Oppositional, Defiant and Anger Issues: Promoting Positive Behaviour to Empower Children and Adolesc

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Oppositional, Defiant and Anger Issues: Promoting Positive Behaviour to Empower Children and Adolescents

Presented by Jack Hirose & Associates. Sponsored by Sunshine Coast Health Centre and Georgia Strait Women’s Clinic

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Oppositional,Defiant, andAngerIssues

Planning Guide

This two-page reference handout distills key insights and tools from the two-day training Oppositional, Defiant, and Anger Issues: Promoting Positive Behaviour to Empower Children and Adolescents. It offers a trauma-informed lens for understanding defiance, summarizes essential DBT and co-regulation strategies, and provides quick-reference frameworks for behavior planning. Whether you’re a clinician, educator, or caregiver, this guide is designed to keep practical, evidence-based strategies at your fingertips when facing challenging behaviors in real time.

Trauma-Responsive Behavior Planning

Identify the function of the behavior (What is the child trying to gain or avoid?)

Clarify emotional triggers (People, places, transitions, feedback)

Include:

Co-regulation tools (STOP skill, calming options)

Skill use by stage (TIP during escalation, thermometer during debrief)

Choose flexible consequences with a built-in path to repair

Always involve youth voice and options ("What do you need when happens?")

DBT-Informed Skills for Emotional Regulation

STOP Skill:

S = Stop

T = Take a breath

O = Observe what’s happening

P = Proceed mindfully

TIP Skill:

T = Temperature change (cold pack, water)

I = Intense exercise (30–60 sec)

P = Paced breathing / paired muscle relaxation

Feelings Thermometer:

�� Plans should support safety, not just compliance.

The Defiance Funnel –What’s Beneath the Behavior

Neurobiological Sensitivity (Sensory overload, impulsivity)

Developmental Disruption (Attachment, safety, unpredictability)

Cultural/Systemic Stressors (Racism, poverty, surveillance)

Emotional Exhaustion (Shutdowns, hypervigilance)

Defensive Behaviors (Arguing, control, refusal)

Mislabeling & Escalation (Punishment, exclusion, mistrust)

*Behavior is a signal, not a diagnosis.*

- Use colors or numbers to rate emotional intensity

- Create a “When I’m at a 6 or above, I can try...” list with the youth

WAIT + Validation = Connection

WAIT = Why Am I Talking?

- Pause to reduce escalation

- Create space for regulation

- Ask: “Am I responding or reacting?”

Linehan’s 6 Levels of Validation (condensed):

1. Pay attention

2. Reflect what you hear

3. “It makes sense given what you’ve been through”

4. Normalize response in context

5. Show it’s valid even if not effective

6. Be radically genuine

�� Validation is not agreement. It’s emotional credibility.

Working Together Today

1. We honor lived experience and professional insight

2. All behavior is communication in youth and adults

3. Challenge ideas, not people

4. Confidentiality: What's shared in discussion stays in the room

5. Growth > perfection

Menti Poll: What comes to mind when you hear "defiance"?

Instructions:

1.Go to https://www.menti.com/alu9an

47a786

2.Enter the code: 3462 2382

3.Submit 1 – 3 words or phrases that you associate with "defiance"

Common words often include: resistance, disrespect, attitude, fear, protection, control

Let’s notice:

• Are your words negative or curious?

• Do they describe the child or your experience of the child?

The Weight We Carry: Stress in the Helping Professions

60% of Canadian educators report moderate to high burnout symptoms (CTF, 2022)

Compassion fatigue is common among teachers, therapists, and helpers

Regulation is contagious: calm breeds calm; chaos breeds chaos

What We Carry Isn’t Just Our Own

Compassion fatigue = depletion from sustained exposure to others' emotional suLering

Secondary trauma = internalizing the pain of those we serve

Burnout = chronic system stress without repair

Signs include:

• Irritability or emotional numbness

• Feeling hopeless or ineLective

• Emotional withdrawal at work or home

"You cannot serve from an empty vessel."
– Eleanor Brownn

Quick Write: How Does Defiance Affect You?

Take 2 minutes to reflect:

• What emotions does defiance stir up in you?

• Where do you feel it in your body?

• Do you tend to respond with control, shutdown, or curiosity?

