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Discussion: Counseling Adolescents

Discussion: Counseling Adolescents


Case Overview

The client in the case study is a female adolescent with anger issues who argues and tells the counselor that he is horrible and stupid. She states that she hates been there and hate talking to the counselor. She further says that the session is worthless and refuses to say anything about her. The adolescent has behaviors aligned to Oppositional defiant disorder, which is a persistent pattern of rebellious, aggressive, and defiant behavior but without violation of social norms or other people’s rights (Cooper, 2018). The disorder is characterized by a child or adolescent anger outbursts, refusal to observe rules, and irritating behaviors.

In oppositional defiant disorder, the child repeatedly argues with adults, loses temper and is resentful, angry, and easily irritated by others (Cooper, 2018). Besides, the child actively oppose adults’ requests and rules and intentionally annoy others. Defiant children and adolescents often blame other people for their behavior and mistakes (Cooper, 2018). The child’s behavior also exceeds the expectations of other children in the same age group. Adolescents with a history of oppositional defiant disorder have a high risk of developing another mental disease in the future and hence should be appropriately managed to minimize the risk.

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Therapeutic Approaches

The adolescent client will be managed with a combination of psychotherapy and pharmacotherapy. Psychotherapy interventions will include:

  1. Parent management training. This will involve training of the client’s parents on adolescent management skills (Kazdin, 2017).
    Discussion Counseling Adolescents

    Discussion Counseling Adolescents

    The parents will be trained on behavior change and hence change the adolescent’s behavior at home. Besides, they will be advised to be attentive to disruptive behavior and to adopt effective and non-aversive punishments (Kazdin, 2017). A thorough assessment of the family interaction will also be conducted.

  2. Behavior therapy. It will involve positive reinforcement of appropriate behaviors and not reinforcing negative behaviors.
  3. Individual psychotherapy. This approach will involve training the adolescent on adaptive responses, anger-management, and ways to express her feelings without offending others.
  4. Cognitive problem-solving training. Training on problem-solving aims at helping the client recognize and change the thought patterns that result in negative behavior (Kazdin, 2017). The training will also be done in collaboration with the parent to enable them to identify practical solutions (Kazdin, 2017). Besides, it will help in reducing undesirable behaviors by teaching the client how to respond to stressful situations positively.
  5. Social skills training. The client will be trained on social skills to enable her to interact with others and will involve teaching verbal and non-verbal behaviors that are crucial when interacting with people.

Pharmacotherapy will aim at treating comorbid conditions such as anxiety or depression. Literature studies suggest that drugs used to treat Attention deficit hyperactive disorder may be successful in the management of oppositional defiant disorder (Connor, 2015). The client will be managed with Atomoxetine and Carbamazepine, which is a mood stabilizer.

Expected Outcomes

  1. Individual psychotherapy. This approach will involve training the adolescent on adaptive responses, anger-management, and ways to express her feelings without offending others.

By the end of the psychotherapy sessions, the client is expected to demonstrate positive behaviors when interacting with others. She should be able to effectively express her feelings, control, and manage her anger and exhibit appropriate adaptive responses. Moreover, she should demonstrate practical problem-solving skills and appropriate social skills when communicating with adults and peers. Furthermore, the parents should report a change in her behavior at home, respect to her parents and adults, and obeying rules and those in authority. The mood stabilizers will act to control anxiety disorders and will help control the client’s mood disorders.

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