Main Discussion

 

The Case Study of Angry Adolescent. The case study selected for the discussion included an adolescent  female who appears to be extremely upset. The first video presented the  client exhibiting extreme anger. The client as observed in the first  video, appeared to be highly disrespectful towards the therapist and  refuses to discuss anything. The client was also observed to have  misbehaved with the therapist. In the second video, it was observed that  the therapist succeeded to initiate a productive discussion with the  client, which revealed significant points regarding the personality of  the client. The client was identified to be a popular girl at her  school; however, she reported having anger-related issues. The clientà behavior indicated that she is most likely to be suffering from  oppositional defiant disorder (ODD). The ODD is a form of disruptive  behavior disorder in which the client experiences irritable or angry  mood, vindictiveness, and disobedient behavior (Cavanagh, et al., 2017).  Clients experiencing ODD finds it difficult to keep their anger under  control and exhibits a rebellious and noncompliant behavior (Cavanagh,  et al., 2017).

DSM-5 Criteria

The DSM-5 criteria for the diagnosis of ODD require that the  client experience a pattern of irritable mood or anger, aggressive or  rebellious behavior, or vindictiveness for a minimum duration of six  months (American Psychiatric Association, 2013). According to the  American Psychiatric Association (2013), the DSM-5 criteria for ODD  requires that the client must exhibit a minimum of four of the following  symptoms:

Frequent loss of temper 

Frequent anger and resentment 

Frequently irritable or get annoyed easily 

Frequent arguments with authoritative figures 

Frequent denial to follow orders 

Frequently upsets others 

Frequently place blame on others for own mistakes 

Remains mean or spiteful 

Because the patient exhibited anger towards the therapist and  behaved disrespectfully, it is suggested that the client is experiencing  ODD. The client exhibited no fear of the consequences of her actions  for being noncompliant.

Therapeutic Approach

The preferred therapeutic approach to be used with the client is  child-based therapy and parent training. This is the preferred  psychotherapies for the clients diagnosed with ODD (Katzmann, et al,  2018). Child-based therapy focuses on problem-solving whereas parent  training supports parents to develop skills required for the management  of troublesome behavior of their child (Goertz-Dorten, et al., 2019).  This is accomplished by applying the technique of limiting involuntary  positive reinforcement of troublesome behavior (Goertz-Dorten, et al.,  2019). Cognitive-behavioral therapy (CBT) is identified to be effective  psychotherapy for clients with ODD (Katzmann, et al, 2018). Therefore,  the client would be referred to CBT and parent training would be  referred for the parents.  

Psychotropic medications appropriate for the treatment of ODD are  second-generation antipsychotics (SGAs) (Arnold & Moody, 2018).  Risperdal is the brand name of risperidone, which is considered the  preferred psychopharmacological agent for the treatment of ODD because  of its proven efficacy for adolescents (Arnold & Moody, 2018).  Therefore, the appropriate psychotropic medication for the client would  be Risperdal.

The expected outcome for the client based on selected therapeutic  approaches will be that parents will be able to have a better  understanding of their childàbehavior. The parents would gain the  ability to manage the disruptive behavior of their child. It would also  be expected that the client would be able to have a better understanding  of herself, her thoughts, behavior, and pertinent actions. It is  expected that the client would experience a decline in ODD symptoms and  become capable of managing her disruptive behavior.  

                                               References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5n Washington, DC: Author.

Arnold, M. J.,  & Moody, A. L. (2018). Atypical Antipsychotics for Disruptive  Behavior Disorders in Children and Adolescents. American Family Physician, 97(11), 5-6. Retrieved from https://www.aafp.org/afp/2018/0601/p715.html

Cavanagh, M.,  Quinn, D., Duncan, D., Graham, T., & Balbuena, L. (2017).  Oppositional defiant disorder is better conceptualized as a disorder of  emotional regulation. Journal of Attention Disorders, 21(5), 1-9. doi:10.1177/1087054713520221

Goertz-Dorten,  A., Benesch, C., Berk-Pawlitzek, E., Faber, M., Hautmann, C., Hellmich,  M., & Doepfner, M. (2019). Efficacy of individualized social  competence training for children with oppositional defiant  disorders/conduct disorders: A randomized controlled trial with an  active control group. European Child & Adolescent Psychiatry, 28(2), 65-65. doi:10.1007/s00787-018-1144-x

Katzmann, J.,  D‚®er, M., & G‹:-Dorten, A. (2018). Child-based treatment of  oppositional defiant disorder: Mediating effects on parental depression,  anxiety and stress. European Child & Adolescent Psychiatry, 27(9), 81-92. doi:10.1007/s00787-018-1181-5