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For this discussion, I selected the angry adolescent that blamed others for his mistakes and getting in trouble. Some of the patient’s behaviors include increased irritability, anger, poor impulse control, argumentative, unwilling to accept his wrongdoings, blaming others, projecting his faults onto the student that told on him and on his gym teacher for leaving his car keys inside the car, as well as denying the need for therapy stating that his parents should be the ones who need it instead. However, although this information is not enough to make a proper diagnosis, based on these observations, I believe that this patient might meet criteria for oppositional defiant disorder (ODD). According to the American Psychiatric Association (2013), the criteria for ODD consists of a pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness that lasts at least for 6 months. In order for the diagnosis to be made, at least four symptoms of the following need to be present: often losing their temper, getting angry, easily annoyed, frequent arguing with adults, refusing to comply with rules, annoying others on purpose, and frequently blaming others for their mistakes. These symptoms must also occur during interactions with individuals who are not considered siblings (American Psychiatric Association, 2013). Some therapeutic approaches that might be effective would be parent management training (PMT), family therapy, and individual therapy such as cognitive behavioral therapy (CBT). Parent training has shown to be effective in treating ODD by providing parents with short-term interventions that focus on specific strategies such as positive attending, ignoring, using effective forms of rewards and punishment and time out to help with the behavioral problems (CHADD, 2020). Family therapy has also shown to be effective in teaching parents how to strengthen their relationships with their children and to help manage their behaviors. Additionally, CBT has shown to be helpful by targeting emotion regulation and social problem-solving skills that are associated with aggressive behavior by using interventions with an emphasis on teaching structured strategies to children to create a change in the way they think, feel, and behave (Sukhodolsky et al., 2016). Although psychotropic medications have shown to be effective in treating ODD, I do not feel that this would be appropriate for this patient at this time. Since children and adolescents with ODD are at an increased risk for developing adjustment problems as adults such as antisocial behavior, poor impulse control, substance abuse, anxiety and depression, an expected outcome of this therapeutic approach would be to prevent this from occurring, meanwhile decreasing the current symptoms the patient is having and helping to manage them better (American Psychiatric Association, 2013). Setting goals for the patient as well as his family will also help with the treatment by providing better strategies for the patient in order to help control his behaviors by identifying the symptoms.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
CHADD. (2020). Disruptive Behavior Disorders. Retrieved from: https://chadd.org/about-
adhd/disruptive-behavior-disorders/
Sukhodolsky et al. (2016). Behavioral Interventions for Anger, Irritability, and Aggression in
Children and Adolescents. Journal of child and adolescent psychopharmacology, 26(1), 58–64. doi:10.1089/cap.2015.0120
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