ADOLESCENT PROBLEMS The Emotional Literacy Handbook Promoting Whole-School Strategies Antidote 1-84312-060-7 Get Their Attention! How to Gain Pupils’ Respect and Thrive as a Teacher Sean O’Flynn, Harry Kennedy and Michelle MacGrath 1-84312-080-1 How to Stop Bullying … Towards a Non-Violent School A Guide for Teachers and Support Staff George Varnava 1-85346-938-6 An A to Z Practical Guide to Emotional and Behavioural Difficulties Harry Ayers and Cesia Prytys 1-85346-778-2 Changing Behaviour Teaching Children with Emotional and Behavioural Difficulties in Primary and Secondary Classrooms (2nd edition) Sylvia McNamara and Gill Moreton 1-85346-745-6 Individual Counselling Theory and Practice A Reference Guide Doula Nicolson and Harry Ayers 1-85346-373-6 ADOLESCENT PROBLEMS A Practical Guide for Parents, Teachers and Counsellors DOULA NICOLSON AND HARRY AYERS Revised Edition David Fulton Publishers Ltd The Chiswick Centre, 414 Chiswick High Road, London W4 5TF David Fulton Publishers is a division of Granada Learning. First published in Great Britain by David Fulton Publishers 1997 Second edition 2004 10 9 8 7 6 5 4 3 2 1 Note: The right of Doula Nicolson and Harry Ayers to be identified as the authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. Copyright © Doula Nicolson and Harry Ayers 1997 and 2004 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. ISBN 1–84312–140–9 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or trans- mitted, in any form, or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publishers. Typeset by RefineCatch Ltd., Bungay, Suffolk Printed in Great Britain by Thanet Press v Chapter 1 Adolescent Problems 1 The Concept of Adolescence 2 Chapter 2 Theories of Adolescent Development 4 Erikson 4 Kohlberg 7 Loevinger 8 Bandura 10 Bronfenbrenner 14 Blos 15 Kegan 17 Chapter 3 Theoretical Approaches to Adolescent Problems 19 Biological Approach 19 Behavioural Approach 20 Cognitive-Behavioural Approach 24 Solution-Focused Brief Therapy (SFBT) Approach 29 Person-Centred (Rogerian) Approach 32 Psychodynamic Approach 33 Ecosystemic Approach 38 Chapter 4 Practice 41 Behavioural Difficulties 41 Emotional Difficulties 49 Learning Problems 55 Academic Problems 57 Adolescent Relationship Problems 59 Contents Self-esteem Problems 63 Adolescent Sexual Relationships 65 Mental Health Problems 70 Anti-social Behaviour (Delinquency and Other Forms) 80 Chapter 5 Detailed Topics 83 Adolescent Aggressive Behaviour 83 Attention-Deficit Hyperactivity Disorder (ADHD) 88 Adolescent Depression 90 Suicide and attempted suicide 94 Self-harm 97 Eating Disorders 100 Substance Abuse and Dependence 105 Juvenile Delinquency 113 Families and Adolescence 115 Chapter 6 Case Studies 119 Depressed 18-Year-Old Student 119 Managing a Sexual Relationship 122 Substance Abuse 126 Eating Disorder 129 Self-harm 133 Student Counselling Interview Sheets 137 Glossary 144 Useful Addresses 151 References and Further Reading 160 Contents vi This introductory book is intended to be a concise, structured, readable and eclectic reference guide to theory and practice with respect to adolescent emotional and behavioural problems. It should prove most useful for teachers, parents and all those who deal with and study adolescent problems, and also for adolescents themselves. This guide includes theories of adolescent development, theoretical and practi- cal approaches to adolescent problems, detailed sections on common adoles- cent problems, counselling interview sheets and addresses and phone numbers of organisations that can help with adolescent problems. The main approaches included in the guide are behavioural, cognitive, social learning, psychodynamic, person-centred and ecosystemic, chosen because they are quite frequently used by practitioners. The biological approach is also mentioned but not in any detail as this approach involves drug therapy which is the province of physicians and psychiatrists. It is worth stating that emotional and behavioural problems can result from physical conditions and the side-effects of drugs. Where this is suspected, it is advisable to consult a GP. It can also be the case that emotional and behavioural problems are symptomatic of a psychiatric disorder or the onset of such a disorder, and again, it is advisable to consult a GP. Certain issues and controversies that fall outside the