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Assignment: Therapeutic RelationshipsA childs or adolescents disruptive behaviors can be challenging for a clinician. Disruptive behaviors can interrupt the counseling process, and they often signify the existence of emotions a child or adolescent is unable to express verbally. Some prospective child and adolescent clinicians may be ill-equipped to manage disruptive behaviors or recognize that the behaviors are symptomatic of an issue or disorder. This lack of knowledge may elicit a nontherapeutic response from a clinician, which can damage the development of a therapeutic relationship. A therapeutic relationship is vital in order to counsel children and adolescents effectively.To prepare for this Assignment, review the Disruptive Behaviors Part Two media and select a particular child or adolescent with a disruptive behavior. Consider one strength and one weakness of the therapeutic relationship with the child or adolescent during the counseling sessions.The Assignment (3–5 pages) is in two parts:Part One: Ineffective InterventionsIdentify the less effective counseling session you selected, and explain why it was less effective.Identify and explain the intent of the target goal in the counseling session.Explain one ineffective aspect of the counseling approach and why.Explain one misstep the counselor made that inhibited the development of a therapeutic relationship and why.Part Two: Effective InterventionsIdentify the more effective counseling session you selected, and explain why it was more effective.Explain one intended goal the counselor was attempting to accomplish in the counseling approach and why.Explain one ineffective aspect of the counseling approach and why.Explain two critical skills the counselor demonstrated that promoted the development of a therapeutic relationship and how those critical skills were used.Support your Assignment with specific references to all resources used in its preparation. You are asked to provide a reference list for all resources, including those in the weeks resources for this course.Disruptive BehaviorsIn the DSM-IV, attention deficit and disruptive behaviors were grouped as a categorywithin the classifications of disorders usually first diagnosed in infancy, childhood, andadolescence.Though it is true that these disorders are generally first diagnosed during these stages,the classifications of these disorders has been reconceptualized to reflect theirsimilarities in manifestation, as well as considerations for the impact on socialfunctioning. ADHD, for example, is grouped in the DSM-5 with neurodevelopmentaldisorders; research has supported a strong biological basis for this disorder as well asfor others found in this classification (see Exceptionalities in Week 11 of this course).However, because the expression of ADHD often includes behaviors that can bedisruptive to the childs social environment, it will be included with the topics for thisweek.Other disorders addressed this week are those now included in a new chapter of theDSM-5: disruptive, impulse-control, and conduct disorders. This new grouping ofdiagnoses reflects a recognition of the similarities of these diagnoses—all of these areassociated with an intrusion upon the rights, property, or physical safety of others. Inaddition, individuals with these disorders generally act against societal expectationsand norms and show a significant inability to control behavioral or emotional impulses.Disruptive, Impulse-Control, and Conduct DisordersThis new DSM-5 chapter includes oppositional defiant disorder, intermittent explosivedisorder, conduct disorder, antisocial personality disorder (also listed in the personalitydisorders chapter), pyromania, kleptomania, other specified disruptive, impulse-control,and conduct disorders, and unspecified disruptive, impulse-control, and conductdisorders.Two of these diagnoses are new to the DSM-5: other specified disruptive, impulsecontrol, and conduct disorders, and unspecified disruptive, impulse-control, and conductdisorders. These take the place of disruptive behavior disorder NOS in the DSM-IV,which has been removed. Both of these diagnoses represent significant clinicaldistress or impairment based on criteria for disruptive, impulse-control, and conductdisorders, but do not meet full criteria for a specific diagnosis in this class. Cliniciansshould use other specified disruptive, impulse-control, and conduct disorders and addthe specific reason for the more general diagnosis (e.g., falling short of duration orfrequency criteria). The latter diagnosis—unspecified disruptive, impulse-control, andconduct disorders—is used when clinicians cannot (or choose not to) identify reasonsfor the inability to make a more specific diagnosis, yet clearly observe multiple criteriafrom the disruptive, impulse-control, and conduct disorder classification.The following is a summary of key changes to diagnostic criteria for this group ofdisorders.Oppositional Defiant Disorder© 2014 Laureate Education, Inc. Page 2 of 2Criterion A has been revised in several ways. First, the symptoms have been groupedinto categories relating to mood, behavior, and malicious intent. Second, the duration,persistence, and frequency requirements have been more clearly described, withconsiderations made for differences related to age, developmental level, gender, andculture. Lastly, a severity rating associated with pervasiveness has been included inthe specifiers for this disorder.Intermittent Explosive DisorderThe criteria for this diagnosis have been considerably revised in the DSM-5. Criterion Ahas been expanded with more specific detail added, including the inclusion of verbalaggression and nondestructive aggressive behavior. Language has also been addedregarding intensity and frequency of the outbursts that are key components of thisdiagnosis. In addition, the minimum age for this diagnosis is now 6 years old; thischange helps to distinguish the diagnostic criteria from normal temper and behavioralvariations in very young children.Conduct DisorderThe DSM-5 criteria for a conduct disorder diagnosis is similar to that found in the DSMIV. However, an important addition has been made: The DSM-5 includes a specifier forobserved limitations in socially appropriate emotional response. This may beexemplified by deficits in empathy, remorse, or guilt. This may also be reflected in ageneral lack of concern over impact of behaviors and decreased expressive affect.Neurodevelopmental DisordersThis group of disorders is covered more thoroughly in Week 11 of this course.However, one of the disorders from this group frequently has a disruptive componentto it and is, therefore, included in this week.Attention-DeficitHyperactivity Disorder(ADHD)Though the basic diagnostic criteria for ADHD is very similar in the DSM-5, there are anumber of key differences from the DSM-IV, including stage-related examples to aid indiagnosis in childhood, adolescence, and adulthood. One of the key changes has beento raise the identification of symptomology from before age 7 to before age 12 and touse a single diagnosis with specifiers rather than several related diagnoses in a group.Specifiers replace prior subtypes, identifying the predominant presentingsymptomology. Specifiers are also now used to reflect severity of impairment offunctioning.Reference:• American Psychiatric Association. (2013). Highlights of changes from DSM-IVTR to DSM-5. Retrieved fromhttp:%20from%20dsm...
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