Featured Discussion 34

Disruptive behavior disorders—including conduct disorder (CD) and oppositional defiant disorder (ODD)--are the most common mental health diagnoses among youth involved in the juvenile justice system. Children and youth with CD and ODD are often assumed to be juvenile sociopaths. As a result, these young people are often treated as if they are incurably “bad.”

In “Bad Conduct, Defiance, and Mental Health,” an article appearing in the new issue of Focal Point, Charley Huffine argues that the CD and ODD diagnoses are not meaningful, and that these labels are often attached to youth who suffer from other (usually undiagnosed) mental health difficulties. Often, youth who receive these diagnoses are reacting to stress, chaos, or dysfunction in their social environments. Huffine contends that we must take a more compassionate view of these young people and offer treatment that responds to their unique life circumstances.

We invite you to read this full article, and/or post your ideas about “bad” behavior and the diagnoses of CD and ODD.

Is there any value to the diagnoses of CD and ODD?
What is your personal experience with youth who have these diagnoses?
Are we being too “soft” if we react to oppositional or noncompliant behavior with compassion or if we offer treatment?
What sorts of approaches—forms of treatment and/or punishment—do you think are most effective for responding to youth who have broken the law and who are also diagnosed with CD or ODD?

Comments:

mprice Utica N.Y.

Although it is difficult to accept... children who are acting out negatively are doing so not capricously, or simply to be yelled at or castigated... but the child's MIND is simply "venting" negative energy being generated within the child's MIND in these negative behaviors.

If at all possible, take some time and get in touch with what is going on within you, at a deep emotional level... because you are unknowingly sending subtle emotional messages of fear and anxiety to your son's MIND, and this simply exacerbates the fear within his MIND.

If you would like, email me and I will try to help you from a distance... if you cannot find competent help close to yourself. esominder@yahoo.com Posted Thursday, April 19, 2007 at 01:13 PM

Mr. Huffine, suggests that "stress, chaos, or dysfunction in their social environments." are the problems... and once again the behaviorally oriented view anything and everything outside of a person as "responsible" for what a person does.

That which causes a person to engage in negative behavior is to be found within that person's MIND. [AND YOUR MIND IS NOT YOUR BRAIN]. Negative behavior is a "venting" of negativity from within oneself, and specifically within ones own MIND. If ones actions or behaviors are negative, then the energy be vented is negative. And the energy is negative because what ones MIND is repressing is negative. Specifically, what ones MIND is repressing is a negative misperception, and until you find a competent psychotherapist who can help you discover that misperception and eliminate it, you are stuck with having to "vent" that negative energy. The typical behaviorally trained counselor or therapist will help you find different ways to vent the energy but they are not capable of helping you discover the "cause"within your MIND because they are as fearful of what's in your MIND as you are. For research try a goggle search for Esochology.

James W. Patterson, Ph.D.

Posted Saturday, March 24, 2007 at 09:18 AM

I am a Revolution Health employee and am enthused that there are folks who are immediately latching on to the big idea that we're trying to put together. We are definitely looking for feedback and realize (as you mention) that much of the power is propor WBR LeoP Posted Friday, March 23, 2007 at 06:34 PM

Medications alone are not enough and most mental health providers don't just rely on meds to fix problems. Mental health/illness should be treated like anything other problem. WBR LeoP Posted Tuesday, March 20, 2007 at 03:25 AM

The problem of reception Medical and health insurance for unemployeds interests WBR LeoP Posted Saturday, January 20, 2007 at 01:35 PM

Who really now is engaged in the control of health? To mine it neglected the large pharmaceutical companies and the medical centers. There should be a centralized management WBR LeoP Posted Friday, January 19, 2007 at 04:58 PM

My son who is 14 years old fits the criteria for CD and ODD but has never been "officially" diagnosed as either one. He has stolen from our home and from the community. Most recently, someone's vehicle, which resulted in a JD charge. He has run away repeatedly, molested his 5 and 6 year old female cousins, started small fires in our home and is "secrectly" cruel to amimals. He was court ordered to have a 60 day inpatient diagnosis but due to his behaviors and medical condition (chronic renal failure) we could not find one place that would accept him. We then tried the RTF/RTC route as he was condidered a "danger to society" but they also refused to accept him for the same reasons. Our only option after all of this was to sign over custody to our local DSS and they placed him in a "foster home". We feel angry/scared at this placement. Angry that we were forced into this option as we could no longer maintain his or others safety in our home or community. Scared that he will hurt someone or "burn down" the unsuspecting foster parents home. We have fully disclosed all of his behaviors to them but my son is the type of child who needs 24 hour supervision because you never know when he will "strike next"!! Posted Monday, October 23, 2006 by mprice Utica New York at 07:43 AM

"Noting there are no scientific or otherwise reliable bases for mental illness diagnoses or treatments and that current Mental Health Law and implementation breach Universal Human Rights we the undersigned Petition for:

A. The current Biomedical Model of Mental Illness approach to be imediately done away with in favour of the Social Model of Mental Health which would be far more productive and less costly over the long run.

