#7 please. detailed in a paragraph PSY 202 axtra.credit (Compatibility Model wha
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#7 please. detailed in a paragraph
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Conduct disorder (CD) is a psychiatric syndrome occurring in childhood and adolescence, and is characterized by a longstanding pattern of violations of rules and antisocial behavior. Oppositional defiant disorder (ODD) is also one of the group of behavioral disorders called disruptive behavior disorders (DBD).The most common behaviors that children and adolescents with ODD show are: defiance, spitefulness, negativity, hostility and verbal aggression.
Treatment for both CD and ODD is typically similar in design. Therapy treatment is typically designed to decrease or eliminate as many current problem behaviors as possible (with a bias toward targeting and eliminating behaviors in order of severity; more serious behaviors that have the potential to harm others or cause more negative consequences are targeted first). Therapy also attempts to change affected children's long-term developmental course toward a more positive outcome.
The following are few effective treatments for CD and ODD:
Cognitive Behavioural Therapy: Cognitive Problem-Solving/ Skills Training is used to reduce inappropriate behaviors by teaching the child positive ways of responding to stresful situations. Children with CD and ODD often only know of negative ways of interpreting and responding to real-life situations. Cognitive problem solving skills training teaches them how to see situations and respond appropriately. Modern therapists recognize that it is as important to address children's thoughts as it is to address their actual problem behaviors. This is because thoughts can serve a motivating function. If children have a wrong, overgeneralized or otherwise exaggerated understanding of a situation, this can make them more likely to misbehave. Cognitive-behavioral approaches to therapy teach children and parents both to identify and address faulty beliefs that make conflict more likely and to help dismantle and debunk those beliefs.
As a part of cognitive behavior therapy, therapists work with children to help them develop several important cognitive skills, including cognitive reframing of stressful events (e.g., helping children to generate alternative, more peaceful ways of thinking about the meaning of stressful situations so that anger is not an automatic consequence). Anger management training, which generally involves teaching people to better manage frustration feelings by learning to recognize and defuse anger sensations with reframing and relaxation techniques such as muscle relaxation or deep breathing, may also be taught.
Behavioral Therapy: Behavioral therapy in children with CD and ODD is based on learning theory. Behavioral therapists essentially set up conditions wherein children can "unlearn" inappropriate behaviors and, in their place, learn new, more appropriate behaviors. Behavioral Family Therapists work directly with disordered children in order to teach them important skills and coping mechanisms (e.g., appropriately expressing feelings such as anger, taking other's perspectives, and appreciating the impact of their own behavior on others).
The basic idea is that behavior patterns are in large part learned from exposure to rewards and consequences, and therefore, inappropriate behaviors can be "unlearned", and replaced by more appropriate pro-social behaviors through the systematic manipulation of rewards and consequences that promote pro-social behavior and discourage antisocial behavior.
Social-Skills Programs and School-Based Programs: to teach children and adolescents how to relate more positively to peers and ways to improve their school work.These therapies are most successful when they are conducted in a natural environment, such as at the school or in a social group.
Psychoeducation: providing parents, upbringers and the child or adolescent with relevant information about ODD or CD and the possible treatment methods. This makes children and adolescent more aware of their own limitations and possibilities. The goal of psychoeducation is to create realistic expectations for the treatment and better acceptance of both pharmaceutical and psychosocial treatment (Dutch Association of Independent Psychiatrists guideline, 2013).
Medication: Medication alone has not been proven effective in treating CD or ODD. However, medication may be a useful part of a comprehensive treatment plan to help control specific behaviors and to treat coexisting conditions, such as ADHD, anxiety, and mood disorders. For example, medication used to treat children with ADHD has been shown to lessen behavioral symptoms when ODD and ADHD coexist. When children and adolescents with ODD also have a mood disorder or anxiety, treatment with antidepressants and anti-anxiety medications has been show to help lessen the behavioral symptoms of ODD. However, medication alone is not a treatment for ODD and CD.
Role of parents in treatment:
Therapy for Oppositional Defiant and Conduct Disorders necessarily occurs within the context of the family; techniques are taught to all family members, most especially to parents. Studies have shown that intervening with parents is one of the most effective ways to reduce the behavioral symptoms of CD and ODD in all age groups. In addition to addressing specific problem behaviors, therapy also tends to focus on helping parents understand how to be more effective and fair disciplinarians. Hence the therapy treatment usually consists of a combination of:
Parent training: teaching parents how to positively reinforce desired behaviour and ignore undesired behaviour in their child by means of individual or group training based on a behavioural therapy perspective. This training focuses on helping parents to be more sensitive to signals from the child or adolescent; this is then brought to bear to improve the parent-child relationship and family atmosphere. The effectiveness of parent training has been assessed in various meta-analyses and has been found to be successful in reducing various forms of defiant and antisocial behaviour in children and adolescents (Dutch Association of Independent Psychiatrists guideline, 2013). Parenting skills such as figuring out which minor problematic behaviors to ignore and which to address, giving children clear rather than vague instructions for how to behave, and developing and communicating specific rules are often taught to parents as part of the therapy, as are conflict resolution (problem solving) and communication skills.
For example, in Parent-Management Training Programs and Family Therapy, parrents, family members, and other caregivers are taught techniques in positive reinforcement and ways to discipline more effectively. It teaches parents positive ways to manage their child’s behavior, discipline techniques, and age-appropriate supervision. It also embraces the following principles: Increased positive parenting practices, such as providing supportive and consistent supervision and discipline, Decreased negative parenting practices, such as the use of harsh punishment and focus on inappropriate behaviors, Consistent punishment for disruptive behavior, Predictable, immediate parental response, etc.
Parent-child interaction therapy (PCIT): During PCIT, therapists coach parents while they interact with their children. In one approach, the therapist sits behind a one-way mirror and, using an "ear bug" audio device, guides parents through strategies that reinforce their children's positive behavior. As a result, parents learn more-effective parenting techniques, the quality of the parent-child relationship improves and problem behaviors decrease.
Parents are taught to be consistent in their use of approved reinforcements (rewards) and, as necessary, punishment techniques. By learning to take better and more consistent control over the reward landscape of their children's environment, parents gain more control over how their children behave. Over time, some rewarded behaviors become habitual, and (more usefully) become reinforced by the environment itself (rather than by parent's actions) such that children start engaging in those actions on their own. For example, parents may create conditions which promote their children's completion of homework, which in turn may result in their getting better grades and experiencing a greater mastery of the subject matter being taught, which causes them to want to avoid homework less.
Both Conduct Disorder and ODD occur in the context of the family and are heavily influenced by the health of family interactions. Therapists working to treat these disorders may thus recommend marital therapy, or substance abuse treatment to parents and caregivers if they believe such interventions will improve the overall health of family interactions.
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