• This is just for you no sharing required.

Menti Poll: What’s the hardest part of working with oppositional behavior?”

Instructions:

1.Go to https://www.menti.com/alu9an 47a786

2.Enter the code: 3462 2382

3.Answer the poll: What’s the hardest part of working with oppositional behavior?”

What Are We Holding?

Common responses often include:

• Power struggles

• Feeling ineffective

• Emotional shutdown

• Judgment from others Reminder:

• Your reaction is shaped by your history and it’s valid

ODD Across Borders: U.S. and Canada Comparisons

Prevalence:

• U.S.: 3–5% of children and adolescents

• Canada: ~2% of children and adolescents (Public Safety Canada, 2017)

Access to Services:

• U.S.: Fragmented access, insurance-based barriers

• Canada: Universal healthcare, longer waitlists especially in rural areas

Systemic Bias:

• Disproportionate over-discipline of racialized youth in both countries

• Black, Indigenous, and immigrant youth face additional diagnostic biases

Psychological Roots of Defiance

• Temperament: naturally intense or highly reactive children may struggle with regulation

• Low frustration tolerance: difficulty managing limits, transitions, or unexpected outcomes

• Cognitive rigidity: black-and-white thinking, difficulty with compromise

• Early signs often mistaken for “attitude” rather than developmental vulnerability

Environmental Contributors to Oppositional Behavior

• Inconsistent parenting or discipline

• Exposure to family conflict, substance use, or mental illness

• Chaotic or unpredictable home routines

• Over-permissiveness followed by sudden control

• These environments teach survival through testing, controlling, or resisting adults

Trauma, Behavior, and What We Miss

“Not

every defiant child is dangerous. But many are hurting.”

The Hidden Forces Behind Defiance

Behavior is a language it reveals, it protects, it survives

What looks like disrespect may be hypervigilance What looks like avoidance may be freeze or collapse

• What looks like manipulation may be a traumaadapted survival strategy

Trauma and the Family System: Hidden

Forces Behind Defiance

Trauma reorganizes family roles and emotional responses

1. Loyalty binds: Youth protect hurting parents by resisting other authority figures

2. Emotional cutoff: Youth detach to protect themselves from overwhelming emotions

Defiance often serves as survival behavior, not simply misbehavior

1. Healing must involve relational repair, not just individual behavior change

"Children do well when they can if they can't, we need to ask why."
— Dr. Bruce Perry

Behaviorism Basics: Reinforcement and Punishment

Negative Reinforcement – When Control Gets Reinforced

Definition:

When Negative Reinforcement Strengthens Defiance

Common scenario:

• Child escalates (tantrums, argues) →

• Adult withdraws demand →

• Child learns escalation works to avoid tasks

Result:

• Short-term relief → Long-term increase in defiant behavior

Cycle:

• Emotional discomfort avoided → Behavior reinforced → Problem intensifies

Real-World Example: Negative Reinforcement in Action

Scenario:

• Child yells and throws a tantrum when asked to clean their room.

• Parent feels overwhelmed and says, "Fine, I’ll just do it myself."

Immediate Effect:

• Conflict ends temporarily.

• Both child and parent feel short- term emotional relief.

Long -Term Impact:

• Child learns escalation is effective.

• Defiance and tantrums increase over time when demands are made.

Case Example: Mateo at Home

Mateo, age 9, refuses to brush his teeth Mom yells, threatens consequences Mateo screams, throws the toothbrush Mom walks away to calm down

• The behavior that was reinforced: noncompliance

Real-World Example: Negative Reinforcement in the Classroom

Scenario:

• Student disrupts during independent work time (talks loudly, refuses tasks).

• Teacher, trying to keep the class moving, sends the student to the hallway.

Immediate Effect:

• Classroom is quiet.

Teacher and classmates feel immediate relief.

Long-Term Impact: Student learns disruptive behavior = escape from difficult or unpleasant tasks.

• Disruptive behavior becomes more frequent over time.

