Nurs 6640 Week 9 Main Discussion Post Counseling Adolescents

Nurs 6640 Week 9 Main Discussion Postcounseling Adolescentsthe Case S

Cleaned assignment instructions:

The discussion involves counseling an adolescent who exhibits blaming behavior, denying responsibility, and possibly has oppositional defiant disorder (ODD). The case study describes a middle adolescent male who stole a car, justified his action by blaming the owner and his parents, and does not accept full responsibility for his behavior. The analysis should include diagnosis considerations, therapeutic approaches such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), the role and limitations of psychotropic medications, expected outcomes of treatment, and relevant evidence-based references.

Paper For Above instruction

Adolescent behavioral issues often present complex challenges for mental health professionals, particularly when symptoms include defiance, blame-shifting, and impulsivity. The case of a middle adolescent male who has stolen a car then justified his actions by blaming the owner for leaving the keys and asserting that his parents require counseling, demonstrates typical features of oppositional defiant behavior. Proper diagnosis, therapeutic interventions, and understanding of outcomes and medication roles are essential to managing such cases effectively.

The adolescent’s refusal to accept responsibility and tendency to attribute blame to others suggest underlying emotional dysregulation, possibly linked to oppositional defiant disorder (ODD) or conduct disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ODD is characterized by a persistent pattern of angry/irritable mood, argumentativeness, and vindictiveness lasting at least six months (American Psychiatric Association [APA], 2013). Children and adolescents with ODD often have difficulty controlling impulses, managing emotions, and adhering to social rules (Frick & Nigg, 2012). In this case, the adolescent's behaviors may also be influenced by underlying emotional dysregulation, possibly influenced by familial or developmental factors.

Diagnosing this adolescent requires a comprehensive assessment. Besides ruling out other disorders such as conduct disorder or attention-deficit hyperactivity disorder (ADHD), clinicians should explore environmental factors like family dynamics, peer influences, or trauma history. The seemingly deliberate nature of the theft and the adolescent’s blame-shifting could reflect an underlying impulse control difficulty or just might be defensive responses to shame or guilt. Such behaviors align with disruptive, impulse-control, and conduct disorders, indicating the need for targeted therapeutic intervention (Amboss, 2019).

Therapeutic approaches for adolescents displaying oppositional behaviors emphasize skill development, emotional regulation, and cognitive restructuring. Cognitive-behavioral therapy (CBT) is a primary evidence-based intervention, focusing on helping adolescents understand that their feelings are normal but their reactions can be modified (Wheeler, 2014). CBT engages clients in identifying maladaptive thought patterns that lead to oppositional or defiant behaviors and trains them in developing healthier behavioral responses. For example, a therapist might work with the adolescent to recognize triggers for defiance and incorporate coping strategies such as problem-solving skills, emotional regulation techniques, and enhancing self-control.

In addition to CBT, dialectical behavior therapy (DBT) can be particularly beneficial for adolescents with impulse control issues, emotional dysregulation, and defiance. DBT emphasizes mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness (Mindfulness Therapy Associates, 2019). The focus on these skills helps adolescents better understand and manage their feelings, decreasing impulsive acts and improving insight into their decision-making processes. Incorporating individual therapy, skills training groups, and phone coaching enhances the treatment's efficacy, fostering accountability and promoting sustainable change.

The role of psychotropic medication in managing ODD is limited. Current evidence indicates that no medications are specifically approved for ODD; hence, pharmacological treatment is generally adjunctive, addressing comorbid conditions such as ADHD or mood disorders (Good Therapy, 2019). For example, stimulant medications might be prescribed if ADHD is present, to improve attention and impulse control. Despite this, medication alone cannot modify oppositional behaviors without concurrent psychotherapy and environmental support, which form the cornerstone of effective treatment (Pelham & Fabiano, 2008).

Expected outcomes from interventions like CBT and DBT include improved emotional regulation, increased insight into problematic behaviors, and greater accountability. Adolescents are expected to develop more adaptive coping mechanisms, recognize the consequences of their actions, and foster healthier social interactions. Outcomes also depend on family involvement, school environment, and peer support, all of which contribute to a comprehensive treatment plan. Long-term, effective therapy can reduce oppositional behaviors, improve academic and social functioning, and decrease the risk of developing more severe conduct problems or antisocial behaviors (Kazdin, 2017).

Implementing appropriate therapeutic strategies requires sensitivity to developmental, familial, and environmental factors influencing the adolescent. Incorporating family therapy can enhance communication, clarify expectations, and provide a supportive framework for change. Overall, a multidisciplinary approach integrating psychotherapy, family involvement, and environmental modifications is essential for comprehensive care and positive long-term outcomes in adolescent oppositional behavioral cases.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Amboss. (2019). Disruptive, impulse-control, and conduct disorders. Retrieved from https://www.amboss.com
• Frick, P. J., & Nigg, J. T. (2012). Current trends in research on conduct disorder and oppositional defiant disorder. Current Psychiatry Reports, 14(5), 387–393.
• Good Therapy. (2019). Oppositional Defiant Disorder Treatment. Retrieved from https://www.goodtherapy.org
• Kazdin, A. E. (2017). Treatment of childhood and adolescent conduct problems: A review of evidence-based practices. Journal of Child Psychology and Psychiatry, 58(4), 477–491.
• Mindfulness Therapy Associates. (2019). Dialectical Behavior Therapy (DBT). Retrieved from https://www.mindfulnesstherapyassociates.com
• Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 184–214.
• Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing.