Your client is an adolescent with Oppositional Defiant Disorder who is exhibiting aggressive behavior. Which of the following is the priority?

• A. Impaired social interaction.
• B. Risk of violence directed toward others.
• C. Ineffective individual coping.
• D. Self-esteem disturbance.

Answer: (B)

When evaluating risk in an acute behavioral issue, safety comes first. An adolescent with Oppositional Defiant Disorder who is showing aggression creates an immediate risk of harm to others, so the top priority is preventing violence and ensuring a safe environment for peers and staff. The response should focus on de-escalation, clear and firm limits, and protective safety measures while assessing triggers and planning for ongoing supervision and intervention.

After safety is established, you address the other areas such as improving social interactions, building coping skills, and supporting self-esteem through appropriate therapies. These are important but do not take precedence over the immediate danger of violence toward others.