Parental Interventions for Oppositional Defiant Disorder Kids
Oppositional Defiant Disorder is characterized by irritability and anger among children. Such children also tend to be argumentative, defiant and vindictive towards anyone with authority over them. Their conduct is an impediment towards the normal daily activities expected of them. There is a lifetime prevalence of ODD that has been measured to stand at about 11% of the population in general. The ODD symptoms are apparent as early as 8 years. It has been established that about 70% of all children suffering from ODD no longer show symptoms of the condition at the age of 18 years. It has also been observed that only a small number of the group proceeds to develop antisocial conduct in adulthood. The disorder elicits a multifactorial basis for its existence. There is proper documentation that points at parenting styles, heredity and other psychosocial factors in the development of ODD. Other studies have also highlighted the role that changes in the structure of the anatomy, plays in the incidence of ODD (Graham, 2018).
It has been shown that ODD responds to therapy. The recommendations on how to treat it are based on the age of the patient. The younger patients are reported to respond best when they are placed under parent management training. Children in middle school have been found to respond best to Cognitive Behavioral Therapy. Adolescents at advanced age are placed under a multimodal programs informed by social learning. There are some classes of medicines that have proved to mitigate the ODD condition; even though he FDA is yet to permit any specific drug for the treatment of the disease (Graham, 2018).
ODD treatment entails the deployment of family members in its execution. It may incorporate a range of psychotherapy and training programs for both the child suffering from the condition along with the parents. The treatment of ODD could take a couple of months or more. Treatment of co-occurring illnesses must be prompt and urgent since they may make the ODD worse if they are not treated in good time (Mayo Clinic, 2018). Some interventions that have been found to work include
· Training in Parenting
A professional in mental health and one that has had experience in handling ODD could help a parent to develop skills of parenting that could help them to avert the ODD condition. In some instances, the child may be incorporate into the training program so as to empower as many people in the family on how to handle the child concerned and even how such children can deal with parents and others of authority around them.
· PCIT,
Also called Parent Child Interaction Therapy, in full, is applied by coaching the parent even as they interact with their children. In one of the methods a therapist finds a place to sit behind a one-way mirror. They make use of an audio, ear bug device and leads parents to internalize strategies that make the positive of the child much stronger. Consequently, parents are helped to learn many effective parenting strategies. The relationship between the parent and the child is enhanced while the problematic aspects decrease.
· Family and individual Therapy:
When you child is provided with individual therapy, they will easily learn how to cope with the anger seizures. They will learn alternative ways of expressing their feelings in a respectable way. Family therapy is known to help to improve one’s communication with the other family members. It encourages unity among family members.
· Cognitive problem-Solving Training:
The child will identify and modify though patterns that create the problems of behavior that they might be suffering from. The collaborative problem-solving approach could help to improve a parent and the ODD child.
· Collaborative Problem Solving (CPS):
CPS has been noted to be a promising problem as far as dealing with children with ODD is concerned. CPS seeks to help problematic children to learn how to deal with disappointment and frustrations. It helps them to learn flexibility. Both parents and their children practice brainstorming in search of solutions to problems. They negotiate and opt for solutions that work for both parties. They learn how to resolve issues without developing a conflict.
· Training in Social Skills:
A child may gain from a therapy that aims at making them to easily fit into the society that they live in. Even though some techniques used in parenting may seem obvious, it is not easy to learn to apply them consistently, especially when parents are confronted with challenges. Routine and practice helps parents to internalize the skills (Mayo Clinic, 2018).
Parental Interventions in handling children with Conduct Disorder
Some children manifest repetitive emotional and behavior complications. Such children re said to have conduct disorder. Children with the conduct disorder problem have a serious problem in following rules, being empathetic and even respecting other people’s personal space. Such children are commonly regarded as delinquent by the society around them. The conduct disorder condition arises because of several factors. Some common factors include neglect, vulnerability genetically, traumas, failure in school and child abuse (American Academy of Child and Adolescent Psychiatry, 2017).
It is important that children with conduct disorder be treated by a mental health professional with experience. It is common for children suffering from conduct disorder to exhibit other co-existing complications such as PSTD, anxiety, ADHD, problems in learning, substance abuse and disorders in the way they think. Such problems can be treated successfully. Available research indicates that children with conduct disorder will continue experiencing the problems if they and their families are not subjected to proper treatment. A lot of conduct disorder children cannot cope with the adulthood demands. They find it hard to maintain a job or even a relationship (American Academy of Child and Adolescent Psychiatry, 2017).
