Adolescents & Children Therapy

ADOLESCENTS AND CHILDREN THREAPY

We offer therapy for a number of adolescents' problems. Please see some examples below

Anxiety Disorders (social anxiety, phobias, panic attacks, generalised anxiety etc)
Depression
Body Dysmorphia
Eating Disorders
Self-harm
Low Self-confidence and Self-esteem
Bipolar,
Obsessive Compulsive Disorders (OCD),
Psychosis, Schizophrenia,
Personality Disorders,
Addictions: Alcohol, Drugs, Gambling, Gaming etc.
Post Traumatic Stress Disorders [PTSD])
Relationship / Friendship Issues
Isolation
Identity Issues
Conduct Disorders
Oppositional Defiant Disorders
Attention deficit hyperactivity disorder (ADHD)
Autism Spectrum Disorder (ASD)

Oppositional Defiant Disorder (ODD)

ODD: What Is It?

It is a given, that sometimes, children will act out. Children with Oppositional Defiant Disorder tend to have a well-established pattern of behaviour problems that are more extreme than their peers. One way to distinguish between typical disruptive behaviour and ODD is how severe the behaviour is and how long it lasts. In order to establish ODD, the children will need to have had extreme behaviour issues for at least six months.

ODD: What to Look For

Children who have ODD will have a well-established pattern of behaviour problems, including the following symptoms:

Being unusually angry and irritable
Frequently losing their temper
Being easily annoyed
Arguing with authority figures
Refusing to follow rules
Deliberately annoying people
Blaming others for mistakes
Being vindictive

When responding to these repeated behaviour problems, parents are often pushed to an extreme and may become either more permissive or more coercive. Unfortunately, neither extreme will effectively change their child’s behaviour, and instead may inadvertently lead to more negative interactions and hostile patterns of behaviour that become routine. Some children with ODD may also struggle with disruptive behaviour in school, but it is not uncommon for a child to only struggle at home with family members.

ODD: Risk Factors

There is a very high overlap in children who have ADHD and ODD. Children who have ADHD are prone to be distractible and impulsive, which often sets them on a collision course with behaviour expectations. Repeated patterns of negative interactions with parents and other authority figures can lead to developing ODD.

Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle to manage emotions like frustration and disappointment as they mature may be at risk of developing ODD.

Experiencing life stress and trauma can also be a risk factor for developing ODD.

ODD: Diagnosis

For a child to be diagnosed with ODD he must have a pattern of disruptive behaviour including at least four symptoms from the following categories:

Angry/Irritable Mood

Often loses temper
Is often touchy or easily annoyed
Is often angry and resentful

Argumentative/Defiant Behaviour

Often argues with adults
Often actively defies or refuses to comply with requests from authority figures or with rules
Often deliberately annoys others
Often blames others for his mistakes or misbehaviour

Vindictiveness

Has been spiteful or vindictive at least twice within the past 6 months

In order to be diagnosed with ODD a child must have had a pattern of behaviour problems lasting at least six months and involving at least one individual who is not a sibling.

Clinicians will evaluate the frequency, intensity and duration of a child’s symptoms, as well as the impairment caused by them, when making a diagnosis. This will involve taking a detailed history of the child’s behaviours in various situations. Since children with ODD may show symptoms only in one setting — usually at home — and are more likely to be defiant in interactions with adults and peers they know well, the symptoms may not be in evidence in the clinician’s office.

ODD is typically diagnosed around primary school ages.

ODD: Treatment

ODD is manageable, usually with behavioural therapy or a combination of behavioural therapy and medication.

Psychotherapeutic: When managing a child for ODD, repairing the parent-child relationship is a priority. This means that parents play a big role in treatment. Parent training programmes are frequently recommended to help parents learn to train their child’s behaviour through setting clear expectations and consistently praising the children when they follow through and using effective consequences when they do not.