Case Example: Aisha at School

Aisha, age 12, is asked to read aloud

She says “no” loudly and slouches in her seat

The teacher avoids confrontation and moves on

• Aisha avoids exposure, and the refusal is reinforced

Why Positive Punishment Often Fails with Oppositional Youth

Positive punishment = adding unpleasant consequences to reduce behavior

Common methods:

• Extra homework

• Detention

• Verbal reprimands

Risks with oppositional youth:

• Increases shame and anger

• Fuels power struggles and defiance

• Triggers trauma responses rather than learning

Why Punishment Fails with Traumatized Youth

Creates fear without teaching regulation

Increases shame, which fuels reactivity

Erodes trust and increases power struggles

• Short-term compliance, long-term disconnection

Using Negative Punishment Carefully with Oppositional Youth

Negative punishment = removing something desirable to decrease behavior

To be effective, consequences must be:

1. Immediate Close to the behavior

2. Predictable Explained ahead of time

3. Proportionate Logical, not excessive

4. Repairable Youth knows how to regain privileges

5. Always paired with emotional coaching, not isolation

Use it intentionally, not emotionally

Pair with skill-building and co-regulation

Follow up with connection: “Let’s try again together”

• Never use it to escape the child’s distress

How Social Media Reinforces Defiance

Digital environments reward emotional reactivity

• Likes, shares, viral content favor outrage over regulation

• (Nesi & Prinstein, 2015; Radesky et al., 2020)

Social conflict is now constant and performative

• Youth model defiant or aggressive behavior seen online

• (Uhls et al., 2014)

Comparison and surveillance amplify shame and defensiveness

• Peer feedback loops = increased impulsivity and anxiety

• (Public Health Agency of Canada, 2021)

• Bottom Line: Youth are conditioned to seek control, visibility, and social power through escalation.

"The more healthy relationships a child has, the more likely they are to recover from trauma and thrive."

Recognizing the Signs and Symptoms of ODD

Emotional Symptoms:

• Frequent anger, irritability, or resentment

Easily annoyed or touchy

Persistent moodiness

Behavioral Symptoms:

• Argues with adults and authority figures

• Actively refuses to comply with rules or requests

• Deliberately annoys or blames others

Relational Symptoms:

Peer conflicts or isolation

Push -pull dynamics with caregivers

• Often perceived as defiant, disruptive, or “bad”

Clarifying the Line: Developmental Pushback vs. Clinical Defiance

Typical Behavior Clinical Concern (ODD)

Eye-rolling, sarcasm in teens Daily verbal aggression or hostility toward adults

Refusing chores occasionally Persistent pattern of refusal across settings

Tantrums at age 3–4 Tantrums that continue past age 7

Saying “no” or talking back sometimes Arguing with authority figures most days

Stomping off during an argument Blaming others for nearly all mistakes/conflicts

How ODD Impacts Youth Functioning

Academic Challenges:

• Refusal to complete tasks, disruptive behavior in class

• Increased disciplinary actions, suspensions, and expulsion risk

Peer Relationships:

Dieiculty maintaining friendships

Social rejection due to irritability, blame, or controlling behavior

Family Dynamics:

• Power struggles, increased parental stress

• Breakdown in communication and trust

Emotional Well-Being:

Low frustration tolerance and frequent anger

Feelings of isolation, shame, and being misunderstood

How ODD Affects Academic and Emotional Functioning

• Difficulty initiating and sustaining tasks, especially non-preferred ones

• Avoidance of feedback due to fear of shame or failure

• Escalated responses to redirection or correction

• Increased disciplinary actions, missed learning opportunities

• Emotional dysregulation rage masking underlying shame, fear, or helplessness

How ODD Affects Peer and Family Relationships

• Difficulty sustaining friendships: oppositional behavior wears down peer trust

• Misreads neutral social cues as threatening (hostile attribution bias)

• Defiance becomes identity: peers and family see them as "the difficult one"

• Family system may shift into chronic power struggle or emotional withdrawal

How Culture and Systems Shape Defiance

Power and Respect are Culturally Defined:

• What looks like defiance in one culture may be self - protection or expression in another Implicit Bias in Schools and Systems: Youth of color are more likely to be labeled defiant or aggressive

Disproportionate disciplinary actions and fewer referrals for support Trauma and Poverty Increase Vulnerability: Survival behaviors are often misread as intentional misconduct Societal Messages:

• Media narratives often frame anger in Black, Brown, and neurodiverse youth as threatening

Cultural Norms vs. Institutional Norms

• In some cultures, deference to elders means avoiding eye contact or remaining silent