B. Imediate reduction in the prescribing of psychotropic medications and medical intervention to help titrate people off of these harmful, mind altering, addictive chemicals should they choose this since once adapted to taking these chemicals the withdrawals can be toxic and cause seizure and death exclusion of any penalties for those that are addicted to these medications and voluntarily want help in getting off of them

C. Significantly more stringent control of the pharmaceutical industry, doctors that prescribe these medications, and psychiatrist

D. For those that shall choose it provision of truly confidential (regardless of current law), appropriate, person centered counseling and appropriate non coercive or forced local social interventions supported by budgets enabling free choice, self actualization, and personal integrity

E. Serious questioning of the psychiatric profession through outside doctors of an ethical vocation and former psychiatric patients which is to be made public imediately

F. The psychiatic medical board to be made and held accountable to an independent regulatory body

G. Repeal of current psycho-social- civil Mental Health Law and its replacement with humane laws
ensuring the safety of all citizens and inclusiveness of all citizens; in turn recognising the full worth of
Human Rights, Self-determination; and Citizenship, consistent with other law requiring that citizens be responsible for their own actions"
Posted Friday, September 22, 2006 at 03:27 AM

I largely agree with the point of view expressed in the article. I think many of us know that kids who end up with these labels often have many other problems in their lives, not just organic mental illness but often mental illnesses that are caused by or exacerbated by chaotic, abusive/neglectful, or highly stressful environments. By the time they come to our attention they often have developed behaviors that are grab our attention and earn them the CD label. At that point often it is easier to feel anger toward the behavior than compassion for the pain that underlies it. Often even when we do try to help, our efforts don't seem to work-- in these instances in particular it may feel better to blame the young person for not wanting to improve him/herself than to acknowledge the true nature of the problem. Posted Thursday, July 27, 2006 at 10:23 AM

I am working with very young children with developmental disabilities and challenging behavior. There is a huge gap in services for this population. These children may not have the "right labels" to qualify for services with the Agency for Persons with Disabilities (ADP.) Medicaid also can't/won't serve these children. According to Medicaid's man made barriers - the behavior is a symptom of the disability. A disability is not treatable thus behavior intervention is ineffective. We know that best practice interventions, such as Positive Behavior Support, are proven effective with all populations. This kind of logic creates the following: A child with pervasive developmental disorder (a mild form of autism) may be too high functioning to be labeled Autistic. Even if the child made it to the top of the many thousand person waiting list, ADP can not serve this non-labeled child. The child has straight A's in school but is socially awkward. He would greatly benefit from behavior intervention for developing his social skills. His lack of social skills make him a target for school bullies. The child becomes depressed and angry but is not entitled to mental health services because he has a disability. What do you think happens to this child and to his family? Contact me if you have any ideas about what to do about this great injustice Posted Wednesday, July 5, 2006 by Madeline Tampa Florida mhornbe at 07:54 PM

It concerns me that these diagnoses are excluded from receiving treatment funding through sources such as Medi-Cal (Medicaid). Most of the kids who wind up with such diagnoses have probably had other diagnoses in the past. I wonder if the failure of treatment interventions resulted in changes to the diagnosis. I also wonder if kids experiencing chaos, either internally and/or externally, engage in behaviors which get them the structured and predictable environments they need. Posted Thursday, June 29, 2006 by ddavis, San Diego, CA at 03:02 PM

I think one of the biggest problems our society has is attempting to call other's names if they don't agree with them, this can be in the form of label making for insurance purposes. Like young school yard children that are scapegoating and chicken yarding, adults often do the same to children.

I guess the King of England would have called every one of us all of the above and more when we had the revolution. Some times it is a matter of perception and how we are deciding to deal with small issues and making them into bigger ones, rather then a matter of any thing that can be defined as a real disease.

As we reflect on what this fourth of July really was about and what happened to bring it about, let's do more then just have a good time, let's all try to look at our part in making America what it has become and what we need to do to get back to what it was suppose to have meant for all of us at one point in time. I think when we do that, that we will start seeing that some of this so called mental-emotional illness / disorder is really a sign of rebelliousness and trying to find ones way.

Many times when those who have these qualitities are given the real opportunities and encouragement and resources, that they need, they can and do end up being called leaders rather then troublemakers. A lot of this depends on how those with authoratarian powers treat them and react to them in what is happening and how or if any empowerment is brought about.

I think parents should be taught to have more pride in their children's rebelliousness at times, but learn how to redirect it into a more positive frame of being, that will take their child along way into adulthoood. This is just my thoughts. Janie Posted Wednesday, June 28, 2006 at 09:08 AM

I have worked with hundreds of youth diagnosed with CD and ODD. None of them were "bad". I have found over the years that if you explain a youth's life to an adult working with them, they have more empathy. Including everyone around in an attempt to find solutions provides the youth with opportunities to succeed. Isn't that all anyone wants? A chance to see our youths - all youths succeed. Posted Wednesday, June 28, 2006 by Tammy- Houston, Texas at 06:09 AM

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Featured Discussion 34

BAD CONDUCT, DEFIANCE, AND MENTAL HEALTH

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