The paper finally notes the importance of assessment and treatment in clinical and health psychology that helps with psychopathological problems such as oppositional defiant disorder (ODD). The mental health professions can be of great help to Marcos, who can be able to fulfill their duties through the airing of detailed diagnostics and proper essential intervention. Therefore, these service providers must firm off positive behavioral change and ensure their overall functionality. Through a multidisciplinary approach coupled with an individualized treatment plan based on each patient’s needs, clinicians can not only help them deal with complex symptoms of mental health issues but also allow them to achieve progress and independence as well. Besides the problem-solving techniques and support resources imparted to the individuals, the clinician’s role is to develop them to an extent where they can face seemingly insurmountable challenges. Moreover, besides the mental health workers, families and help networks play equally essential roles in re-balancing and allowing individuals to recover fully. By responding appropriately to assessments and interventions, we can illustrate society’s mindfulness, compassion, and wholesome care and guarantee that recipients of such services enjoy comprehensive well-being.
Assessment of Marcos’s Behavior
Nine years old, Marcos exhibits habitual tendencies of becoming physically aggressive and exhibiting disruptive behavior at both home and school lately. The typical behaviors of this child are regular arguments and disobedience with authority figures like teachers or parents, ignoring requests, physically fighting with friends and family members, and causing true destruction by breaking toys. Besides his emotional pain, Marcos shows interest in the character when he feels sulky and spiteful. These behavioral characteristics raise the question that Marcos may have the symptoms of oppositional defiant disorder (ODD). This childhood behavioral disorder manifests as defiance, oppositeness, and hostility to adult figures.
Manifestations of ODD (oppositional defiance disorder) are, among others, anger, quarrelsomeness, insults, and many other kinds of disrespectful behavior, especially towards adults (Booker, 2023). Some of the children with ODD show poor ability in controlling their impulses. As a result, they always express their anger outwardly and assert irresponsibly. A few factors in a complicated scene to know what causes ODD are: situations could be biological, psychological, and social factors. The potential risk factors for ODD are a genetic predisposition, parental family history of disorders such as ADHD or mood, exposure to adverse childhood experiences, and challenges between families or with studying a particular subject (Gonzalez et al.,2023).
In the case of Marcos, the risk factors of the potential outcome of his behavior could be some of them. He may have it in him, as his mother does, a genetic heritage of mood disorder that is usually associated with anxiety, depression, and social inadequacy. Marcos lost his grandmother, who was the main source of his stability and care, by which his mental health is also affected. Besides parental supervision being rare due to his mother working long hours and school problems, which include academic problems and peer rejection, also worsened his situation. The diagnosis of ODD is carried out through a comprehensive evaluation of the disorder by qualified mental health professionals who utilize diverse techniques, including interviews, observations, questionnaires, and psychothesets (Gonzalez et al.,2023). The diagnosis will be made using the criteria listed in the DSM-5, and the child has to experience at least six months of consistent symptoms, which are very disruptive to the child’s functioning in various aspects of life. When discussing Marcos, many things fit the definition of ODD, such as frequent changes of mood, defiance of authority figures, attempting to provoke others, and expressing one’s anger through spiteful or vindictive behaviors. However, a professional diagnosis must consider other possible contributors and make ODD the principal cause of Marcos’s conduct.
The ODD treatment frequently utilizes the combined use of psychotherapy and sometimes the prescription of drugs as well. The main treatment objectives include decreasing the number of problematic behaviors, increasing their social and emotional abilities, improving the connection between the parents and the child or the teacher, and enhancing people’s performance in various settings (Booker, 2023). The treatment plans are individualized based on the symptom’s magnitude, the child’s age, and any co-occurring behavioral or psychological diagnoses. Overall, Marcos’s behaviors are a good case for clinically diagnosing him with ODD, considering his consistent patterns of aggression and resistance. Determining the best treatment method will be accomplished through a thorough examination by mental health professionals to identify the specific needs of Marcos and to provide the necessary support for him to achieve greater levels of functioning and a high level of well-being (Gonzalez et al.,2023).