Parent training programmes might include sessions with parents and children working together, or just parents alone. Some different programs include:

Parent-Child Interaction Therapy (PCIT)
Parent Management Training (PMT)
Defiant Teens
Positive Parenting Program (Triple P)
The Incredible Years

Some children might also benefit from social skills training to improve their peer relationships or CBT if they are struggling with anxiety or depression. Children struggling with extreme emotional dysregulation may benefit from DBT.

ODD: Risk For Other Disorders

A small percentage of children diagnosed with ODD will go on to develop conduct disorder. Conduct disorder is a more severe behaviour disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later makes this less likely.

Conduct Disorder Basics

Conduct Disorder (CD) is characterized by callous disregard for and aggression toward others, from pushing, hitting and biting in early childhood to bullying, cruelty and violence in adolescence.

Conduct Disorder: What Is It?

Conduct disorder is a severe condition characterized by hostile and sometimes physically violent behaviour and a disregard for others. Children with CD exhibit cruelty, from early pushing, hitting and biting to, later, more than normal teasing and bullying, hurting animals, picking fights, theft, vandalism, and arson. Since childhood and adolescent conduct disorder often develops into the adult antisocial personality disorder, it should be addressed with treatment as early as possible; the earlier treatment starts, the better the outlook.

Conduct Disorder: What to Look For

One of the hallmarks of conduct disorder is a seemingly callous disregard for societal norms and the rights, feelings, and personal space of other people.
Children and adolescents with CD seem to “get a rise” out of causing harm. For them, aggression, deceit, coercion—behaviours that result in a power differential—are gratifying. Picking fights, trespassing, lying, cheating, stealing, vandalism, and emotionally or physically abusive behaviour, including wielding a deadly weapon or forcing sex, are all signs that an older child may have conduct disorder.
Signs of the disorder in younger children may be harder to discern from more normal acting out, but are similarly coercive: relentless bullying, lying for the sake of lying, stealing items of no apparent worth.
Since all children and adolescents act out from time to time, experts caution that a persistent pattern of this sort of behaviour must be in evidence before CD is considered. Professionals also attempt to determine if the behaviour is a negative adaptation to a troubled environment, a “learned” behaviour, or if the gratification that comes from aggression seems to originate from within.

Conduct Disorder: Risk Factors

Children with a parent (biological or adoptive) or a sibling with conduct disorder are more likely to develop the disorder.
Children whose biological parents have ADHD, alcohol use disorder, depression, bipolar disorder, or schizophrenia are also at risk.
Children who experienced abuse, parental rejection or neglect, and harsh or inconsistent parenting are more at risk, as are those exposed to neighbourhood violence, peer rejection, and peer delinquency.

Conduct Disorder: Diagnosis

A child is diagnosed with CD if he exhibits a callous disregard for others and a sustained pattern of behaviours that fit into these general categories: aggression against people and animals, destruction of property, deceitfulness and theft, and serious violations of rules. A professional will talk with parents, teachers and other adults involved in his life to rule out other possible causes.

Conduct Disorder: Treatment

Conduct disorder is difficult to overcome, but it is not hopeless. In situations where an effective support network of parental figures, teachers, and peers can be assembled, the disorder is manageable.

Psychotherapy:

Treatment for conduct disorder is complicated by the negative attitudes the disorder instils. As such, psychotherapy and behavioural therapy are often undertaken for long periods of time, and the entire family and support network of the child is brought into the loop.

The earlier the condition is diagnosed, the more successful the therapy will be. While a child learns a better way to interact with the world at large, the family learns the best ways to communicate with him.

In younger children, treatment for CD can resemble treatment for ODD—parent management training may be undertaken by a therapist to teach parents how to encourage desired behaviours.

In adolescents, therapy may target not just the home life but interactions with authority figures at school, and ensuring that peer relations are beneficial, not harmful.

Since conduct disorder is often (but not always) diagnosed along with a number of other conditions that can be treated pharmacologically, medication may figure into treatment plans for the disorder.

Conduct Disorder: Risk For Other Disorders

ADHD and oppositional defiant disorder occur with frequency in children with conduct disorder.
Other disorders that may occur with CD include specific learning disorder, anxiety disorders, depressive or bipolar disorders, and substance use disorders.