There are many family-based therapies of the conduct disorder problem that have been developed. They are based on evidence. They have recently been shared among over 800 communities in their practice centres. The models used include:
· Multi-family group: It is designed to help families experiencing similar problems to cooperate in resolving their problems. I provide an avenue for acquiring new skills and knowledge in dealing with children with the conduct disorder problem. The model uses both educational content that is structured and allows time for the participants to socialize. It may incorporate such social activities as attending a concert, enjoying a common potluck supper or going to the movies. Such a group should constitute between 10 to 12 parents from diverse socio-economic backgrounds. The sessions should be designed to run for between 1 and 2 hours (Henggeler and Sheidow, 2012).
· Functional Family therapy: the program is designed to handle children that are dysfunctional or youths experiencing problems in their behaviour. The model has been used in a wide range of settings and with a large number of patients from various backgrounds. The targeted groups fall within the pre-adolescents to young people with severe or moderate issues such as CD, violent behaviour and drug abuse. The sessions for treatment stretch between 12 and 14 hours. Each session has specified aims, foci for assessment, specified techniques for intervention and the therapeutic skills needed to succeed (Henggeler and Sheidow, 2012).
· Multidimensional Treatment: The model was created in the early 80s. The model was aimed at offering foster care based within the community that would be an alternative to detention by the state. I was to handle cases that had proved difficult for other ordinary foster care centres. The model is informed by the social learning theory principles. They are about behaviour and the effect of the social environment on the learning process. The interventions are put to use in a socio-ecological setting that puts emphasis on the major and important role of supervision by parents. It also seeks to promote performance at school (Henggeler and Sheidow, 2012).
· Brief Strategic Family therapy: The model is informed by family and strategic theories. It applies techniques of family therapy to positively alter how family members interact. The modification is aimed at eliminating the interactive systems that encourage the conduct disorder occurrence and problem behaviour exhibited by the children. Reaching a therapeutic alliance is gained by joining the members of the family. The approach focuses on the strengths. It is what gives guidance to the assessment and the treatment plan. The maladaptive interactive patterns that have been identified are dealt with through restructuring. The procedure includes solving problems practically via a format that is already prescribed. Individualization of services is done based on the needs of each of the families, and provided in the family weekly clinic of home sessions. The treatment duration is, typically, four months. The sessions can stretch between 8 and 24; as determined by the family needs (Henggeler and Sheidow, 2012).
Appropriate teacher-intervention in handling Conduct Disorder learners
There is a need to deal with students that manifest conduct disorder problems using special education facilities and expertise until such time that their behavior has positively adjusted to fit into the general programs. Such children require a specially structured environment that ensures support, encourages them to develop their self-esteem and incentivizes desirable conduct. Some of the common interventions applied by teachers are listed below
· Routine and Rules: The teacher outlines what they expect a learner to do and not do within the classroom environment. Rules that are positively stated inform the teachers reward system including praising and approving. The rules that are negatively stated inform how the teacher metes out punishment. Classroom management is enhanced by use of routines. Learners with behavioral and emotional complications have a problem in transitioning and change that is expected. Teachers may want to review the day’s schedule with the learners so as to start off the learners that may, otherwise, experience challenges. It fosters their self-confidence (Chiasson, 2015).
· Contingency Contract: The model involves the use of performance agreement with the learners; specifying the roles each is expected to play and the consequences. The model highlights to the learner what they are expected to do and what they should expect at the end of their compliance. The contract is formulated by the teacher, bearing in mind the intellectual capabilities of the learner (Chiasson, 2015).
· Positive Peer Review: Learners are requested to be on the look-out for their peers and to identify behavior that is positive. Both the learner exhibiting positive conduct and the one identifying are rewarded. The approach encourages the learners to work in teams to achieve their objectives and establish social support anchors (Chiasson, 2015).
· Verbal Feedback: the teacher provides feedback relating to given social or academic behavior. There should be clarity n the feedback and it should be positive. The teacher should never get into an argument. Timing is of essence (Chiasson, 2015).
· Systematic Social Skills Training: The model imparts skills that help the learner to develop positive social interaction skills. It helps them to develop networks for social support. The program is systematic and intensive. The objective is to implement the skills in a natural environment where they are needed (Chiasson, 2015).
· Self-control and self-monitoring training: the program uses consistent recording, tracking, monitoring and evaluation of the learners conduct. It is aimed at positively changing one’s behavior. It makes the learner able to prompt themselves when they are veering off he lane and applying the consequences. The model calls for motivation from the teacher and thorough training. However, the program may not work with learners who exhibit aggressive tendencies or learners lucking the requisite social maturity and cognitive awareness (Chiasson, 2015).
