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Angry Adolescent

 A large majority of my psychiatric mental health experience has been with children and adolescents. I have worked with a large number of adolescents that experience all four behaviors as shown in the case studies. I have selected the case study of the “angry adolescent” for this discussion board. 

This adolescent projects on the counselor with statements of “you are a horrible counselor,” “I hate being here,” “I hate talking to you,” “this is worthless,” “you are stupid,” and “you know nothing about me” (Laureate Education, 2013). This young female displays angry emotions towards the counselor about the session. A possible diagnosis for this patient would be oppositional defiant disorder (ODD) according to the DSM-5. The DSM-5 criteria describes oppositional defiant disorder as angry/irritable, often argumentative to authority figures, refuses to comply with requests, often blames others, and vindictive at least twice in the past 6 months (American Psychiatric Association, 2013). 

Therapeutic approaches are available with an adolescent and ODD. Methods include parenting education, social-emotional skills training, and medication use. Parenting education takes a look at the relationship between the parents/guardians and the child. The best approach for ODD is helping the parent learn new parenting strategies to create structure and consistency. The social-emotional skills training will aid the child in identifying their feelings, how to have better relationships, and decision-making skills. Some effective medications are stimulants for ADHD, antidepressants for depression and anxiety, and other medications. Some medications include Ritalin, Dexedrine, Lexapro, Prozac, Tenex, Risperdal, and Abilify (Boston Children’s Hospital, 2020).

Early identification and early treatment of ODD will have a better opportunity for improvement/changes. Behaviors associated with ODD can be difficult and take some time to alter. Studies have shown that 67% of children with ODD were symptom free after approximately three years. Many are likely to develop other conditions such as ADHD, anxiety, or mood disorders. Also, about 10% of children develop a personality disorder late in their life. Therefore, early treatment is essential in a child with ODD for the best expected outcomes (AACAP, 2019). 

References:

AACAP (2019). ODD: A guide for families by the American academy of child and adolescent psychiatry. American Academy of Child and Adolescent Psychiatry. Retrieved from: https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/odd/odd_resource_center_odd_guide.pdf

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 

Boston Children’s Hospital (2020). Treatments for oppositional defiant disorder in children. Boston Children’s Hospital. Retrieved from: http://www.childrenshospital.org/conditions-and-treatments/conditions/o/oppositional-defiant-disorder/treatments

Laureate Education (2013). Disruptive behaviors – Part 1 [Multimedia file]. Baltimore, MD: Author.