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Conceptualizations in Oppositional Defiant Disorder
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In this section, I will discuss situations in which I ask parents with teens who exhibit oppositional defiant disorder to try reframing. These situations are: aggressively provoked teens; seemingly hopeless situations; and misinterpreted realities. A common trait among teens is to look at the world in negative and unrealistic perspectives of a situation.
To communicate effectively with these teens I, like you, find the technique of reframing helpful. Many times teens feel they have no hope. But, by utilizing different sides of the viewpoint, or reframing, they are able to view a perspective other than their own. In doing this, the client can ultimately conclude a more positive outlook on his or her situation. In such cases, the parents of the teen are extremely influential in restructuring their child’s attitude of the world.
3 Situations in which Parents Should Use Reframing
♦ #1 Aggressively Provoked Teens
I use reframing to assist the client in coping with situations that could be potentially aggression provoking. What I find useful is to remind parents that teens will use anger as a catalyst for self-harm or other ways of gaining attention. I use reframing by rebuilding an idea from a new viewpoint, or in a reconstructive manner. It helps them to free themselves from the condition or make permanent changes to help in future cases when dealing with similar circumstances.
Fifteen year old Catalina was angered that her parents had moved her two hundred miles away from her friends and were forcing her to start a new life. Soon, Catalina began to act out angrily at the dinner table and with friends. She would also villainize her parents, stating, "I’m not anything to you! You move me and you don’t even care that you’ve ruined my life!" Her parents Maria and Georgio likewise responded in angry voices and the situation would escalate. As you can clearly see, Catalina had established a certain negative outlook on her situation rather than emphasizing the positive aspects.
How would you reframe this for Catalina? I asked Maria and Georgio to try and reframe the situation in her mind. The next time Catalina looked as though she were about to become infuriated, they pointed out the opportunities of their move. Georgio would say, "We have a much bigger house and I have a much better paying job. So, if you can prove you’re responsible, we can afford to help you buy a car because of these new arrangements." By showing Catalina the positive side of the move, Georgio reframed his daughter’s outlook and quelled her anger.
♦ #2 Seemingly Hopeless Situations
Clients and parents may also use reframing when dealing with situations that, at that moment in time, appear hopeless. Heather, aged thirteen, recently lost her brother in a tragic car accident caused by a drunk driver. For a while, Heather mourned her brother's death and blamed herself for allowing him to drive that night. She would often say to her mother and father that she could never feel happy again.
asked her parents, Lilly and Kurt, to try and give Heather a purpose to her grief. Eventually, Lilly and Kurt were able to arrange a family-oriented inspirational speech about the dangers of drunk driving with Heather at the center. They stated, "Heather seems to feel a little more confident about herself and her depression looks like it’s not as prevalent as it was before." As you can see, instead of changing the outlook of reality, Catalina’s parents were able to give her a new purpose, which is also a manifestation of reframing.
♦ #3 Misinterpreted Realities
The last situation in which reframing proves useful is when a client is trapped in a cycle of misinterpreted realities. Seventeen year old Doug had just recently broken up with his girlfriend Amy. This is his fifth breakup in the last three months. Doug rationalizes the situation and believes the cause of the relationship ending is in the girl’s state of mind. According to him, the reason that he could not keep a stable relationship, and the immediate acquiring of another relationship, is the fickleness of the girls. Doug stated, "I can’t keep them off of me, but as soon as they get in with me, they start looking for something better. I figure I’ll get rid of them before they have a chance to do the same."
However, I was concerned that the many superficial relationships were leading Doug down a cycle of low self-esteem. I decided to examine the source of Doug’s attitude a little further. After several sessions, I discovered that Doug’s mother had left their family when he was 7 years old and Doug had lived with his father, Jim, ever since.
His father, angry that his wife had left him, instilled in Doug the idea that no woman could be trusted, "No female can be loyal forever!" or "There is no such thing as commitment to those bitches!" Doug related his father’s values of loyalty with not only his mother, but with all females. It was the woman’s fault. With this negative frame of reference on women, Doug was unable to have a healthy relationship with a girl without some suspicion involved.
When Doug first came to the office, he could not admit that the problem lay in his own perspective. He needed to realize the source of the problem and how to reframe the situation better.
♦ 4-Step Technique: Outside Looking In
To help Doug reframe his situation, I asked him to try the "Outside Looking In" exercise.
I told Doug to write down ten adjectives he would use to describe the girls that he has come into contact with. A few of these included: silly; superficial; tricky; two-faced.
Now, I said to Doug, "Put yourself in your father’s shoes. I want you to think of how you would feel if someone you loved left you. Now write down those feelings." A few of these were: angry; vengeful; hurt.
I then asked Doug to compare the two lists. I stated, "Do you see how the second list, the one that expressed your father’s feelings, would actually produce the adjectives on the first list?" He stated, "I guess. I think I can kind of see how my dad might have put all that stuff into my head throughout the years. But it wasn’t like he didn’t have a reason! I mean, she did leave us."
I then gave Doug a small assignment. I asked him to interact with the girls at his school, at least three girls a day, asking them specific questions about their interests, beliefs or opinions. I emphasized to him the importance of keeping prejudices out of the picture.
When he returned, Doug stated, "Well, I had quite the eye opener. I learned girls really like to talk. But most of them had really interesting things to say - even the nerdy ones, who I would normally not even look at twice. When I think about it, a lot of them are a hell of a lot smarter and more loyal than I gave them credit for."
By recognizing that his prejudices came as a result of his father’s own feelings of betrayal, Doug could be more cynical about his own preconceptions. Think of your Doug. Do you think they would benefit from "Outside Looking In"?
In this section, we discussed situations in which I ask parents to try reframing. These situations are: aggressively provoked teens; seemingly hopeless situations; and misinterpreted realities
In the next section, we will discuss the three dimensions that I consider when first becoming familiar with families with disruptive teens. These four dimensions include: contemporary developmental pressures on the family, history, and structure.
Peer-Reviewed Journal Article References:
Amemiya, J., Mortenson, E., & Wang, M.-T. (2020). Minor infractions are not minor: School infractions for minor misconduct may increase adolescents’ defiant behavior and contribute to racial disparities in school discipline. American Psychologist, 75(1), 23–36.
Causadias, J. M., & Umaña-Taylor, A. J. (2018). Reframing marginalization and youth development: Introduction to the special issue. American Psychologist, 73(6), 707–712.
del Carmen Espinoza, M. (2020). The use of collaborative/therapeutic assessment with oppositional defiant disorder: A longitudinal case study. Rorschachiana, 41(2), 200–222.
Pardini, D. A., Frick, P. J., & Moffitt, T. E. (2010). Building an evidence base for DSM–5 conceptualizations of oppositional defiant disorder and conduct disorder: Introduction to the special section. Journal of Abnormal Psychology, 119(4), 683–688.
Rowe, R., Costello, E. J., Angold, A., Copeland, W. E., & Maughan, B. (2010). Developmental pathways in oppositional defiant disorder and conduct disorder. Journal of Abnormal Psychology, 119(4), 726–738.
What is one reframing exercise in helping someone admit they have a problem?
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