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Section 2
Role of Family Experiences in Oppositional Defiant Disorder

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In the last section, we discussed situations in which I ask parents to try reframing.  These situations were:  aggressively provoked teens; seemingly hopeless situations; and misinterpreted realities.

In this section, we will discuss the three dimensions that I consider when first becoming familiar with families with teens who exhibit oppositional defiant disorder.  These three dimensions include:  pressures on the family, Other-Person-Centered Responding, and structure.

3 Dimensions of Families with Oppositional Defiant Teens

♦ #1 - Pressures on the Family
The first aspect I use is developmental pressures on the family.  These pressures occur when a family and its members are developing their own identities rapidly.

One of my clients, the Henderson family, has developmental problems involving both the teens and parents.  The parents, Dave and Abbie, age 32 and 31, have five children, three of whom are teens.  Dave and Abbie have the task of raising these children as well as trying to satisfy educational and job skills they missed as teens. 

The three teens, Dennis, Lisa, and Karen, are all trying to develop their own educational and physical personalities.  The pressures the Henderson family face turn to behavioral problems, which include drinking, violence, and poor performance at school and work. I explain to the Hendersons that the stress of the family may be the cause of these behavioral problems. 

Because so many family members are all trying to develop in some way, everyone is actually afraid that the family will eventually grow apart.  Without the support of this familial structure, the parents do not have the strength they need to resist these behavioral problems.

♦ Technique:  Other-Person-Centered Responding - 11 Main Ideas
One communication skill I present to parents with oppositional defiant teens is to have parents think of and interpret their responses as their teen may have perceived them.  This exercise can be called Other-Person-Centered Responding.  The general goal is to be committed to what their teen needs as opposed to their own needs as the parent.  I find 11 Main Ideas to present to parents in Other-Person-Centered Responding:

During a family session with the Abbie, Abbie talks about her 15 year old daughter Joanna who is currently experiencing  depression.  Abbie stated, "Joanna is constantly out with friends partying and will not tell us where she is at night!" 

Joanna explains to me that she is just out "being a kid."  "I am not using drugs or doing anything illegal!" she states, "I am just out with my friends having fun, and my parents don’t understand that!"  I asked Abbie to try the Other-Person-Centered Responding exercise to try and help her understand her teen’s side of the issue.  Abbie began by asking Joanna about her night out with her friends. 

Joanna stated, "Ugh, Marianne was being such a brat last night!  She kept trying to hook up with Danny when she knew that Ashley liked him.  They’re best friends too.  She can be such a bitch!" 

At this point, there are several thoughts running through the mother’s mind that she would wish to say such as: 
-- "These kids are too young to be hooking up"
-- "My daughter is using curse words" and
-- "Joanna used to be such good friends with Marianne." 
All of which are perfectly legitimate questions, but in the context of reaching out to her teen, I felt Abbie needs to focus on Joanna’s own situation.  Other issues can be handled at a later date. 

Instead of voicing her reactionary opinions, Abbie stated, "Oh man, so are Ashley and Marianne still fighting?"  Here, Joanna has utilized number five "What does their story mean to them?"  By taking an interest in what Joanna was saying, Abbie also demonstrated to Joanna that she was there to listen and be interested. 

♦ # 2 - Structure
In addition to developmental pressures and family history, the third feature of the four dimensional model is the structure.  Structure is the organization of relationships both within and outside family relations.  One client I would like you to consider is the Jones family in which an uncle had sexually assaulted the teenage daughter.  Many professional social systems were already at work within this family: the mother’s therapist, the father’s therapist, the teen’s therapist, and the court. 

Jody, the 13-year-old teen exclaimed, "I want to be out of the house.  I do not care if I am a minor; I have a right to be moved away from this situation!"  Her parents went on to tell me, "We are sorry for what happened, but we want Jody to stay and live with us.  We don’t keep in contact with her uncle anymore, and it would be best for Jody."  Each person, inside and outside the family, had their own opinion as to what the best course of action to take with Jody would be. 

I explained to Jody that although she wants to forget what happened, destroying the familial structure her family has worked so hard to achieve would not help ease the pain.  In order to expand my point further, I made this analogy to Jody, "Suppose you hurt your hand in some way, either by falling on it or hitting it on something.  It may be hurt or broken, but you would never cut it off.  Why wouldn’t you?" 

Jody stated, "Well, the body needs the hand."  I then said, "That’s right, just like your family needs you.  But doesn’t the hand need the body as well?  When a hand is separated from the body, not only is it unable to function, but it also loses the capacity to heal what has been broken.  If you separate yourself from your family, who loves you and supports you, don’t you also separate yourself from the people who could help you most?"  Jody reluctantly agreed. 

Think of your Jody who wants to separate from his or her family.  Would this act hurt or help the client?  How can you help your client find the best path for him or her?

In this section, we discussed the three dimensions that I consider when first becoming familiar with families with disruptive teens.  These three dimensions include:  contemporary developmental pressures on the family, Other-Person-Centered Responding, and structure.

QUESTION 2
What are four aspects of the three-dimensional model? To select and enter your answer go to Test.

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