Comorbid Diagnosis of ADHD & ODD Chapter

Excerpt from Chapter :

journal and literature review that all centers on the same single test case of a patient situation that is known to the author. Indeed, the case in question is one the author of this report is aware of from an internship as a social work intern. The specific case is that of a seven-year-old Hispanic male that has been diagnosed with both Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). The boy in question comes from lower socioeconomic status and, obviously, is of a racial minority group at the same time. The author will cycle through five different book excerpts and journal articles that pertain in whole or in part to the plight and diagnosis faced by the boy mentioned above and the learning gleaned from each source will be applied to his case. While the boy in question has a comorbid diagnosis and faces some societal roadblocks due to his race, he absolutely has a chance at a normal and productive life provided he receives the proper treatment and counseling.

Literature Review

Each of the sources to be used in this literature review is derived from a particular unit covered during this class. The seventh unit's source comes from a book chapter authored by Robert Malgady and appears in a larger volume of chapters authored by Weisz and Kazdin. The chapter title alone for this source makes it clear why this would be great for the test case used for this report. The chapter pertains to the treatment of Hispanic children and adolescents using narrative therapy. The overview of the chapter goes onto assert that there is a program of psycho-therapeutic treatment-outcome research that addresses behavioral conduct disorders and anxiety disorders that are ostensibly highly present in Puerto Rican children in the New York City public schools. One method that was used in this case and one that might work well for the test case for the author of this report was the first intervention described, that being cuento/folktale therapy. This involves the use of Puerto Rican folktales that involve a well-known fictional character in Puerto Rican folklore by the name of Juan Bobo aka Juan the Fool. It depicts Juan as a "hapless" character who keeps finding ways to fall into precarious situations. After trying several "maladaptive" ways to escape the messes he finds himself in, Juan is ultimately able to resolve his problems by resorting to more socially acceptable manners of problem resolution. While this technique may have to be adapted based on the specific Hispanic lineage of the child that the author of this report is helping with, the overall technique sounds like a proper one. Indeed, it is a way of telling stories about a person that the person being treated can closely identify with on a personal and racial level. Once that connection is made, the child being treated can notice how the character in the story him or herself falters, much like the patient has. However, the patient can then continue to follow the narrative and realize that the character in the story learns to adapt and change in a way that attains a resolution to the problem without making a different or bigger mess (Weisz & Kazdin, 2010).

The journal article for the eighth unit also obviously applies to the boy that is the centerpiece for this piece of analysis. Indeed, the article talks about strength-based mental health counseling for children with ADHD. It is also described as an integrative model of adventure-based counseling and Adlerian play therapy. In other words, it is a method that, like the seventh unit's approach, is less about making it obvious that the child is being treated and more about making it "fun" and something that be enjoyed and learned from at the same time. The article notes that the stakes are high because anywhere from two to five percent of the United States population as a whole has some form of ADHD. This translates to about two million children experiencing some symptoms of ADHD and it is noted that the disorder by far the most widely and commonly diagnosed. As noted before, the test case boy's diagnosis as ADHD, his comorbid diagnosis of ODD and the fact that he is Hispanic puts him in a rather vulnerable position. The journal article for this unit piles even more adversity when it is explained that "the increasing expectations and demands placed on children today are drastically affecting their ability to function in classrooms, family settings and social activities with same-age peers" (Portrie-Bethke, Hill & Bethke, 2009). The Adlerian method mentioned by this journal article is noted as involving the assessment of the child's needs by counselors through what is known as "play therapy" using the Adlerian lens. This method allows a number of different factors and traits to be discovered including mistake goals, faulty assumptions, lifestyle issues and the ability to strive for significance (Portrie-Bethke, Hill & Bethke, 2009). These are all things that can and should be explored for the Hispanic boy mentioned at the onset of this report.

The ninth unit of the class brings to this report an article about the overall redefinition of Autism Spectrum Disorder using the DSM-V criteria and how there are implications for the proposed DSM-V criteria for the same. When it comes to the autism spectrum, the more commonly named disorders and issues include those like Asperger's, general autism and so forth. However, the DSM-V criteria was obviously used to assess and discern the boy mentioned throughout this report and that is how the two diagnoses that were came to happened. Through careful analysis and assessment of the boy's reactions, behaviors and mannerisms, it can be figured out with relative precision what precisely is his particular malady or maladies are. The DSM-V data set has a clear definition for what ODD and ADHD happen to boy and he presumably met the criteria for both based on what is known about him and his history (Young & Rodi, 2013).

The offering for the tenth unit of this class as it relates to the Hispanic boy patient in this report, the author points to a book published by Jacqueline Corcoran back in 2003 that pertained to the clinical applications of evidence-based family interventions. The snippet of that book focused on for this report is the third one and it's the right one to center on because it pertains to the treatment of Oppositional Defiant Disorder. Indeed, the example used in the book chapter pertains to a boy with a Hispanic name, that being Cruz. The resolution and treatment of this disorder for Cruz and others like him is a "solution-focused therapy." In the case of Cruz and "clients" like him and the boy that the author of this report is focusing on, there is a giving of credit for deciding their own goals and having the necessary overall strengths and capacities to achieve the goals that are created. In applying this to kids like Cruz and the author of this report's patient, a goal can be set (like it was with Cruz) to stop getting into trouble. At the same time, the mother's goal was for Rubin to "do what he' stold," which would include doing his chores, his schoolwork and so forth without making a racket and arguing about it. So as to bring the goals of the mother and the goals of the boy into alignment, the practitioner "works to elicit times when Rubin's behavior is more aligned with compliance and completion of chores and schoolwork." This sort of approach could and should be used with the boy the author of this report is working with. Surely, the boy does not like to always be in trouble and perhaps goals can be set by the boy and/or his parents in a way that gets everyone involved the peace and goal attainment that they both want (Corcoran, 2003).

Finally, we come to the eleventh unit treatise and that would be a journal article that focuses on the family factors relating to the development, treatment and prevention of childhood anxiety disorders. While neither of the disorders that the Hispanic boy in this journal is diagnosis with are anxiety-related, there is surely at least some anxiety happening with the boy due to them being present and them being an aggravating factor in his own life and that of his family. Further, the family factors that aggravate or help his treatment have to be taken into account when treating him and otherwise helping him. Indeed, if the wrong patterns and habits emerge with the family members, anxiety issues could be created or aggravated. Indeed, the Drake and Ginsburg study looks at the "familial role in the development, treatment, and prevention of anxiety disorders" (Drake & Ginsburg, 2012). The two authors further note that anxiety disorders (as well as other mental illnesses) tend to run in families (Drake & Ginsburg, 2012).


As noted throughout this report, the boy that…

Sources Used in Document:


Corcoran, J. (2003). Clinical applications of evidence-based family interventions.

Oxford: Oxford University Press.

Drake, K., & Ginsburg, G. (2012). Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders. Clinical Child And Family Psychology

Review, 15(2), 144-162. doi:10.1007/s10567-011-0109-0

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