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Main Discussion

The Case Study of Angry Adolescent. The case study selected for the discussion included an adolescentfemale who appears to be extremely upset. The first video presented theclient exhibiting extreme anger. The client as observed in the firstvideo, appeared to be highly disrespectful towards the therapist andrefuses to discuss anything. The client was also observed to havemisbehaved with the therapist. In the second video, it was observed thatthe therapist succeeded to initiate a productive discussion with theclient, which revealed significant points regarding the personality ofthe client. The client was identified to be a popular girl at herschool; however, she reported having anger-related issues. The client’sbehavior indicated that she is most likely to be suffering fromoppositional defiant disorder (ODD). The ODD is a form of disruptivebehavior disorder in which the client experiences irritable or angrymood, vindictiveness, and disobedient behavior (Cavanagh, et al., 2017).Clients experiencing ODD finds it difficult to keep their anger undercontrol 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 theclient experience a pattern of irritable mood or anger, aggressive orrebellious behavior, or vindictiveness for a minimum duration of sixmonths (American Psychiatric Association, 2013). According to theAmerican Psychiatric Association (2013), the DSM-5 criteria for ODDrequires that the client must exhibit a minimum of four of the followingsymptoms:
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 andbehaved disrespectfully, it is suggested that the client is experiencingODD. The client exhibited no fear of the consequences of her actionsfor being noncompliant.
Therapeutic Approach
The preferred therapeutic approach to be used with the client ischild-based therapy and parent training. This is the preferredpsychotherapies for the clients diagnosed with ODD (Katzmann, et al,2018). Child-based therapy focuses on problem-solving whereas parenttraining supports parents to develop skills required for the managementof troublesome behavior of their child (Goertz-Dorten, et al., 2019).This is accomplished by applying the technique of limiting involuntarypositive reinforcement of troublesome behavior (Goertz-Dorten, et al.,2019). Cognitive-behavioral therapy (CBT) is identified to be effectivepsychotherapy for clients with ODD (Katzmann, et al, 2018). Therefore,the client would be referred to CBT and parent training would bereferred for the parents.
Psychotropic medications appropriate for the treatment of ODD aresecond-generation antipsychotics (SGAs) (Arnold & Moody, 2018).Risperdal is the brand name of risperidone, which is considered thepreferred psychopharmacological agent for the treatment of ODD becauseof its proven efficacy for adolescents (Arnold & Moody, 2018).Therefore, the appropriate psychotropic medication for the client wouldbe Risperdal.
The expected outcome for the client based on selected therapeuticapproaches will be that parents will be able to have a betterunderstanding of their child’s behavior. The parents would gain theability to manage the disruptive behavior of their child. It would alsobe expected that the client would be able to have a better understandingof herself, her thoughts, behavior, and pertinent actions. It isexpected that the client would experience a decline in ODD symptoms andbecome capable of managing her disruptive behavior.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: Author.
Arnold, M. J.,& Moody, A. L. (2018). Atypical Antipsychotics for DisruptiveBehavior Disorders in Children and Adolescents. American Family Physician, 97(11), 5-6. Retrieved from
Cavanagh, M.,Quinn, D., Duncan, D., Graham, T., & Balbuena, L. (2017).Oppositional defiant disorder is better conceptualized as a disorder ofemotional 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 socialcompetence training for children with oppositional defiantdisorders/conduct disorders: A randomized controlled trial with anactive control group. European Child & Adolescent Psychiatry, 28(2), 65-65. doi:10.1007/s00787-018-1144-x
Katzmann, J.,Döpfner, M., & Görtz-Dorten, A. (2018). Child-based treatment ofoppositional 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

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