• School settings may interpret this as defiance or lack of engagement

• Children from immigrant households may navigate conflicting authority expectations at home vs. school

• Cultural styles of expression (e.g., loud voice, movement) may be pathologized

Systemic Patterns of Mislabeling

• Racialized youth are 2–3 times more likely to receive punitive discipline (suspension, expulsion)

• Black, Indigenous, and neurodiverse youth often under-identified for support and over-identified for defiance

• LGBTQ+ youth may express defiance in response to identity invalidation or school-based trauma

• Labels like "non-compliant" or "disruptive" can reflect institutional power struggles more than clinical need

Disruptors That Shape Oppositional Patterns

Developmental Disruptors:

• Early attachment rupture or inconsistent caregiving

• Prenatal exposure to substances or toxic stress

• Neurological dimerences (impulsivity, sensory dysregulation)

Cultural/Systemic Disruptors:

• Exposure to racism, poverty, or chronic injustice

Displacement, immigration trauma, or loss of cultural identity

• Over - surveillance and under - support in schools or institutions

• Result: Emotional survival becomes behavioral resistance.

Mapping the Roots of Defiance: Individual or Group Reflection

Choose a child, teen, or student who displayed defiant behavior

Reflect on or discuss:

1.What developmental disruptors may have shaped them? (early attachment issues, trauma, neurodivergence)

2.What cultural or systemic stressors may have played a role? (poverty, racism, identity conflict, school surveillance)

3.What might their behavior be protecting them from?

4.How has your perspective shifted based on today’s conversation?

Final Reflection

Final Reflection: What Shifted for You Today?

Take 2–3 minutes to reflect on any of the following:

• What felt new, surprising, or validating?

• What belief about defiance are you rethinking?

• What part of today challenged you or stayed with you?

• What do you want to carry into tomorrow?

• � You can journal, sketch, or pause in silence. � Optional: share 1 word or insight with a partner or in the chat.

Let It Land

Take 5 minutes to write or discuss:

• What insight will you carry into tomorrow?

• What’s one question you’re still sitting with?

From Behavior to Belief

What if defiance is a child saying, “Will you still love me if I resist you?”

What if behavior is not the problem, but the signal?

• What if your compassion is the intervention?

Reframing Defiance: What Do You See Now?

Revisit one youth you met earlier (e.g., Mateo, Aisha)

Group prompt:

• What do you see diLerently now?

• How would your response shift tomorrow?

Behavior + Emotion: Why Both Matter

1. Behavior is what we see but emotion is what drives it

2. Defiance is often emotional dysregulation in disguise

3. Our systems tend to focus on control, not connection

4. Lasting change comes from supporting both:

• External behavior

• Internal experience

– L.R. Knost Quote
“Behind every behavior is a need. Behind every need is a feeling. Behind every feeling is a story.”

Thank You for Today! What’s Ahead Tomorrow

Today we explored:

• The roots of oppositional behavior

• Cultural, systemic, and developmental disruptors

• How behavior is shaped by emotion and survival Tomorrow we’ll dive into:

• Practical interventions and relational strategies

• Emotion regulation tools that actually work

• Planning systems that support youth, families, and staL

Optional Share or Journaling

• Turn to a partner and share one thing that stuck

• Or, jot down a few notes for yourself

• Online: use chat or type quietly to reflect

Guided Reflection – Your Team

• Think of a youth you support: are the adults aligned in their expectations?

• Who’s holding the relationship? Who’s holding the rules?

• What’s one step you could take to support alignment?

Building Trust Through Validation

"Defiance decreases when youth feel seen."

What Validation Is… And Isn’t

Validation IS:

• Acknowledging a youth’s internal experience

• Naming the emotion without judgment

• Staying connected even in the middle of escalation

Validation IS NOT:

• Agreeing with poor behavior

• Letting go of boundaries

• Fixing the problem right away

Linehan’s Six Levels of Validation

1.Pay attention be present and nonjudgmental

2.Reflect repeat what you hear without interpretation

3.Read between the lines validate unspoken emotions and body language without interpretation

4.Understand in context acknowledge past learning and trauma

5.Normalize show that the response makes sense

6.Show equality through radical genuineness treat the youth as capable and deserving

Trust Starts With Safety

• Predictable responses from adults

• Repair after rupture (especially after yelling, shutting down)

• Letting youth know, "You don’t have to earn safety it’s your starting place"

• Consistent boundaries delivered with warmth

Rebuilding the Bridge

• Begin with connection, not correction

• Use brief, specific affirmations ("I see you trying")

• Offer choices within boundaries

• Show up consistently not just when behavior is good

• What have you done that helped a youth lower their guard?

