper diagnosis and effective intervention. This is because of the effect it has on the child’s social functioning and academic performance as well as the economic impact it has on their families. The main purpose for this study was to evaluate the efficacy of cognitive behavior therapy (CBT) among children with oppositional defiant disorder (ODD) in selected primary Schools in Nairobi County, Kenya. Two primary schools were purposely selected in Nairobi, Kenya. 315 participants between 9-14 years provided assent and their parents provided the consent. The teachers and the parents completed the CADBI tool. Out of 249 participants who met the criteria for ODD, systematic sampling was applied to acquire the required sample size of 180.The experimental group received CBT intervention for three months, while the control group did not receive any intervention. Data collected was analyzed using SPSS version, Descriptive statistics was done, Statistical analysis was conducted using IBM SPSS version 23. Microsoft Excel was used in processing statistical output as well as construction of data tables and graphs. Spearman’s correlation analysis, chi-square analysis for association between ODD and ADHD with risk factors was done. T test was done to compare the responses between baseline, midline and endline of the study and show the difference in deference (DID). The key findings of the study were that overall ODD prevalence was 79%, with males having a higher prevalence than female towards the adults and peers 78.2% and 88.5% female 74.6% and 85.3% respectively. The comorbid condition associated with ODD was ADHD 78.3% and 47.8% teachers and parents respectively. Risk factors associated with ODD were; low social-economic status, conflicts with parents, punishment, suspension from school, not going for counseling, friends and religion. Cronbalch alpha of the CADBI tool showed reliability at (α =.918 to. 890) for both teachers and parents. DID showed significance difference between baseline and midline and between baseline and end line respectively (p < 0.001). Since CBT was effective in the reduction of ODD symptoms in children psychologist should use this intervention in primary school and also in the hospital setting so as to prevent the children from developing other serious problems in adulthood such as antisocial personality disorder depression and anxiety. Medication should also be used in the treatment of ADHD since it presents as a comorbid condition.