Client Recovery-Focused Treatment Plan Oppositional Defiant Disorder

ClientRecovery-Focused Treatment Plan: Oppositional Defiant Disorder

InstitutionAffiliation

June is a 16-years old Caucasian female patient who was referred byher class teacher and mother to a mental health facility. They havenoticed disruptive behavior problems with her lately. June has beenplaced on probation once and suspension from school within a span ofone year. During the first instance, she assaulted her games teacherwho simply inquired why she was sleeping in class during a physicaleducation session. In the second instance, she slapped a friendseverally for allegedly misplacing her book. June’s aggressivehabits have been evident even around her family members. According toher family members, she has been hostile on an average of two timesin a week, as seen in behaviors such as smashing things whenirritated, hitting her brother, cursing out loud and yelling aroundthe house when irritated. She is extremely irritable.

June also suffers chronic truancy. Being absent from school hasextremely affected her performance since she joined high school. Sheis currently in tenth grade. June has been among the bottom fivestudents in performance for five consecutive evaluation tests so far.During the past year, she missed 40 school days.

June has also admitted to smoking cigarettes, marijuana and recentlybegan taking alcohol. Her school counselor suspected that she wasusing drugs to escape depression.

June has a strained relationship with her mother. She is rude to herand their conflicts have been increasing with time. She barely doeschores that her mother directs. She is rarely at home and gets homelate almost daily. Whenever her mother attempts to talk to her aboutit or tries to make some rules, she yells at her.

Diagnosis

WHODAS DSM-5Diagnosis

313.81Oppositional Defiant Disorder

The followingsymptoms as reported in June point to Oppositional Defiant Disorder:

  1. She gets angry and resentful quite often

  2. She gets into arguments with her mother and yells at her.

  3. She is non-compliant with requests from her mother and teacher.

  4. She had been vindictive within the last six months. June assaulted her teacher.

June has moderate Oppositional Defiant Disorder, as her behavior isevident at both home and school.

GenomicConsiderations

Accordingto the Valley Behavioral Health System, Oppositional Defiant Disorderhas genetic links. Children who suffer ODD are likely to have otherfamily members with mental illnesses such as mood disorders andanxiety disorders.( Valley Behavioral Health System, 2016). June’smother just revealed that her late father, Mr. Thomson was diagnosedwith bipolar disorder a while back. Thus, it is safe to assume thatJune’s condition has genetic links

EthicalConsiderations

The physicianwill adhere to the following principles during the course ofdiagnosis and treatment of June:

  1. The principle of beneficence: The psychologist will strive to benefit the patient and take caution not do any harm. The diagnosis could has the client, neighborhood, and her family. She might also misinterpret the results and this might damage her self-understanding

  2. Fidelity and responsibility: the therapist will manage conflicts between June and those around her.

Legal Consideration

  1. The therapist will have regard for the patient’s rights and dignity. She will respect her identity, race, sexual orientation and her religion.

  2. The psychologist will keep confidential information concerning the diagnosis, and personal details secret.

Treatment Plan

Currently,there is no approved medication for the treatment of Oppositionaldefiant disorder (WebMD, 2016). Psychotherapy and general trainingfor the child is the most recommended technique (Mayo Clinic Staff,2016). In June’s case, the treatment plan will involve individualand family therapy to help her improve over a period of four months.

EngagementPhase (Early Intervention)

Date of plan: 5thNovember 2016

Goal 1

June will reduceof aggressive behavior significantly

Objectives

Withdrawal fromany form of aggressive behavior within her school, neighborhood, andhome for the next six weeks.

June will speakout her emotions when angry and start using alterative copingstrategies when frustrated.

Interventions

Therapist willcollaborate with June and Ms. Ella (mother) to ensure that sheremains steadfast with her treatment and help in assessing outcomes.

Therapist willevaluate the relationship between June and her family members so thatthe treatment needs work for everyone involved.

Date of target:5th December 2016.

Goal 2

June will stopmissing school days and improve her conduct in school.

Objectives

June not miss asingle day of school, unless with the doctor’s consent.

June willinteract with other students and teachers appropriately. She will notbe aggressive and will not be involved in any verbal or physicalfights.

June willimprove her participation in class and work towards making her gradesbetter. He must not score any grade below C for all assessment testsoffered during the period.

Intervention

The therapistwill continue to work with close associates of June in order tocontinue with assessment in school. This time, she will include herclass teacher who will monitor her conduct in school.

