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Blaming Adolescent

            The client presents irritable, defensive, and minimizes contribution to taking his teacher’s vehicle for a joy ride. The client’s states his parents should be the ones getting therapy. The client blames his teacher for leaving the keys in the vehicle. States that if the teacher would not have left his keys in the vehicle, he would have not taken it. Client also blames peer who told on him stating that if peer would have not said anything, he would not be in therapy. Throughout interview client never took ownership for his actions and blamed his teachers, his parents, and his peer for his behavior.

            Even though minimal information was given. In accordance with behaviors presented by client during interview the client is presenting with characteristics of Oppositional Defiant Disorder such as he is touchy and easily annoyed, and presents resentful against parents, peers, and teacher. The client argues with authority figures and defies requests from authority figures or rules in general.

            The severity of behavior can be concluded to be moderate because the behavior occurs with parents, teachers, and peers; the client presents with these behaviors in at least two settings. It is also said that clients can present with Oppositional Defiant Disorder without the disorder. The client must present with four or more symptoms within 6 months of client being assessed (APA, 2013)

           Treatment for ODD

            The psychotherapy approach that can be taken with this patient is CBT to help the client manage and reduce the inappropriate behaviors. The client will learn positive ways to respond to stressful situations. The cognitive problem-soling skills will help client be more mindful of situations and respond more appropriately. In addition to CBT social-skills and school-based programs seem to help clients relate more positively to peers and help improve schoolwork. This type of therapy is more effective when conducted in natural environments such as school and in a group (AACAP, 2009).

            In therapy with children therapy should be conducted in alignment with the child’s developmental level and their orientation to the here and now. Involving the child’s family in treatment and treatment decisions. The family consists of obtaining the parent’s view of treatment needs, establishing treatment goals, and the means of achieving goals. The family-centered approach does not mean treatment focuses on the family. This approach is to help improve familial interactions, keep family engaged, educate family about condition. The family-approach also helps maintain adherence to treatment (Wheeler, 2014).

            Medications alone have not been shown to be effective in the treatment of ODD. Medications can be helpful when treating comorbidities of ODD like ADHD, anxiety, and other mood disorders. When ADHD and ODD co-exist treatment for ADHD will improve behaviors, as well as when the client suffers from a mood disorder or anxiety treatment with an antidepressant and an anxiolytic can help improve behavioral symptoms. Early detection, identification, and treatment improve client outcomes (AACAP, 2009).

     References

American Academy of Child & Adolescent Psychiatry. (2009). ODD a guide for families by the

            American Academy of Child and Adolescent Psychiatry. Retrieved from

 https://www.aacap.org/

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

            (5th ed.). Washington, DC: Author

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company