Some of the most effective interventions for ODD are:
Successful tactics for oppositional defiant disorder (ODD) are behavioral techniques in which both the kid and caregiver learn ways to transform behavior by setting rules and associating reinforcers with penalties. Cognitive-behavioral therapy (CBT) is aimed at identifying and modifying irrational patterns of thinking with a focus on decision-making and skills-building related to anger and stress (Arias et al.,2021). Social skills relearning, which includes efficient interaction skills, is the main focus of humanizing education. Through family counseling, the family returns to a well-organized functioning, resolving any family issue affecting the kid’s behavior. Prescribing medication to mitigate the identified symptoms of ODD or treating co-occurring disorders, such as ADHD and mood disorders, may also be an option. The eventual outcome, which depends on factors such as the severity of the symptoms, treatment success, and the co-occurring conditions, may vary from one child to another, with some children getting better and others developing even worse conditions (Booker, 2023). Early intervention and a secure supporting environment are of utmost importance in safe outcomes for some who might get to the extreme picture about conditions like conduct disorder or substance use disorder.
Comprehensive Assessment Tools for Understanding Marcos’s Behavior: Clinical Interview, Behavioral Observation, and Questionnaires
To ascertain Marcos’ diagnosis, various instruments must be utilized to give detailed information on his conduct, feelings, and adaptation to different environments and activities. Some of the tools that I would use are: Some of the tools that I would use are:
Clinical interview: This is a formal or informal conversation between the psychologist and the child and the parents or other caregivers, where the psychologist asks them about the child’s history of problems, day-to-day activities, capabilities, and requirements (Fucà et al., 2023). This assessment method enables us to get affinity with clients, collect necessary data, discuss patients’ goals and progress, and give temporary diagnosis and therapy. The most significant information that a clinical interview can provide is the child’s personal and family background, the onset and the duration of the symptoms, the frequency and intensity of the behavioral acts, triggers and consequences of the behaviors, the impact of the behaviors on the child’s social, educational and maintenance functioning, comorbidity of other disorders that may hinder the child’s behavior (Woenckhaus & Mylapalli, 2020). The presence of other problems that may impact the child One of the main benefits of this instrument is that it provides an informed opinion and a picture of the child which is based on the overall perspective, thus providing a way to custom the assessment and intervention to child’s needs and desires.
Behavioral observation: This is the objective and systematic observation of a child’s behavior in a natural or controlled environment like at home, at school, and in the clinic (Arias et al.,2021). The clinician can employ the following methods: direct observation involves the clinician watching the child’s behavior, while indirect observation involves using video recordings, audio recordings, or the reports of those who observed the child. A clinician may use a checklist, a rating scale, or a frequency count to make behavioral measurements of a child. Behavioral observation aids in assessing how the child behaves in true-to-life situations, determining the factors that precipitate and result in the behavior, determining the efficacy of the intervention, and monitoring treatment progress and outcomes (Woenckhaus & Mylapalli, 2020). The sort of information that the behavioral observation can provide includes the form, rate, duration, strength, and context of the behavior of the child, the interactions of the child with others, the reactions of the child emotionally and physiologically, and the compliance of the child with the rules and requests of the teachers (Fucà et al., 2023). The purpose of opting for this tool is that it furnishes objective and valid data regarding the child’s engagement in a particular behavior and can represent the variability and complexity of the behavior through different settings and situations.
