Case Study on Defiant Disorders

Case Study on Defiant Disorders

Abstract

Children form an important part of the future of the society. This is the reasoning behind most of the churches to be actively involved in dealing with children with special needs that risks the development to productive citizens. One of the most common disabilities among the youths is the oppositional defiant disorder (ODD) and the conduct disorder (CD). It is common disability among the youths aged between 6 and 11 years. Children suffering from these disorders tend to be more aggressive and have the tendency to purposefully bother and irritate others (Elliott, 2014).  It is a dangerous condition that can often lead to enormous costs to society, especially if the condition is left unattended. Extreme cases of this condition lead to depression, anxiety and other neuropsychiatric disorders, thus making the life of the child far more difficult. From past studies, the vice is found to be more prevalent among the male children as compared o their female counterparts.

It has therefore been the undertaking of several church ministries to ensure that the future of young children suffering from such conditions is guaranteed. This paper is designed to give insights on how church ministry has dealt with ODD and CD prevalence among children in our society. The paper will address sensitive issues regarding these conditions such as etiology, etiology, prevalence, characteristics, prognosis, current research, and social dynamics. The paper will also discuss at length an example if church ministry that has taken a leading role in dealing with children suffering from this condition. The church details including vision and mission statements will be the major areas of concern. It will also be worth noting that the paper will provide insights on both short and long term objectives that this child program intends to achieve. The paper will end with a comprehensive conclusion and recommendations on how to improve this condition in future.

Church and children ministry

St. Francis Priesthood Center is a local church that has taken a leading role in the promotion of the local child growing in the direction. Over the years, the ministry has strived to ensure that the children attending the church are brought up in a way that will help them become an important part of the society. The church has a strong children programs that teach children important tips that help them being important members of the society. Children suffering from Oppositional Defiant Disorder and Conduct Disorder are not left behind in the church program.

The church has strictly outlined objectives; mission and vision statements that provide the road map to assisting the children grow in a Godly way.   As the Bible says that the children should be brought closer to God, the ministry strives to ensure that children in the society learn the word of God and are taught the right way to grow (Elliott, 2014).  The church ministry firmly believes that through effective teaching of the Bible to the children, the society can manage to get the kind of children that will help in future prosperity.

Ministry’s goals and objectives

  • To give service, share the gospel and build the community
  • Promote child development by impacting knowledge of the love of God the Father, Son, and the Holy Spirit.
  • To assist children in character development, emphasizing moral principles and Christian values.
  • Tom encourages children to develop a personal relationship with Jesus Christ.
  • To feed each child with the holy word of God as contained in the Holy Scripture and also deepen the knowledge of the teachings, practices and traditions of Christian faith and also foster peaceful coexistence with other religious.

Ministry objectives

  • To provide a rich variety of faith experiences among the community children through a Christ-centered curriculum, prayer services and encouraging them attend Christian Sunday services.
  • To encourage community service that helps in helping the needy children in the society through the collection of relief food and other medical needs.

Oppositional Defiant Disorder and Conduct Disorder

As aforementioned, the Oppositional Defiant Disorder and Conduct Disorder are common occurrences in young children. In most cases, these conditions are learned behavior and it is possible to reverse the situation through a strict and a consistent routine. To start with, the oppositional defiant disorder is a common psychiatric disorder that explains the tendency of aggressiveness and purposeful irritation of others by young children.  On the other hand, conduct disorder is viewed as a worse version of the ODD. Nevertheless, there are some notable differences between the two disabilities common among the young people. While children suffering from ODD are more aggressive and irritating, the patients of Conduct Disorder are described to have better social skills. In essence, conduct disorder is defined as a repetitive and persistent pattern of behavior where basic rights of others and social rules are grossly violated (Q. Ashton Acton, 2012).

Though these conditions are prevalent among children in the society, it is the role of the church and society and the family to strive in ensuring safety among children and that we have a prosperous future.  Dealing with such disorder requires that one must understand why children may opt to be oppositional and defiant to fellow children, adults and animals. For instance, from time to time, children have experienced hunger periods, stressful moments and general dissatisfaction that can easily lead to them being upset and result in opposition mood (Elliott, 2014). During such periods, children will tend to be more opposing and may opt to disobey their teachers, parents, and other adults or result in aggressiveness and fights amongst them.  It is, however, prudent noting that a recurrent pattern of this behavior must be of great concern to the community and proactive measures should be put in place to ensure the situation is adequately controlled.  Prevalence of these conditions can only be proved by observing this pattern for a period not less than six months (Elliott, 2014).  It is however prudent to note that these conditions are in most cases associated with other mental health issues and thus it may be difficult for diagnosis and treatment. Nevertheless, the conditions can be treated through medications and other therapies that can help reduce traits of disruptive behaviors.