• What’s one thing an adult did that helped YOU feel seen when you were younger?

Regulate Before You Redirect

Why Regulation Comes First

• Youth in distress aren’t thinking they’re surviving

• The brain needs calm to access logic, memory, and empathy

• Co-regulation helps them borrow your calm before they find their own

T

DBT TIP Skills: Rapid Reset for Emotional Storms

I = Intense Exercise:

• Short bursts of vigorous activity (jumping jacks, sprinting in place)

P = Paced Breathing / Paired Relaxation:

Why Behavior Plans Often Fail

• Focused only on compliance, not emotional needs

• Lack of youth voice or agency in the process

• Over-reliance on rewards and punishments

Collaborative Behavior Planning – Youth as Partners, Not Projects

� Ask directly:

• “What happens for you when you get upset?”

“What helps you come back down?”

� Build the plan together:

• “What should we try first?”

• “What kind of support feels helpful?”

� Reinforce shared language:

• Use visuals (e.g., thermometer, STOP skill) to normalize discussion Frame interventions as support, not control

� Set structure with flexibility: Clear expectations and space for trial-and -error

• Room to revise the plan with their input

WAIT Strategy and Offering Limited Choices

WAIT = Why Am I Talking?

• Stay calm.

• Avoid power struggles.

• Allow time for youth to regulate and respond.

Offer limited choices:

2–3 clear, acceptable options

Shifts focus from opposition to autonomy Keeps authority connected, not controlling

Example:

• Instead of "Clean your room NOW!" →

• Say: "Would you like to clean your room now or after dinner? You choose."

WAIT Strategy – Giving Space Without Disconnection

� The power of the pause:

• Reactivity feeds reactivity

• Slowing down invites safety

� WAIT = “Why Am I Talking?”

Pause before correcting, explaining, or escalating

Ask: “Am I responding or reacting?”

� Regulate first, respond second:

• Use STOP skill yourself

• Co -regulation > correction

� ONer limited choices when possible:

“Do you want to take a break or stay at the table?”

“You can come back to the group when you're ready.”

Distress Tolerance: Surviving Emotional Storms

Distress tolerance = surviving emotional overwhelm without making things worse

Focus is on riding the wave, not fixing emotions immediately

DBT teaches physical strategies to regulate the body:

• Change body temperature

• Use intense exercise

• Practice paced breathing

• Engage in muscle relaxation

TIP Skills – Fast Tools for Fast Emotion

T = Temperature Change

� Splash cold water on the face or hold an ice pack

� Triggers the dive reflex → slows heart rate, calms system

I = Intense Exercise

� 30–60 seconds of jumping jacks, running in place, or wall push-

ups

� Burns oi adrenaline → resets arousal curve

• P = Paced Breathing & Paired Muscle Relaxation

� Inhale for 4, exhale for 6 (or longer exhale than inhale)

� Tense muscles on inhale, release on exhale

� Signals safety to the body

Menti Poll: Which TIP skill would you teach first?

Instructions:

1.Go to https://www.menti.com/alu9an 47a786

2.Enter the code: 3462 2382

3.Answer the poll:

" Which TIP skill would you introduce first to a youth in distress?

Group Activity: Building Jordan’s Intervention Plan

In your groups, discuss and create a basic plan for Jordan:

1.Identify Jordan’s strengths (Islands of Competence)

2.Choose one emotional regulation skill you would introduce

1. (Example: STOP skill, breathing exercise, or feelings thermometer)

3.Choose one behavioral strategy to support him

1. (Example: Positive reinforcement, oeering limited choices, clear and calm limits)

4.Identify one family or school support action that would strengthen his environment

• Goal: Build a plan that supports safety, resilience, and relationship.

• Reduced intensity of outbursts?

• Use of a self-regulation tool?

• Trust in one adult?

