Oppositional Defiant Disorder Case Study

Introduction: Title

In this paper several aspects of play therapy will be reviewed in depth. The overview of this paper will consist of the use of puppets in therapy to address children (ages 6-12) with Oppositional Defiant Disorder (ODD). An overview of the history and development of children with ODD and puppetry will be discussed. A comparison of the effectiveness of the different play therapy interventions that are used today to aid children with ODD will be highlighted. Moreover a discussion of the comparison of ODD symptoms and how using puppets as an intervention can increase better therapeutic outcomes for children with ODD. Furthermore this paper identifies gaps in the literature and considers new contributions to the research.

Oppositional

Defiant Disorder
ODD is a common behavior health disorder diagnosed in childhood. ODD appears around the age of 4 and increases until the age of 8; however, as children become older ODD appears to decrease. In addition ODD is more common in boys than in girls (Dinolfo & Malti, 2013). As stated by Dinolfo and Malti (2013) ODD has been compared to conduct disorder and antisocial behavior; therefore, it is important to highlight the symptoms of ODD in order to differentiate it from other disorders. Although ODD has antisocial components there is a significant difference in behavior; ODD has an argumentative and antagonizing element that influences the ability for the child to function appropriately with other individuals (Dinolfo & Malti, 2013).
According to Maxmen, Ward and Kilgus (2009) ODD is a disorder predominately found in children that display extreme anger; children with this disorder often lose their temper, defy adults, purposefully annoy others, are vindictive, cannot take responsibility for mistakes and can be manipulative.

Moreover, children with ODD mainly direct their behaviors towards their peers and adults. Thus children with ODD may have difficulties making friends, maintaining friendships, get into trouble at school and at home. In addition, children with ODD have low self-esteem, temper outburst and experience low frustration tolerance. Moreover having ODD influences social skills, academic achievement and occupational functioning in negative outcomes (Maxmen, Ward & Kilgus,

2009).
Puppetry History/Development
Puppetry is an intervention used by many therapist to aid children. Woltman was the first individual to have documented the use of puppetry; Woltman used puppetry to help children that were hospitalized to process being away from their parents and to help them process their illnesses. Therapist find puppets to be an effective intervention for the reason being that puppets are easy to manipulate and can represent different things. In addition, there are several types of puppets: hand puppets, ventriloquist’s dummies, muppets and marionettes; however, therapist tent to use hand puppets because they are easier for children to maneuver (Carter & Mason, 1998). Moreover, puppets can be used to build self-esteem, encourage emotional release, help with decision making, and can increase the development of healthy communication skills.
Puppets provide children with an opportunity to express a wide range of feelings. Using puppets provides children with an opportunity to narrate a story, but also allows them to act out events or feelings (Gil, 2015). According to Landreth (2012) puppets allow children to express their emotions in a safe and nonthreatening manner; children feel safe expressing their feelings since they think that the puppets are the ones expressing their feelings. Moreover if a child is not able to express a particular emotion the use of puppets does not prevent or hinder the process of the child expressing or acting out a story when using puppets (Landreth, 2012). Therefore using puppets as part of play therapy with children can provide them an interactive way to explore, express themselves and at the same time keep them engaged in the therapy process.
Gaps In The Literature
Carter (1987) used puppets to help children who have experienced trauma such as witnessing the murder of a family member. The use of puppets has been proven to positively influence the therapeutic outcome for children with PTSD (Brown, 1996). In addition, puppetry has been shown to be significantly successful when implemented in Native American children due to the use of story telling. According to Aiello (1988) puppets have been effective in addressing children with disabilities. However, there is a lack of research to address the use of puppetry in children with ODD.
Puppetry Interventions and Children With ODD
Board games are a tools therapist may use to facilitate boundary making skills, but will not help this population in the exploration of real life experiences or express a wide range of emotions (Landreth, 2012).

When it pertains to children with ODD it is essential to have activities that will allow them to express themselves, thus puppets help children with ODD meet those needs. The use of this type of play therapy will reinforced positive rather than negative behavior in children with ODD. Using puppets cannot only benefit children with ODD, but the parents as well; through the use of puppetry parents can change the way they interact with their children and promotes a more encouraging environment through play. According to Schaefer and Kaduson (2015) symbolic expression is essential in the way children and their parents narrate conflict and reduce behavior problems, thus using puppets can provide this symbolic expression. Also using puppets provide the child with a sense of control and exploration in expressing what they feel. As stated by Schaefer and Kaduson (2015) when it pertains to treating children with ODD it is more effective to use short-term interventions and since puppetry is a short-term intervention then it can maximize compliance in children with

ODD.