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 8 th graders 27% of 10 th graders 40% of 12 th 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 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 Development R OUTINE O BSERVATION D EVELOPMENTAL C ONCERNS D EVELOPMENTAL O BSERVATIONS R EQUIRING A TTENTION Brain development and abstract thought EgocentrismAnxiety Increased caloric intactFocus on physical appearance Heightened concern with body image Eating disorders Menstruation (girls) and nocturnal emission (boys) Early maturing girlsEarly pregnancy Sex abuse and rape Romantic involvementSexual identity exploration Sexual behavior Sexually Transmitted Infection’s Teen Dating Violence Decreased interest in schoolAcademic difficultiesSchool Drop out Heightened emotionsMoodinessDepression IndependenceSpending more time alone Spending less time with family Violent behaviors and exposure to violence AutonomyIncreased parent-child conflictRisk behaviors (e.g., automobile safety, substance use) Transition to middle schoolIncreased peer influenceConduct disorder and delinquency Firearm 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 6 th and 7 th 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.