Questionnaires and rating scales: They represent a class of tests that contains a group of questions/statements that the child and parents or caregivers are compelled to answer or rate, generally on a Likert scale. Questionnaires or rating scales allow one to objectively measure the child’s behavior, feelings, or functioning in comparison with the normative or clinical samples to screen the existence or severity of the disorder and the problem and evaluate the child’s improvement over time (Woenckhaus & Mylapalli, 2020). This data can be measured by scales and questionnaires that include information about the child’s symptoms, attitudes, beliefs, coping skills, self-esteem, self-efficacy, and you name what. The reason for adopting this tool is that it gathers valid and reliable data on children’s behaviors, and administering, scoring, and interpreting this tool is relatively easy (Arias et al.,2021). Some examples of questionnaires and rating scales that are commonly used for ODD are: Some examples of questionnaires and rating scales that are widely used for ODD are:
The Disruptive Behavior Disorders Rating Scale (DBD-RS): It is a 45-item scale, which is a rating scale, that is used for the evaluation of ODD, ADHD, and conduct disorder symptoms in children between the ages of 6 and 18 (Fucà et al., 2023). The valuation scale is accomplished through the teachers and parents, who note the degree of the behavior using a 4-point scale as follows: from never too often. The scale has three subscales: A: Communication and Language Deficit, on the other hand, is based on the triad of deficits, namely, Communication, Attention, and Hyperactivity/Impulsivity. The ODD scale is a 111-item instrument that matches the DSM-5 criteria for ODD, such as often losing temper, arguing with adults, or being spiteful or vindictive.
The Oppositional Defiant Behavior Inventory (ODBI): The ODD Scale is made of 42 items that help to measure how strong ODD is and to what extent it impacts a child under the age of 12 to 18 years (Arias et al.,2021). The last component of the scale is completed by parents or teachers, who base their scores on how much they agree with the statement about the child’s behavior. The scale has five points – from strongly disagree to agree strongly. The scale has four subscales: conducting problems, being colorful within, social sadness, and school failure. The same scale has a total score that symbolizes ODD’s overall strength (Woenckhaus & Mylapalli, 2020).
The Eyberg Child Behavior Inventory (ECBI): The Eyberg Child Behavior Inventory (ECBI) is a measure for moms and dads to rate the level of disturbing behaviors shown by their kids. It consists of 36 items in which parents order behavior frequency from 0 (never) to 6 (always) and behavior intensity from mild to strong (Arias et al.,2021). The scale has two subscales: frequency, the unit of which measures how much the behavior occurs, and intensity, the meaning of which measures its impact. While poverty, homelessness, and drug abuse are thriving in the community, ECBI is an important resource tool to discover behavioral issues in children, which will help to design focused interventions and supportive strategies (Woenckhaus & Mylapalli, 2020).
“Integrated Treatment Approaches for Oppositional Defiant Disorder: A Multidisciplinary Perspective”
For the successful treatment of Marcos’ conduct disorder, I would use behavioral therapy, cognitive-behavioral therapy (CBT), social skills training, and family therapy because these therapies are the most efficient interventions for ODD in the experience of literature. Additionally, I would request to talk to a psychiatrist who will judge if medications are needed for the ODD treatment or any co-occurring disorders, and it is essential to find out whether we are dealing with ADHD, mood disorders, or anxiety disorders.
The treatment would consist of 12 weekly sessions, each lasting 50 minutes, divided as follows:
Session 1: Addressing the two essential parts, the clinical interview and behavioral observation. Here, I will conduct a policy layer where I will conduct a clinical interview with Marcos and his mom, whose motive will be to review the diagnosis, the goals, and the requirements of the treatment, as well as to establish rapport and trust. I will also monitor Marcos’ behavior in the clinic and use a checklist or rating scale to quantify the frequency and intensity of his ODD symptoms.
Session 2: A lesson on behavioral therapy. In this session, I will introduce Marcos and his mother to behavior therapy principles, such as setting clear and consistent rules and standards, using positive reinforcement and praise, and ignoring minor misbehavior and penalties for disobeying the regulations (Ogundele & Morton, 2022). In addition to helping them create it would be with a behavior contract in which the parents and their children mutually agree on the rules their children would follow at home and school and would be responsible for the penalties if Marcos’ does not adhere to the contract. Another thing I would do is design homework, for example, to keep a daily journal on Marcos’ behavior and responsibility contract adherence.