Interventions that help teachers to deal with ODD learners
Schools provide an opportunity for resilience by learners to forestall mental health complications. Giving students the support that they need to withstand stressful conditions enables them to thrive in difficult circumstances. The approach is, especially effective with children that emanate from homes that offer little support. Indeed, the school’s intervention can be pivotal under such circumstances. The sheer knowledge that one belongs somewhere, such as a school is a known protective shield against mental illness. The exercises that support mental health occur under a range of headings. They include being emotionally literate, emotionally intelligent and resilient. Knowledge of how to prevent violence, stop bullying and how to cope are indispensable. It has been established through a systematic review of the research that applying the best of the interventions is effective enhancing positive mental health for everyone. It also targets people with mental problems (Department for Education, 2016).
There is a range of strategies that schools apply. Some of them are highlighted below. They are designed to support children under high stress levels and those that may be affected by mental health complications. The support may come from within the school or from an outsourced specialist.
· The Incredible Years Teacher Classroom Management – It is meant for use with children between 3 and 8 years. It enhancing proactive and positive strategies for teaching. They promote positive teacher-learner relationships and that between teachers and parents. When teachers apply effective classroom management strategies, they reduce disruptive behaviour and increase interest in learning possible. The program breaks the coercive cycle ha is deemed negative and associated with ODD. It applies principles of social learning and relationship theories. Offering the required instructional base can provide a buffer against disruptive conduct. It entails providing a friendly environment for learning (Department for Education, 2016).
· PATHS: It used in several countries. It is meant to reduce aggressive behaviour and other classroom behaviour that is disruptive. It enhances empathy and decision making hat is responsible. PATHS, currently focuses in individual class levels of the learners starting from pre-school (Davies, 2016).
· The Good Behaviour Game: It is designed to tone down disruptive behaviour. It advises learners to overlook bad behaviour that is pre-determined. They are encouraged to focus on the positive behaviour aspects. The teachers who focus on positive reinforcement strategies find the game easy to use and effective. In one incident, aggressive learners who played the game were noted to have become less aggressive in the subsequent years (Davies, 2016).
· School-wide Positive Behavioral Supports: Apart from the home environment, the school can affect the behavior patterns of a child. A lot of school programs have developed systems to enhance support for positive behavior. The program aims at fostering positive social behavior and academic success for all learners. The programs come with consistent and clear consequences for specific behavior. There are also positive plans for positive behavior and services emanating from the teams targeting learners with extreme behavior needs (Davies, 2016).
· The challenges that counselors of schools encounter when handling learners with oppositional defiant disorder
The behavior of children commonly presents a myriad of challenges to teachers. Teachers are irritated, sometimes, when they are handling learners with a wide range of abilities in learning. Some children also interfere with the normal operation of the classroom for some time. There are also times when teachers have faced challenges that relate to their ability to deliver their services as professionals. Furthermore, teachers are increasingly challenged by behaviors that are associated with varying social norms from those of the teacher (Jacobsen, 2013).
If there is diagnosis of a child with ADHD, it is not an automatic indicator that such a child should be subjected to special education. It is, therefore, a challenge to a teacher. The teaching community finds it perplexing, if such a child is not put on any treatment form. Teachers, generally believe that children with conduct disorder of even ODD do not have control over their actions; relative to other learners with a higher level of emotional disruptions. Mental disorder is viewed as a condition that is not easily controlled since it is considered a neurobiological problem (Jacobsen, 2013).
Teachers find it hard to acknowledge that one student may have a need, and that they may need special attention that differs from what the rest of the learners may require. However, it remains important to attend to the learner and get them back on track. There is a challenge because teachers are trained to consider the needs of learners as a class; as opposed to an individual (Jacobsen, 2013).
The Challenges that counselors in mental health face in the course of counseling learners with ODD and those with conduct disorder
It remains a challenge for counselors to identify the most appropriate intervention for a family that has a child with mental disorder. It is even more challenging to identify preventive programs or those meant for early interventions. It is equally hard to know the groups that stand the best chance to gain from the interventions. Some of the factors that are associated with triggering conduct disorder include parental activity such as inconsistency in the way of carrying out one’s parental duties. They may also touch on mental health problems of the parent. Other factors include environmental causes such as being poor, and grooming (Rowan, McAlpine and Blewett, 2013).
MNS cases are commonly stigmatized. Such stigmas related with one’s mental health has been known to have a devastating effect on the lives of those suffering from mental health illnesses; including their care givers. There are other perspectives such as belief in the supernatural, religion and magic. The latter contribute to the establishment of stigma against people with mental illness. Such developing countries as Kenya experience such trends quite commonly. The practice is a hindrance to the effort to encourage people to seek mental health treatment whenever such problems are detected (Rowan, McAlpine and Blewett, 2013).
