John Sommers-Flanagan, Ph.D. Department of Counselor Education University of Montana
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Transcript of John Sommers-Flanagan, Ph.D. Department of Counselor Education University of Montana
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 informationEmail: [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 mood2. argumentative/defiant behavior, or3. 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 Animal2. Destruction of Property3. 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 non-threatening – This is what I want/know
Questions and Comments
• Now, as we transition from the EB-Relationship 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