Transcript ODD CD Webinar II

Engaging and Treating Youth with Oppositional
Defiant Disorder and Conduct Disorder
(and their Parents)
John Sommers-Flanagan, Ph.D.
Department of Counselor Education
University of Montana
On behalf of Western Montana Addiction Services – 6/10/14
For more information
Email: [email protected]
Blog: johnsommersflanagan.com
Learning Objectives & Plan
• Briefly review ODD and Conduct Disorder
Diagnoses
• Identify and describe two evidence-based
relationship strategies for engaging young clients
with ODD and/or CD and their parents
• Identify and describe two evidence-based
approaches (techniques and models) to treating
ODD and CD
• Provide an overview/summary of essential
ingredients for “best” practice
Remember ODD Diagnosis . . .
. . . Involves a pattern of . . .
1. angry/irritable mood
2. argumentative/defiant behavior, or
3. vindictiveness
It lasts at least 6 months as evidenced by
at least four symptoms from DSM-5
Remember CD Diagnosis . . .
. . . is a repetitive and persistent behavior
pattern in which basic rights of others or
societal rules are violated. Three symptoms
are needed over the past 12 months
involving:
1. Aggression to People and Animal
2. Destruction of Property
3. Deceitfulness or Theft
4. Serious Violations of Rules
These are “Tough Kids” right?
• Yes, but . . .
• The evidence is clear: If we think of these as
tough, difficult, or resistant youth, our outcomes
are likely to be poorer
• This is because positive outcomes are based
more on relational connection with these youths
than specific techniques
• And so, before you get in the room, get straight
about . . .
. . . Your Attitude
• The “kids” are not tough – the situation is tough
• Young people can track the scent of blame . . .
and so unless we ALREADY HAVE a strong and
influential relationship . . . Pushing youth to
accept responsibility too soon can increase
defensiveness
• You really have to battle culture here
•
•
•
•
Undeveloped brains
Bad attitudes
Disrespectful
Emotionally unstable
Use These EB Relational Ideas
• Radical Respect – Satanic Golden Rule
• Radical Acceptance – Rogers and Linehan
and 30 min of profanity
• Collaboration – Punching example
• Be transparent (genuine) and nonthreatening – This is what I want/know
Questions and Comments
• Now, as we transition from the EBRelationship factors to EB-Techniques, is a
good time for you to pose questions or
make comments
Use These EB Techniques
• Self-Disclosure and Feedback
• Problem-Solving
• Brainstorming
• Consequential Thinking
• Methods for achieving goals using prosocial means
• Asset Flooding
• Parenting Interventions
• Passionate reinforcement
• Boring consequences
• Character feedback
• Limit-setting, natural consequences,
• Regular affection or child-centered play
EST Models (require training)
• The Incredible Years:
http://incredibleyears.com/
• Multisystemic Family Therapy:
http://mstservices.com/
• Functional Family Therapy:
http://www.fftllc.com/
• Parent Management Training:
http://global.oup.com/us/companion.websites/
0195154290/
EST Models (cont.)
• Overall, jury is out on working most effectively
with youth who have ODD and CD diagnoses
• It may be especially important to address the
more “treatable” symptoms first (e.g., trauma,
clinical depression, substance-related disorders)
Overview/Summary
• EBRs are the foundation for the success of all
therapies with these populations
• EBTs can be used separately and in conjunction
with EBRs
• EST models are great, but require specialized
training
Additional Info
• Johnsommersflanagan.com
• Books