Characteristics

It is worth noting that existence of these conditions can only be confirmed if the following characteristics are persistently observed;

  • Often the loss of temper.
  • Constant arguments with the adults
  • Constant disobedient to rules and requests from the adult.
  • Often blaming others for one’s mistakes
  • Often angry, resentful and easily annoyed by others.
  • Often initiate physical fights
  • Physical cruelty to animals
  • Often intimidate and bully others.

Previous studies have proved that both Oppositional Defiant Disorder and Conduct Disorder are related in one way or the other. It is evident that conduct disorder is a severe form of the oppositional defiant disorder.  In essence, an ODD is a precedent to CD and thus it is critical that we treat cases of ODD as they emerge to prevent excessive cases of CD. It imperative noting that the major concern for patients suffering from CD is their safety since they are very aggressive. Personal safety and safety of others in the community remains a critical area of concern (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). Nevertheless, children suffering from ODD are an only annoyance but not necessarily dangerous. It is, therefore, essential noting that these conditions are the hardest pediatric neuropsychiatric disorder to live with as a parent, sibling or any member of the society. It is, therefore, critical that we deal with these issues decisively.

Current research and prognosis

The existence and prevalence of ODD and CD have resulted in numerous empirical researchers aimed at giving more insights into these conditions. For instance, the empirical studies have noted a certain relationship between Attention-deficit/hyperactivity disorder (ADHD) and ODD/CD. ADHD is a common occurrence to most school going children mostly between the ages of 8 to 15 years.  Though it is a condition prevalent even in adults, it is imperative noting that the condition is more to children as compared to the fellow adults. The studies indicate that most children suffering from ADHD are also likely to suffer from other conditions and CD, and ODD are the leading conditions associated with ADHD (Connor, Steeber & McBurnett, 2010).

In most cases, the existence of ODD/CD is associated with personality disorder. Personality disorder is a term mostly used by psychiatrics referring to persons with traits that cause major problems to their personality. As aforementioned, these conditions do not come and go but in most cases tend to stay for decades especially in adult males. A person’s personality starts in teenage years and carried on to adulthood. It is however prudent noting that of the ODD/CD victims who carries these traits to their adulthood may look strange and different from other people (Elliott, 2014).   This makes it difficult for them to integrate well with other people and state as they always find themselves in the wrong side of the law. Recent empirical studies have proved that children who exhibit ODD/CD traits have the tendency of showing personality disorders in their adulthood.

It is essential noting that disruptive behavior disorders, CD, and ODD being good examples, co-exist with ADHD. It is paramount to note that more than two-thirds of all children suffering from ADHD have high chances of experiencing other disorders such as CD and ODD. Co-existent of these conditions does not only complicate the diagnosis process but also the prognosis process is quite difficult to implement. These researches assert that most children with ADHD condition are more likely to adjust while those within which co-existent of CD, ODD and ADHD are evident, dire consequences are expected. For instance, most cases of school drop outs have been as a result of the co-existence of these disorders (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). It has therefore been recommended that early diagnosis and treatment of these conditions is the absolute form of defense lest the disorders are vet calamitous.

Further researches have indicated that more of the reported cases of disruptive behavior, ADHD, ODD, and CD, are mostly from male children.  Though the rate of psychological and intellectual morbidity is on the increase, it is worth realizing that it is not at the same rate within the gender disparities. The studies have indicated that more boys than girls have exhibited disruptive behaviors such as aggressiveness, disobedience and outbursts of temper (Elliott, 2014). It is, however, imperative noting that prevalence of these conditions is similar across the ages of school going children.

These studies have also indicated that cases of these disorders are more prevalent among children born to single mothers, divorced or brought up in a low socioeconomic status. Children with a sense of low esteem are at great risk of suffering from disruptive behavior conditions as compared to those whose self-esteem is at acceptable levels. Although ADHD is also prevalent among the adults, the condition has severe consequences to children as compared to the grownups. Empirical studies claim children diagnosed with CD/ODD are twice likely to experience difficulty while reading and also be at greater risk of experiencing social and emotional problems (Q. Ashton Acton, 2012). With such analysis, it is wise concluding that non-aggressive conduct problems increase with age, and it is at this point that the aggressive symptoms become less common. Nevertheless, these studies have also suggested that failure to diagnose and treat these conditions early can be carried on to adulthood.

