Intervention with Adolescents

Chapter 4

Adolescence

Risks to Health and Well-Being

• Includes risk taking at earlier time points and in greater amounts in areas including:– Alcohol– Illicit drugs– Earlier age of first sexual

intercourse– Multiple sexual partners – Use of synthetic marijuana

• School Dropout• Suicide

Issues and Problems• Rapidly occurring physical

changes– Puberty– Appearance of secondary sex

characteristics

• Shift from concrete to formal operational thinking

• Peer pressure for approval and conformity– Directly related to engagement in

risky behaviors

• Emotional Development– Wide fluctuation of emotional

reactions

Prevalence Rates for Selected Behavior Problems and Disorders

• Drug Use:– Reported drinking in the past 30 days:

• 13% of 8th graders• 27% of 10th graders• 40% of 12th graders• By high school graduation:

– 50% have used illicit drugs

• Substance use disorders:– 11% of youth meet the criteria for a substance use disorder.

• Suicide– Overall suicide rate of 7% for 15-19 year olds

• 2% of adolescent females and 11% of adolescent males

• Anxiety Disorders– Overall rate for any kind is 32%

• Behavioral Disorders– 20% of all adolescents

• Autism Spectrum Disorder– 1 in 88

Adolescent DevelopmentROUTINE OBSERVATION DEVELOPMENTAL CONCERNS DEVELOPMENTAL OBSERVATIONS

REQUIRING ATTENTION

Brain development and abstract thought

Egocentrism Anxiety

Increased caloric intact Focus on physical appearanceHeightened concern with body image

Eating disorders

Menstruation (girls) and nocturnal emission (boys)

Early maturing girls Early pregnancySex abuse and rape

Romantic involvement Sexual identity explorationSexual behavior

Sexually Transmitted Infection’sTeen Dating Violence

Decreased interest in school Academic difficulties School Drop out

Heightened emotions Moodiness Depression

Independence Spending more time aloneSpending less time with family

Violent behaviors and exposure to violence

Autonomy Increased parent-child conflict Risk behaviors (e.g., automobile safety, substance use)

Transition to middle school Increased peer influence Conduct disorder and delinquencyFirearm exposure/use

An important skill in working with adolescents is being able to identify common developmental concerns, issues needing closer observation, and developmental observations requiring attention.

Overview of Prevention Programs• Midwestern Prevention Program

– Substance abuse prevention– Targets all 6th and 7th graders in a

school– 10 session classroom based resistance

skills training– Parent training on parenting skills– Community component – Mass media campaign

• Project Northland– Classroom, family, peer and

community components

• Life Skills Training– Cognitive behavioral strategies – Four step problem solving model

• Stop, options, decision and action

• Adolescent Coping with Depression Course– CBT– Intervene in dysfunctional cognitions

• Multisystemic Therapy (MST)– Broad based therapy– Decrease antisocial behavior,

improve psychosocial functioning and reduce out of home placements

– Ecological theory influences• Individual• Family• School• Peer group• Community

Overview of Prevention Programs Continued

• Functional Family Therapy– Family Systems framework– Social learning focus– Improve communication

patterns, problem solving skills, negotiation skills

– Involves family treatment

• Multidimensional Foster Care– Designed as an alternative to

group care settings• Interventions occur in foster

family, school and community• Trains foster families in social

learning and parent training model

• Lasts 6-9 months on average.

• Problem Solving– Problem definition and

formulation– Generating alternative

solutions– Decision making and selection

of a solution– Implementation and

evaluation of a solution

• Social Skills Training– Small group format– Behavior group therapy

principles and strategies for teaching specific skills.