Therapist will give improvement-based statements in order to buildhope within the family and minimize negativity that surround herbehavior at school.

Date of Target:5th December 2016.

Goal 3

June becomecloser with her mother and brother.

Objectives

June will alwaysget home on time. She will also stop being away from homeunnecessarily and work towards building a great relationship with herfamily. She will also perform all household chores assigned to her.

June and herfamily members will communicate better. She will have more respectfor will also stop being violent towards her younger brother.

Interventions

Thetherapist will monitor the behavioral pattern of the family to makesure that she shifts their perceptions of each other as they worktogether towards a common goal.

The therapistwill boost the relationship between June and her mother by coming upwith a theme hint that will help them get along and minimizeconflict.

Date of target:5th December 2016

Goal 4

June will undergofurther evaluation to determine how much she has met the objectivesand whether she needs further assistance.

Objectives

June will go through a drug and alcohol evaluation to measure theseverity of substance abuse and determine whether she needs anytreatment.

June will undergo a psychiatric evaluation and if warranted, get arecommendation on the type of drugs she needs. They will discuss anymore concerns pertaining her medication.

Interventions

The therapistwill engage the class teacher and June’s mother in supervisionregarding drug and alcohol abuse. She will then determine whether anoutside, more complicated evaluation is necessary.

Therapist willstart to organize for psychiatric evaluation if necessary.

Date of target:5th February 2017

(Behaviorchange Phase) Complementary Intervention

Goal 1

June will reduceof aggressive behavior significantly

Objectives

Withdrawal fromany form of aggressive behavior within her school, neighborhood andhome for the next six weeks.

June will speakout her emotions when angry and start using alterative copingstrategies when frustrated.

Interventions

Ms. Ella willinteract with June daily to discuss her day and help her with anychallenges she might have.

Date of target:7th December 2016

Goal 2

June will stopmissing school days and improve her conduct in school.

Objectives

June not miss asingle day of school, unless with the doctor’s consent.

June willinteract with other students and teachers appropriately. She will notbe aggressive and will not be involved in any verbal or physicalfights.

June willimprove her participation in class and work towards making her gradesbetter. He must not score any grade below C for all assessment testsoffered during the period.

Intervention

The classteacher will ensure that June conducts herself well and does not missschool.

June will joinan interactive club in school to improve her relations with otherstudents.

Date of Target:7th January 2017

Goal 3

June becomecloser with her mother and brother.

Objectives

June will alwaysget home on time. She will also stop being away from homeunnecessarily and work towards building a great relationship with herfamily. She will also perform all household chores assigned to her.

June and herfamily members will communicate better. She will have more respectfor her mother and will not yell or curse when addressed. She willalso stop being violent towards her younger brother.

Interventions

June andher mother will talk more frequently and resolve their issues througheffective communication.

Date of target:7th January 2017

Goal 4

June will undergofurther evaluation to determine how much she has met the objectivesand whether she needs further assistance.

Objectives

June will go through a drug and alcohol evaluation to measure theseverity of substance abuse and determine whether she needs anytreatment.

June will undergo a psychiatric evaluation and if warranted, get arecommendation on the type of drugs she needs. They will discuss anymore concerns pertaining her medication.

Interventions

The therapistwill have a drug and alcohol evaluation and see a psychiatrist.

Date of target:5th February 2017

AlternativeTreatment (Tertiary prevention)

An alternativetreatment for Oppositional Defiant Disorder is based on the medicalmodel. Medical studies have linked ODD to Attention deficithyperactivity disorder (ADHD)-related impulsivity. Patients may beshowing oppositional symptoms by default since they do not havecontrol over their impulses. Therefore, putting June on ADHDmedication like Adderall will alleviate her symptoms. However, thedrugs have side effects such as weight gain and sleeplessness.Medication may be used during the later stages of the currenttreatment to prevent the recurrence of further symptoms in future.

References

Mayo Clinic Staff. (2016). Oppositional Defiant Disorder.Retrieved from&lthttp://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/basics/treatment/con-20024559&gt

Valley Behavioral Health System (2016). Symptoms &amp Signs ofOppositional Defiant Disorder. Retrieved from &lthttp://www.valleybehavioral.com/disorders/odd/signs-symptoms-causes&gt

WebMD. (2016). Mental Health Center. Retrieved from&lthttp://www.webmd.com/mental-health/oppositional-defiant-disorder?page=2&gt