• A single moment of co-regulation?

Group Share-Out: Jordan’s Plan Highlights

In your groups, choose a spokesperson to share:

1.One of Jordan’s strengths your group identified

2.One emotional regulation tool you would introduce

3.One behavioral or environmental support you would prioritize

• Focus on practical steps that build connection and resilience!

How Systems May Reinforce Dysregulation

• - School: Zero tolerance policies escalate power struggles

- Family: Inconsistent discipline + emotional reactivity

- Therapy: Too much talking, not enough regulation support

- Youth services: Surveillance over support 52

Jordan’s Real Plan – Not the Fantasy One

• - TIP skill in backpack with a visual reminder

- STOP card taped to desk – can Ilip when he needs a reset

- One adult ally in the building with a 30-second script: “Want to breathe or walk?”

- Repair path: draw/write after escalation (no verbal processing at Iirst)

- Weekly 5-minute check-in where he gets to suggest one plan edit

53

Family Coaching Layer

Helping Adults Respond Differently

• - Teach parents: defiance = dysregulation, not disrespect

- Help them develop nonverbal signals and neutral tone responses

- Normalize cycles: rupture → retreat → repair

- Include youth in planning family recovery rituals (music, meals, shared time)

54

Embedding Regulation in the IEP

• - Embed emotion regulation goals alongside behavior goals

- Integrate co-regulation breaks with trusted adults

- Include self-advocacy prompts (“What do you need right now?” cards)

- Allow opt-out points from overstimulating settings with return agreement

55

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Teach a Tool – Skill Pair Practice

• - Pair up: one person is the 'youth', one is the 'supporter'

- Teach a DBT skill (STOP, TIP, or Thermometer) in 60–90 seconds

- Then switch roles and try a different skill

What Did You Learn Teaching the Skill?

- What surprised you?

- What felt awkward or empowering?

- What was easy to explain? What wasn’t? 57

What Will You Try in the Next 7 Days?

• - What strategy, script, or tool are you committed to trying this week?

- Who will you need to loop in or prep in advance?

- How will you measure whether it helped for you or for them?

Menti Poll: What’s One Word You’re Leaving With?

Instructions:

1.Go to https://www.menti.com/alu9an

47a786

2.Enter the code: 3462 2382

3.Answer the poll: What’s One Word You’re Leaving With?

“You can’t punish the pain out of a child. But you can sit with them long enough for the pain to ease.”

Key Takeaways

1. Behavior is a story – not a symptom.

2. Defiance is often a protective adaptation, not a personal attack.

3. Emotion regulation must come before behavior redirection.

4. Collaborative planning reduces resistance and builds ownership.

5. Tools like STOP, TIP, and the thermometer must be taught before they can be used.

6. Defiance often masks disconnection – repair is the intervention.

7. Planning must be relational, trauma-informed, and flexible.

8. You are not just teaching skills you’re creating emotional safety.

✨ You are part of the regulation plan.

• Eboni Webb, PsyD, HSP, Consultant

• Office Locations

• Franklin: 367 Riverside Drive, Suite 250

• To Schedule a Consultation Call 615-613-7639 www.webbjamconsulting.com ewebb@webbjamconsulting.com

APA Reference Sheet –

Oppositional,

Defiant, and Anger

Issues Training

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

• Linehan, M. M. (2014). DBT skills training manual (2nd ed.). The Guilford Press.

• Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook (3rd ed.). Basic Books.

• van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

• American Academy of Pediatrics. (2024). There are no bad kids: An antiracist approach to oppositional defiant disorder. Pediatrics, 155(2), e2024068415. https://doi.org/10.1542/peds.2024-068415

• Assessment of oppositional defiant disorder and comorbidities in children with Down syndrome. (2022). Frontiers in Psychiatry, 13, 1062201. https://doi.org/10.3389/fpsyt.2022.1062201

• Goldstein, N. E. S., Serico, J. M., Haney-Caron, E., Giallella, C. L., Kalbeitzer, R., Zelechoski, A. D., Riggs Romaine, C. L., & Kemp, K. (2023). The juvenile justice anger management (JJAM) treatment for girls: Facilitator guide and participant materials. Oxford University Press.

