A Grounded Theory Study of Power Dynamics in the Psychological Treatment Process of Defiant Adolescents

Abstract

This study aimed to explore the power dynamics within the psychological treatment process of defiant adolescents using a grounded theory approach based on their lived experiences. This qualitative research was conducted using the grounded theory method. Data were collected through semi-structured interviews with 16 adolescents diagnosed with oppositional defiant disorder (ODD) in Tehran. Participants were selected via purposive sampling, and data collection continued until theoretical saturation was achieved. All interviews were recorded, transcribed, and analyzed using NVivo software. Data were coded through open, axial, and selective coding based on Strauss and Corbin’s framework. Analysis led to the identification of three major categories: adolescent power assertion, therapist's position of authority, and interpersonal tensions in the therapeutic space. In total, 15 subcategories and over 70 open codes were extracted. The results revealed that adolescents employed active, passive, and symbolic resistance strategies to maintain control over the therapeutic relationship, while therapists utilized soft power, relational restructuring, and direct confrontation to manage these dynamics. Power dynamics in the treatment of defiant adolescents reflect deeper psychological and identity-based processes rather than mere behavioral resistance. Understanding these dynamics can enhance therapeutic alliance and intervention effectiveness. Therapists are encouraged to adopt a culturally sensitive, flexible, and empathic approach that acknowledges adolescents' resistance as part of the therapeutic journey.