Session 3: Behavior therapy integrates several approaches that focus on learning new ways to interact with others (Yule et al.,2023). In this lesson, I would check the assignments and let them know that they had done well, and if they had difficulties, I was there for the reinforcement. Above all, I would act as a supporter to help them solve any problems they might have and adjust the contract whenever necessary. I also credit the token system, which Marcos can use to earn tokens for potential positive behaviors in exchange for privileges or rewards. I will also provide them with work assignments, like the continuation of the reported incidents they must record and the token economy system.
Session 4: Cognitive-behavioral therapy (CBT) is one of the most effective and widely used forms of psychological treatment for depression, anxiety, and other mental health issues (Colizzi et al.,2023). In this session, I will upload cognitive behavioral therapy (CBT) principles to Marcos and his mother to identify and challenge the thoughts and beliefs that may motivate his behavior. I would also introduce them to coping skills for anger, frustration, stress, and so on, such as relaxation techniques, problem-solving skills, or assertion. Besides this, I will provide them with assignments on keeping a thought diary and practicing coping skills.
Session 5: CBT. In the following session, I will review all the completed homework assignments and give Marcos and his mother feedback and encouragement. I would assist them in using the CBT mentioned above strategies in actual problem-solving situations and facilitate applying the skills through role-playing, acting, or behavioral experiments. In addition, I will set the homework tasks for them, which will include continuing their thought diary and coping skills and applying them to various situations.
Session 6: Social-skill training. During this session, I will give them skills to handle social interaction appropriately, for example, taking turns, sharing, cooperating, listening, expressing feelings, or resolving conflicts. I would also facilitate them to engage in role-plays and use modeling and games to practice social skills. I, however, would also assign them home activities, such as practicing with home family, friends, and schoolmates and keeping a record of the results.
Session 7: The training of social skills. During this session, I would review the homework assignments with Marcos and his mother and provide positive feedback and reinforcement. In that line, I would teach them to apply what they learned in various settings and situations using role-playing, modeling, or behavioral experiments. In addition, I would provide them with some exercises for homework, for example, practicing social skills, record-keeping, and getting feedback from others.
Session 8: Family therapy will also be instrumental to the new milestones I will be hitting. In this session, I would like Marcos’s father and family members to participate, being careful not to violate privacy if necessary. As part of the treatment plan, I would cooperate with the family members to accordingly respond to the family’s strengths and weaknesses, role dysfunctions, poor communication, or possible issues, including relationship conflicts, financial hardships, and parent’s mental problems. A family contract will be the second thing I could help them to develop: it would require them all to agree on the rules, the roles, the responsibilities of each family member, and the ways to support each other. I would then provide them with such tasks as following the family agreement and having a family alliance regularly.
Session 9: By introducing family sessions, I can move the focus to the whole family, allowing us to work together to improve the situation and ensure everyone is on the same page. During this session, I will give you constructive criticism about the homework you completed and repeat the most important information you should remember. Another crucial aspect of my role might be assisting them to solve any problems or difficulties they may face and slightly modifying a family contract if required. I will also add a family reward system, which will award tokens or points to everybody in the family who shows positive behavior. Then, these can be used to obtain a family activity or reward. I propose giving them assignments such as following the extended family contract and maintaining the family reward system.
Session 10: After doing a review and integration session. In session 28, I will review and synthesize everything Leones and I have worked on during the treatment. Some examples are behavior therapy, cognitive behavior therapy (CBT), social skills training, and family therapy. Besides, I would assist them in assessing the efficacy of the treatment and determining the outcomes of the therapy by again applying the questionnaires and the evaluating instruments used at the beginning of the treatment and comparing these measures and scores with each other. The further responsibility would be to supply the participants with homework that includes running and practicing regularly with skills and techniques, plus keeping an account of the outcomes.