From the previous studies, children suffering from such conditions are at great risk of being on the wrong side of the law. The cases are more complicated in instances where4 there is co-existence of ADHD, CD and ODD. Most of these children will spend most of their time in police cells and corridors of justice. TItCD/ODD victims will often steal, fight, lie and also disregard the plight of others.  With such kind of behaviors, then it is evident that these children will always be in for legal troubles. On this note, research has also proved that most of untreated cases of ODD/CD have resulted in increased substance and drug abuse. it is noted that most children with CD/ODD characteristics are thought to be in drug abuse even before it is confirmed. According to previous researches, children with CD/ODD traits are 3 times more likely to smoke cigarettes, five times more likely to smoke bhang and three times more to drink alcohol as compared to children of similar age with no CD/ODD symptoms.    In fact, it has been noted that about 50-70% of children aged ten years with CD/ODD symptoms will be in drug abuse four years later (Elliott, 2014).   Drug abuse and other antisocial behavior have been noted to have a correctional relationship.

Also, cases of CD and ODD are also known to lead increased stress and depression. These empirical studies have noted that there is a significant relationship between mood disorder and CD/ODD. The relationship has been missed for a long time, and it has been proved that there are so many different stressors. Children with CD/ODD symptoms have experienced mood disorders as compared to children with no such symptoms (Q. Ashton Acton, 2012). Comorbid depression has been on a tremendous increase among children, and most cases are associated with CD/ODD. Such cases have brought dissatisfaction among families since cases of suicide and family disintegration have significantly increased as a result of CD/ODD symptoms. Most of suicide cases among teenagers are found to be about three times more in children with CD/ODD and 15 times more in substance abuse (Elliott, 2014). From above analysis, substance abuse among the youths is mostly associated with CD/ODD symptoms.

Additionally, more than 30% of CD/ODD children carry these problems into adulthood. Nevertheless, just as is the case in the prevalence of these conditions across the gender, it is common for the male to carry on these problems to adulthood as compared to females. Contrary to male patients, females with CD/ODD often end up having mood and anxiety disorders as they grow up. A recent study has also indicated females with CD/ODD have much worse physical health as compared to their normal counterparts. It is nevertheless prudent understanding that by time female adults mature, more than 70% of these girls do not exhibit CD/ODD characteristics (Connor, Steeber & McBurnett, 2010). Though some of them get well, the most likely occurrence is that these conditions remains or get worse. Most of these girls live in depression but lacks CD/ODD characteristics as compared to their male counterparts.

Social dynamics

The prevalence of CD/ ODD conditions among our children is a disaster to the society. This is because the future prosperity of the community largely depends on the success of our children. It is, therefore, imperative for the society to work in unity and ensure that the menace of disruptive behaviors is decisively dealt with. It is worth noting that most of CD/ODD patients carry these problems into their adulthood thus making it difficult to be productive citizens in the community (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). Most of these patients end up in antisocial behaviors that do not promote development and social justice.

For instance, girls are an important part of the growth and development of the society. However, with the increased cases of CD/ODD symptoms in our society, there are high chances that the community growth and development is at stake. Girls with CD and ODD symptoms are likely to engage in early sex life. This will be a retrogressive step since this increases chances of early pregnancies and transmission of Sexually transmitted diseases. This is great undoing to the society since most children born by underage parents is likely to get the required levels of upkeep. It is also worth noting that chances of giving birth to children infected with deadly diseases are also very likely to happen. This presents a great tragedy to the development and growth of the society.

From previous analysis, it is evident that most of traits associated with CD/ODD translate to antisocial behavior. People will suffer from violent behavior, high crime rate, family breakages among other antisocial behavior. These vices are detrimental to growth and development of the society (Matthys, Vanderschuren & Schutter, 2012). Most of these vices are associated with drug and substance abuse that in most cases are as a result of the existence of CD/ODD symptoms in youths.

The cases of CD/ODD will likely lead to increased cases of school drop outs. Uneducated society will be left backward in terms of social and economic development. In the modern society, it is very difficult for uneducated people getting in beneficial economic activities. The vicious cycle of poverty will be evident in a community where the number of school dropouts is on the increase. Education equips members of the society with adequate knowledge essential in dealing with social problems.

Apart from the stress on the side of the victims, there are also cases of stress to other family member and the society at large. In most cases, CD/ODD has been a major cause of family problems since it is always difficult to deal with victims of CD/ODD. Most families have suffered immensely resulting from incidences of CD/ODD. This problem is carried on to adulthood thus making it difficult for children to understand the behavior of their CD/OOD parents (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). Most of the patients suffering from CD/ODD carry these vices to adulthood where they become drug addicts and alcoholics. With these vices, there are high chances that these people will lead a poor personal life, poor health, less career achievement and increased number of children with single parents. Such cases results in pot family ties and dire cases may result in family disintegration. In essence, the prevalence of CD/ODD has dire consequences on the overall social dynamics.