The Challenges encountered by family members when trying to counsel learners with conduct disorder and oppositional defiant disorder
There is a high risk of serious negative outcomes from children that exhibit severe conduct disorder and live in complex family situations. They may end up in crime, drug and substance abuse and even limit their chances of being employed. They are candidates for a myriad of social and economic costs linked to conduct disorder problems (Oruche et al, 2015).
The primary care givers who have children with mental health disorders concur that there is a high level of negative effect. They sigh under the weight of their children’s mental health needs and are concerned about the care of their children in future. Such distress could make parenting ineffective. They may lead to viewing oneself negatively as far as parenting roles are concerned and the lack of extending warmth to one’s own child (Oruche et al, 2015).
Primary caregivers including parents with children with conduct disorder problems or ODD are prone to developing stress because the behavior of their children is hard to manage. Such behavior is often disruptive to the functioning of one’s family. The distress could be worse when dealing with adolescents with the disorder. The young people face the challenge of grappling with the challenges of evolving into adulthood (Oruche et al, 2015).
The main challenge facing the caregivers as far as adolescents are concerned is the yearning to manage aggression by the adolescents. There is likely to be fights, persistently, between the adolescent and the siblings. They may destroy property and rub shoulders the wrong way with the adults. Such incidents are disturbing to parents. It is common for the aggression by the adolescents towards their siblings to be ferocious and mean (Oruche et al, 2015).
Since parents naturally feel that they are responsible for controlling the behavior of their children, parents of children with such aggressive tendencies feel inadequate and think that it is their fault for not taking control of their children and preventing them from dealing with the unfolding events. Trying to stop fights between siblings is particularly challenging because the fights are constantly recurring. Parents try to keep such adolescents at home so as to prevent them from causing harm to outsiders. The effect is: more fights between the siblings, and consequent higher stress by the parents (Kazdin, 2008).
Some caregivers complain of the lack of time and resources to handle their aggressive adolescents effectively. Such parents commonly call for the help from another adult to contain the situation at home. There are times when the police have been called in. There are instances when the problems hit the roof and the parents cannot take it anymore. It leads to the parents turning violent themselves. Even such tactics come under threat because as the adolescents grow older, the caregivers are also exposed to a significant amount of risk, and they become worried about their own safety too (Oruche et al, 2015).
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References
American Academy of Child and Adolescent Psychiatry. (2017, June). Conduct Disorder. Retrieved October 11, 2018, from https://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/FFF-Guide/Conduct-Disorder-033.aspx
Chiasson, P. (2015). Conduct Disorder. A Handbook for Elementary School Educators,90-157. Retrieved October 11, 2018, from http://dr.library.brocku.ca/bitstream/handle/10464/5829/Brock_Chiasson_Presley_2014.pdf?sequence=1&isAllowed=y
Davies, N., Dr. (2016, January 07). Oppositional defiant disorder in the classroom. Retrieved October 11, 2018, from http://www.headteacher-update.com/best-practice-article/oppositional-defiant-disorder-in-the-classroom/112142/
Department for Education. (2016). Mental health and behaviour in schools: Departmental advice for school staff.
Graham Y. (2018). Oppositional Defiant Disorder. In: Vinson S., Vinson E. (eds) Pediatric Mental Health for Primary Care Providers. Springer, Cham
Henggeler, S. W., & Sheidow, A. J. (2012). Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents. Journal of Marital and Family Therapy, 38(1), 30–58. http://doi.org/10.1111/j.1752-0606.2011.00244.x
Jacobsen, Kari. (2013). Educators’ Experiences with Disruptive Behavior in the Classroom. Retrieved from Sophia, the St. Catherine University repository website: https://sophia.stkate.edu/msw_papers/199
Kazdin, A. E. (2008). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. Oxford University Press.
Mayo Clinic. (2018, January 25). Oppositional defiant disorder (ODD). Retrieved October 11, 2018, from https://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/diagnosis-treatment/drc-20375837
Oruche, U. M., Draucker, C. B., Al-Khattab, H., Cravens, H. A., Lowry, B., & Lindsey, L. M. (2015). The Challenges for Primary Caregivers of Adolescents with Disruptive Behavior Disorders. Journal of Family Nursing, 21(1), 149–167. http://doi.org/10.1177/1074840714562027
Rowan, K., McAlpine, D., & Blewett, L. (2013). Access and Cost Barriers to Mental Health Care by Insurance Status, 1999 to 2010. Health Affairs (Project Hope), 32(10), 1723–1730. http://doi.org/10.1377/hlthaff.2013.0133
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