• Hoffman, L., & Rice, T. R. (2016). Manual of regulation-focused psychotherapy for children (RFP-C) with externalizing behaviors: A psychodynamic approach. Routledge.

• Konok, V., et al. (2024, January 4). Toddlers given phones to calm them down 'have anger issues later'. The Times. https://www.thetimes.co.uk/article/toddlers-givenphones-to-calm-them-down-have-anger-issues-later-f60j3l6q7

• Liu, Y., et al. (2023). Preschooler screen time and temperamental anger/frustration during the COVID-19 pandemic. Pediatric Research. https://www.nature.com/articles/s41390-023-02485-6

• Sukhodolsky, D. G., et al. (2022). Evidence base update on the assessment of irritability, anger, and aggression in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 51(1), 1–17. https://doi.org/10.1080/15374416.2023.2292041

• Teodorescu, D., Fyshe, A., & Mohammad, S. M. (2023). Utterance emotion dynamics in children's poems: Emotional changes across age. arXiv preprint arXiv:2306.05387. https://arxiv.org/abs/2306.05387

• Cleveland Clinic. (2023). Oppositional defiant disorder (ODD): Symptoms & treatment. https://my.clevelandclinic.org/health/diseases/9905-oppositional-defiant-disorder

• National Institute of Mental Health. (2022). Disruptive mood dysregulation disorder. https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-disorderdmdd

PARENTINGSTYLEANDADULT ATTACHMENT

IntegratingaTrauma-FocusedLens

THESTRANGESITUATION SECUREATTACHMENT

oReunionbehaviorsaremoreinsightfulthan separationbehaviors.

oImmediatereassurancefromthereturnof theirsecurebase(distressisnaturaland expectedatseparation).

oReconnectionpromptsreturnto independentexplorationandplay.

oChildBehaviors:Flexibilityandresilience

oSecureParent=Sensitivity,attunement, acceptance,cooperationandemotional availability

THESTRANGESITUATION AVOIDANTATTACHMENT

oReunionbehaviorsaremoreinsightfulthan separationbehaviors.

oApparentlackofdistressshouldnotbe mistakenforcalm.Superficialindifference isatraumadefense.

oReconnectiondisplaysactiverejectionof bidsforconnectionbyparentresultingin limpphysicalconnection.

oParentBehaviors:WithdrawandRebuff

oAvoidantParent=Inhibitedemotionality, aversiontophysicalcontact,and brusqueness

THESTRANGESITUATION

AMBIVALENTATTACHMENT

oReunionbehaviorsaremoreinsightfulthan separationbehaviors.Lookingfortheirabsent parentevenwhentheparentispresent.

oTwopresentations:AngryorPassive

oReconnectiondisplaysovertbidsfor connectionandexpressionsofrejection(e.g. full-blowntantrums,leaningaway,etc.)to implicitbidsforsolacedisplayedin helplessnessandmisery.Lackofexploration. ParentBehaviors:Unpredictableand Intermittentlyavailable

oAmbivalentParent=Insensitivesignaling, neitherverbalorphysicallyrejectingwhile discouragingautonomy

ParentingStyles

Comparingnurturanceandstructurelevelsonascaleof0-100.

Neglecting-UninvolvedParenting

Lownurturance,expectations, controlandcommunication

Indulgent-PermissiveParenting

Highnurturance,moderate communication, lowexpectations,andcontrol

CHILDANDADOLESCENT ATTACHMENT

AttachmentStyle:Adolescent (Chara,2005)

Characteristics

Optimism;mature emotionalityPredominantEmotions

Detachment; callousness

AbilitytoTrust

Desirestrust;finds iteasytotrust

Indifferenttoward trustmistrustfulof others

Anxiety,anger

Desirestrust;but mistrustfulofothers

Fear,doubt

Desires,butwaryof, trust,suspiciousof others

AbilitytobeIntimate (mutualself-disclosure)

FearofAbandonment

Avoidsintimacy; difficultybeing genuinelyintimate Desiresintimacy; abletobeintimate

Desiresintimacy,but doubtfulintimacyis sincere;difficulty beingintimate

Intimacydesires mixedwithfearand doubt;difficultybeing intimate

Low;findssecurity inrelationships

Low;indifference bornofself-reliance

High;fearsbeing rejected

High;strongfearsof rejection

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