Child program goals and objectives

The church ministry is very much aware of the importance of dealing with the menace of the prevalence of CD/ODD among our children. From the previous discussion, it is clear that existence of this problem among the children is a disaster to the society. With this in mind, the church has an elaborative child program aimed at ensuring that cases of CD and PDD are maintained at manageable levels. The first objective of the church program is working with members of the family to deal with the problems associated with CD/ODD. The church program admits that both ODD and CD are treatable occurrences, and it is only wise if the necessary efforts are put in place to offer a solution to these problems. The church acknowledges that parent and family intervention is critical to treating these cases (Elliott, 2014). Child program in this church will ensure that the case of a child in this program will be handled with great expertise. Parents, family members, peers and staff from the ministry will be very instrumental in the healing process.

The church ministry is aware that involving parents and family members in treating CD and ODD will be of great inmport6ance in dealing with the problem. From previous researches, it is evident that parents play an important role in child’s life, and thus it becomes paramount to involve parents in the treatment process. It is clear that improved cooperation from parents will lead to better performance in the children development. The process involves what is popularly known as a dyadic treatment where the child will engage in vigorous sessions with their parents. During these sessions, parent-child relationship thrives and increase chances of recovering from CD and ODD. Parents have the ability to instill self-belief and self-esteem among the children thus enhancing the recovery process (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). The church ministry acknowledges the role of parents in providing structure and reinforcing appropriate behavior. Parents have an obligation of discussing their children behaviors with the respective personnel such as pediatrician and family practitioners.

Parent training is also another important step towards reduction of the disruptive behavior menace.  The child program has been sensitizing parents to the importance of engaging their child in training programs that will help in the treatment of defiant behaviors. Parents are also sensitized on how to relate with their children especially in terms of punishments and rewards. Parents are taught on some of the major causes of defiant behavior among the children and how to deal with such cases in case they are eminent in the society (Connor, Steeber & McBurnett, 2010). This implies that the child program will put the parents on a training schedule that will ensure that parents with school going children will be trained on the best way to deal with defiant kids.

Another short term objective of the child program is involving local school to help the child in the recovery process. It is imperative understanding that children spend most times in their schools. With this in mind, the child program has put more emphasis on adopting the schools in the treatment of the disruptive behaviors (Connor, Steeber & McBurnett, 2010). Teachers and peers of the child suffering from the behaviors can be of great importance in the recovering process. School intervention remains an important aspect of the recovery process. Just like the home environment, the school environment has a significant contribution to child’s behavior patterns. The church ministry has therefore been proactively involved in sensitizing schools to develop systems and programs that promote positive behavioral supports. The idea behind this objective is ensuring academic as well social behavior gains among the learning community (Elliott, 2014). School intervention programs will consist of; positive contingencies for appropriate behaviors, clear, consistent consequences for inappropriate behavior and also team-based services especially in cases of extreme behavioral needs. The church will also encourage parent-teacher discussions aimed at understanding the behavior of their children.

Schools are known to have professional counselors and psychologists who have a significant role in behavioral characters of the children. As the teachers handle classroom matters, psychologist and counselors have a significant role in the behavioral intervention of the student (Connor, Steeber & McBurnett, 2010). The church promotes consistent behavioral management at home, church and at schools. The child program enhances and advocates for appropriate instructional support in the classroom that ultimately leads to lesser cases of disruptive behaviors.  This is achieved through; creating an accepting and supportive classroom climate, establishing clear rules and procedures, promoting emotional and social skills, monitoring child behavior, managing anger and aggressiveness as well as prompt response to mild problem behaviors. In essence, the child program will be greatly concerned with the role of the school in achieving its ultimate objective of bringing up children who are of benefit to the society and God.

Long term objectives

The long term plan of the child program is to ensure almost zero cases of CD/ODD in the community. It is the objective of the child program to put in place comprehensive programs that will conclusively eradicate the issue of disruptive behavior amongst our children. This implies that the church program must incorporate other stakeholders in the rehabilitation process. For instance, the church ministry acknowledges that family therapy will be a vital tool in dealing with the occurrence of disruptive behaviors (Matthys, Vanderschuren & Schutter, 2012). It is evident that family therapy has a positive contribution in improving communication among the family members. Honesty and openness in a family setting is an important aspect that will substantially reduce CD/ODD cases in a family. Cases of family therapy are even more productive in cases where a child is involved in stealing, running away from home and disobedience. The therapy gives the child an opportunity to express them and thus making it a productive open session. The church also promotes group therapy where members can get assistance from their peers. It is on this premise that the church ministry will strive to encourage both family and group therapy to CD/ODD patients.