Session 11: Relapse prevention and maintenance. In the next session, I would assist Marcos and his family in identifying and anticipating the most common relapse trigger factors as well as situations such as extreme stress, conflict, or change. At this time, they would detail their resource and the strategy that they can use to cope and prevent a relapse. In addition to that, I will develop a maintenance plan with them. This will comprise the goals and activities they will carry out to build their resilience further and keep the positive and adaptive functions going. Additionally, I would offer them a homework assignment to enact the relapse prevention and maintenance plans and to seek support from friends and family.
Session 12: Termination and guidelines. In the last stage of the treatment, I would stop the recovery journey and thank Marcos and his family for their efforts and accomplishments. Furthermore, I would review the main ideas and the lessons achieved through the treatment and give them a summary and a feedback report. In addition, the follow-up plan would involve scheduling periodic appointments and booster sessions to monitor the progress and results and then reinforce them. Therefore, I will also introduce them to referrals to such bodies as support groups or recommended readings to continue the learning processes.
Conclusion
In conclusion, this paper finally notes the importance of assessment and treatment in clinical and health psychology that helps with psychopathological problems such as oppositional defiant disorder (ODD). The mental health professions can be of great help to Marcos, who can be able to fulfill their duties through the airing of detailed diagnostics and proper basic intervention. Therefore, these service providers must firm off positive behavioral change and ensure their overall functionality. Through a multidisciplinary approach coupled with an individualized treatment plan based on each patient’s needs, clinicians can not only help them deal with complex symptoms of mental health issues but also allow them to achieve progress and independence as well. Besides the problem-solving techniques and support resources imparted to the individuals, the clinician’s role is to develop them to an extent where they can face seemingly insurmountable challenges. Moreover, besides the mental health workers, families and help networks play equally essential roles in re-balancing and allowing individuals to recover fully. By responding appropriately to assessments and interventions, we can illustrate society’s mindfulness, compassion, and wholesome care and guarantee that recipients of such services enjoy comprehensive well-being.
References
Arias, V. B., Aguayo, V., & Navas, P. (2021). Validity of DSM-5 oppositional defiant disorder symptoms in children with intellectual disability. International Journal of Environmental Research and Public Health, 18(4), 1977.
Booker, J. A. (2023). Oppositional Defiant Disorder. Handbook of Clinical Child Psychology: Integrating Theory and Research into Practice, 857–877. https://link.springer.com/chapter/10.1007/978-3-031-24926-6_40
Colizzi, M., Lasalvia, A., & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? International journal of mental health systems, 14(1), 1-14. https://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9
Fucà, E., Cirillo, F., Celestini, L., Alfieri, P., Valentini, D., Costanzo, F., & Vicari, S. (2023). Assessment of oppositional defiant disorder and oppositional behavior in children and adolescents with Down syndrome. Frontiers in Psychiatry, 13, 1062201. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.1062201/full
Gonzalez, J. C., Klein, C. C., Barnett, M. L., Schatz, N. K., Garoosi, T., Chacko, A., & Fabiano, G. A. (2023). Intervention and implementation characteristics to enhance father engagement: a systematic review of parenting interventions. Clinical child and family psychology review, 26(2), 445–458. https://link.springer.com/article/10.1007/s10567-023-00430-x
Ogundele, M. O., & Morton, M. (2022). Classification, prevalence and integrated care for neurodevelopmental and child mental health disorders: A brief overview for pediatricians. World journal of clinical pediatrics, 11(2), 120.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985496/
Woenckhaus, S. R. H., & Mylapalli, S. N. R. (2020). Screening and measurements for oppositional defiant disorder. https://core.pubpub.org/pub/58t52iet/release/1
Yule, A. M., Fernandes, C. S. F., Stormshak, E. A., Yang, Y., Shelley, L., Fiellin, L. E., … & Bonar, E. E. (2023). Multidisciplinary strategies for preventing opioid misuse and escalation by targeting mental health symptoms and conditions. Prevention Science, 1–11. https://link.springer.com/article/10.1007/s11121-023-01556-8
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