Lecture 16: Problems in adolescence

Question 1

Common Problems in Adolescence

Answer 1

• Vulnerable period for onset of MHP
• High suicide rates & other risky behaviours
• Problems often have systemic component e.g. related to changing family relationships
• Problems often have a developmental component e.g. related to identity
• Diagnosed according to DSM-5
• Commonly diagnosed problems = depression, eating disorders, self harm, substance use

Question 2

Barriers to seeking help in adolescence

Answer 2

• Young people have highest rates of MHPs but <20% make use of formal services
• Barriers = perceived social stigma & self stigma
  = Concerns about confidentiality & trust
  = Reliance on self to solve problems
  = Difficulty identifying symptoms of MHP (recognising seriousness)
  = Lack of access to services
  = Lack of appropriate services
  = Concern about characteristics of provider

Question 3

Do we know what young people want?

Answer 3

• Research often driven by professional agenda

- Need research approach that allows young people to tell us about their world & what they want

Question 4

The Mirror Project

Answer 4

Reflecting young people’s views on MH

Question 5

How to improve adolescent engagement with therapy

Answer 5

• Focus on relationship development
• Take it slowly to allow for dev. of trust
• Respect autonomy & allow choice
• Avoid judgement & pathologising - focus on normalising
• Communicate at the right level
• Avoid over-structuring sessions
• Provide opportunities for emotional expression
• Adapt focus to identity of the individual
• Listen more than talk
• Support rather than give advice
• Offer flexibility
• Encourage feedback
• Be clear about confidentiality/privacy

Question 6

Adapting Approaches to Fit with Adolescent Priorities

Answer 6

• Few therapy approaches been designed for adolescents
• So much variation in adolescence, it would be difficult to find a one size fits all
• Adapt content to dev. needs
• Follow general guidelines for engaging adolescents

Question 7

Client-centred therapy

Answer 7

• Basis of most school counselling & NGO services
• Involves active listening, facilitating problem solving by client
• Fits well with young people’s concerns for autonomy, emotional expression etc.

Question 8

CBT

Answer 8

• Adapting CBT adolescents keep in mind client’s cognitive level = use more behavioural strategies
• Adapting tools to adolescent’s own concerns - current issues, values etc.
• Try & avoid patronizing pedagogical approach e.g. homework
• Recognise potential for overt compliance - secret resistance

Question 9

Systems (family) therapy

Answer 9

• Managing changing relationships in family in adolescence
• Managing conflict
• Helping parents to understand challenges of adolescence
• Family therapy specifically designed for problems such as anoraxia & substance use

Question 10

Other ideas

Answer 10

• Peer support
• Group work
• Using tehcnology