The child program is also aware that psychopharmacological treatment alone does not offer effective treatment to the conduct disorder and oppositional defiant disorder. The church acknowledges that effective medication combined with psychopharmacological treatment can offer the required results as far as CD/ODD treatment is concerned. From clinical researches, it is evident that there are stimulants and non-stimulants that are critical components in CD/ODD treatment.  The researches further affirm that children with these disorders and treated with these medications have registered positive results. The level of aggressiveness and antisocial significantly declined as the level of attentiveness increased substantially.  With this in mind, the ministry intends to collaborate with health care providers to ensure that children suffering from these conditions have access to the right medication (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). The ministry may also think of setting up a health facility under the ministry whose mandate would be ensuring that children in the child ministry are covered in all medical needs and not only in cases of conduct disorder and oppositional defiant disorder.

Another long-term goal of the child program is initiating a collaborative problem-solving technique in dealing with instances of disruptive behaviors. This technique has proved to be effective when adequately applied. The technique tries to teach adolescents and difficult children how to deal with frustrations and teach them how to be adaptable and flexible. The technique embraces collective brainstorming between parents and children and enables them coming up with the best solution. The technique embraces problem solution in a conflict-free environment.

Evaluation

The child program is a very serious programs and the management always ensure a follow up to determine the level of success that the program has made. A constant evaluation program will be conducted to ensure that the objectives of the Ministry are met within the set timelines. The child program will make follow up in the local schools to ensure that children with defiant disorders are adequately taken care of (Connor, Steeber & McBurnett, 2010). On this note, the ministry will also conduct research every year to note the trend in the number of school dropouts. A decline in the number of dropouts will be a positive indication that the church has triumphed in the fight against disruptive behavior among the children.

On this note, the ministry is also expected to carry out workshops and capacity building sessions with the parents. Such sessions will be important for the ministry to access the role of parents in dealing with the issue of disruptive behaviors. During such forums, the ministry will try to access knowledge possessed by parents regarding existence, causes and treatment of these behaviors amongst their children (Matthys, Vanderschuren & Schutter, 2012). The ministry will also be concerned with the role of the health care providers to the fight against the CD/ODD symptoms.

Conclusion

It is crystal clear that CD/ODD prevalence is real and a major challenge in the community today. Though the two disabilities have some distinct features such as safety concerns and the level of aggressiveness, it is imperative noting that the two concepts have some relationship and are more prevalent among the males as opposed to females. The most important aspect remains that the two conditions have adverse effects on the society, and the only remedy is early diagnosis and treatment of the same (Di Trani, Di Roma, Scatena & Donfrancesco, 2013). It is on this premise that the child ministry at this church has laid out a comprehensive plan to deal with the menace. The church ministry must also look at the main causes of stress and other mental health issues if the dream of eliminating cases of disruptive behavior will be realized. It is, however, essential to encourage further research that will enable early diagnosis and treatment of these defiant disorders.

 

References

Connor, D., Steeber, J., & McBurnett, K. (2010). A Review of Attention-Deficit/Hyperactivity Disorder Complicated by Symptoms of Oppositional Defiant Disorder or Conduct Disorder. Journal Of Developmental & Behavioral Pediatrics, 31(5), 427-440. http://dx.doi.org/10.1097/dbp.0b013e3181e121bd

Di Trani, M., Di Roma, F., Scatena, M., & Donfrancesco, R. (2013). Severity of symptomatology and subtypes in ADHD children with comorbid oppositional defiant and conduct disorders. International Journal On Disability And Human Development, 12(3). http://dx.doi.org/10.1515/ijdhd-2012-0106

Elliott, G. (2014). Oppositional Defiance Disorder to Conduct Disorder. Defiant Behaviour. Munich: GRIN Verlag GmbH.

Matthys, W., Vanderschuren, L., & Schutter, D. (2012). The neurobiology of oppositional defiant disorder and conduct disorder: Altered functioning in three mental domains. Dev Psychopathol, 25(01), 193-207. http://dx.doi.org/10.1017/s0954579412000272

  1. Ashton Acton, P. (2012). Attention Deficit Hyperactivity Disorders. ScholarlyEditions.

 
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