Case Study: The Chosen Psychot

Case Studythe Case Study That I Have Chosen Is Titledpsychotic Student

The case study I have chosen is titled "Psychotic Student," found on page 159 of Cipani and Schock's (2010) text. It discusses a male adolescent enrolled in both residential and day treatment programs for emotionally disturbed children. He displays various undesired behaviors, including avoidance of academic tasks, leading to decreased productivity. To address this, policies restricting his free time until work completion were implemented, which gradually improved his task completion both in treatment settings and at home.

Due to his disruptive and avoidant behaviors, I would diagnose him with oppositional defiant disorder (ODD). However, further assessment of his developmental, familial, and environmental background, as well as trauma history, is necessary for an accurate diagnosis. Co-occurring conditions such as depression or anxiety are also possible and should be evaluated through interviews, behavioral observations, and self-report scales.

The fact that he is in specialized treatment suggests possible past trauma contributing to his behaviors. Individuals with ODD typically show defiant, disruptive, and hostile behaviors before age 8 and are at heightened risk for antisocial behaviors and other psychopathologies (Burnette, 2013). His increasing non-compliance and use of defiance to escape tasks indicate behavioral escalation that may be reinforced by environmental factors (Cipani & Schock, 2010).

A suitable treatment plan would include cognitive-behavioral therapy (CBT) and behavioral parent training, which can be delivered by staff or teachers within his treatment environments. Research indicates that these combined interventions effectively improve attention, emotional regulation, social skills, and problem-solving abilities in children and adolescents with ODD (Matthys et al., 2014).

Paper For Above instruction

Addressing the complex needs of adolescents diagnosed with oppositional defiant disorder (ODD) requires a comprehensive understanding of their behavioral patterns, developmental history, and environmental influences. The case of the adolescent boy described in Cipani and Schock’s (2010) case study exemplifies the multifaceted challenges clinicians face when managing disruptive behaviors in youth with emotional disturbances.

Diagnosis of ODD hinges on recognizing persistent patterns of defiance, hostility, and oppositional behaviors that impair functioning across settings. Although the adolescent demonstrates symptoms consistent with ODD, confirming this diagnosis necessitates thorough assessments that include developmental history, familial dynamics, trauma exposure, and co-morbid conditions such as anxiety or depression (Burnette, 2013). Early diagnosis is vital, given the potential for these behaviors to escalate into conduct disorder or antisocial personality disorder if unaddressed (Burke, Rowe, & Boylan, 2014).

The etiology of ODD often involves an interplay of genetic, neurobiological, and environmental factors. Traumatic experiences, neglect, inconsistent parenting, and exposure to violence can contribute to the manifestation of oppositional behaviors (Imbach et al., 2013). This case suggests that past trauma may underpin some of his disruptive actions, emphasizing the importance of trauma-informed care in treatment planning.

Effective interventions for adolescents with ODD combine behavioral strategies with cognitive-behavioral therapy. Behavioral parent training aims to modify parental responses to defiant behaviors, fostering consistent discipline, and positive reinforcement (Matthys et al., 2014). Cognitive-behavioral interventions focus on developing emotional regulation, social skills, and problem-solving abilities, enabling youths to better manage frustration and impulsivity (Kazdin, 2017). Implementing these interventions within a structured environment aids in generalizing skills across settings and reduces maladaptive behaviors.

However, several barriers can impede treatment efficacy. An environmental barrier includes the lack of family involvement or support, which is critical for maintaining behavioral gains post-intervention (Karver & Caporino, 2010). The adolescent’s placement in a residential setting, especially one populated with peers exhibiting similar behaviors, may reinforce negative patterns. Moreover, cultural factors influence how behaviors are perceived and managed, necessitating culturally sensitive approaches tailored to the individual’s background (Burke et al., 2014).

To address these barriers, clinicians should incorporate cultural competence into assessment and intervention strategies. Engaging families and schools in treatment enhances consistency and supports the adolescent’s social ecology. Culturally adapted interventions respect individual beliefs and practices, increasing engagement and adherence (Lieberman & Van Horn, 2018). In addition, collaborative care involving multidisciplinary teams can improve outcomes by addressing trauma, family dynamics, and environmental influences comprehensively.

Furthermore, ongoing assessment and flexibility in interventions are essential. Monitoring progress and adjusting strategies based on response ensures responsiveness to the adolescent’s evolving needs. Incorporating strong therapeutic alliances and employing motivational techniques can foster cooperation and intrinsic motivation for change (Kazdin, 2017).

References

• Burnette, M. L. (2013). Gender and the development of oppositional defiant disorder: Contributions of physical abuse and early family environment. Child Maltreatment, 18(3), 171–180. https://doi.org/10.1177/1077559513479091
• Burke, J. D., Rowe, R., & Boylan, K. (2014). Functional outcomes of child and adolescent oppositional defiant disorder symptoms in young adult men. Journal of Child Psychology and Psychiatry, 55(3), 350–359. https://doi.org/10.1111/jcpp.12150
• Cipani, E., & Schock, K. M. (2010). Functional behavioral assessment, diagnosis, and treatment: A complete system for education and mental health settings. Springer.
• Imbach, D., Aebi, M., Metzke, C. W., Bessler, C., & Steinhausen, H. C. (2013). Internalizing and externalizing problems, depression, and self-esteem in non-detained male juvenile offenders. Child and Adolescent Psychiatry and Mental Health, 7, 8. https://doi.org/10.1186/1753-2000-7-8
• Karver, M. S., & Caporino, N. (2010). The use of empirically supported strategies for building a therapeutic relationship with an adolescent with oppositional-defiant disorder. Cognitive & Behavioral Practice, 17(2), 203–213. https://doi.org/10.1016/j.cbpra.2009.09.004
• Kazdin, A. E. (2017). Evidence-based psychotherapies for children and adolescents (4th ed.). Guilford Press.
• Lieberman, A., & Van Horn, P. (2018). Culturally sensitive evidence-based interventions: An exploration. Journal of Child & Family Studies, 27(2), 491–502. https://doi.org/10.1007/s10826-017-0844-2
• Matthys, W., Vanderschuren, L. J., Schutter, D. G., & Lochman, J. E. (2014). Treating disruptive behavior disorders in children and adolescents: Advances and challenges. Child and Adolescent Psychiatric Clinics, 23(4), 559–575. https://doi.org/10.1016/j.chc.2014.04.009
• World Health Organization. (2003). Caring for children and adolescents with mental disorders. WHO.