remit of this book do arise from time to time and need to be considered. For example: ● the influence of heredity and the environment on emotional and behavioural problems, i.e. how far there is a biological and genetic basis for such problems; ● whether a problem should be seen as categorical, i.e. a distinct, discrete category or dimensional, i.e. as lying along a continuum; ● how far these problems are the results of traits or states or an interaction between the two, e.g. temperament and situations; 1 Adolescent problems CHAPTER 1 ● the validity and the reliability of the assessment of emotional and behavioural problems and the prevalence of such problems; ● the influence of culture and ethnicity on how problems are perceived and assessed; ● the relative effectiveness of the different approaches with respect to such problems. The concept of adolescence Adolescence is a transitional stage between childhood and adulthood. It is a period of biological, social, emotional and cognitive development which, if not negotiated satisfactorily, can lead to emotional and behavioural problems in adult life. It is customarily defined as beginning at approximately 10 to 13 years of age and ending between 18 and 22 years of age. It is usually subdivided into early and late adolescence. Particular psychological and psychiatric problems can have their onset in adoles- cence or become more prevalent or noticeable during adolescence, e.g. phobias, anxiety, depression, suicide and attempted suicide, attention-deficit disorders, anorexia and bulimia, conduct disorders, schizophrenia and substance abuse. Adolescence is also a time when adolescents strive to create their own personal identities and sense of autonomy which may at times lead to major or minor, temporary or permanent disagreements with their parents, carers or teachers. Most adolescents negotiate this phase satisfactorily and enjoy positive relation- ships with their parents and other adults. Adolescence can be viewed from different developmental perspectives. It can be seen as being influenced by a variety of factors: genetic, temperamental and environmental. Puberty begins during adolescence, a period of hormonal and bodily changes which in turn are associated with psychological changes. Adolescents can become preoccupied with bodily image and physical attractive- ness, particularly in relation to their peers or in relation to media models or ideals. They may be early or late maturers and as one or the other may experi- ence particular problems, e.g. fears and doubts about what is normal develop- ment for their age. Additionally, they may engage in risky behaviour and be catapulted into early adulthood. Cognitively, adolescence is a time when, in Piagetian terms, adolescents should reach the formal operational stage which means that they should be able to reason logically and abstractly, consider hypothetical possibilities and engage in problem-solving activities. They should also be able to engage in meta-cognition, i.e. reflecting on their own cognitive processes. There is also a tendency to compare themselves with their peers and to what they perceive as ideal stan- dards; this may lead them to become self-conscious and this can adversely affect their self-esteem, particularly with regard to their own perceived lack of physical attractiveness. Low self-esteem may contribute to particular problems, e.g. loneli- ness, depression, suicide, anorexia and conduct disorders. They may try out Adolescent problems 2 Adolescent problems different roles on their way to forming a sense of personal identity. Adolescents also have fantasies about themselves and their futures. In terms of social cognition, adolescence is a time when adolescents reason about themselves and their social world. This means that adolescents become egocentric, thinking others, either imaginary or real, are as interested in them as they are in themselves. There is an emphasis on how others see them and a desire to be noticed and recognised. Adolescents also develop perspective-taking and, if successful, come to understand the thoughts and feelings of others. They may become idealistic and interested in religious, philosophical and politi- cal ideas and movements. As a result, the adult world may appear to them to be hypocritical and immoral. Psychodynamically, adolescence is a time when adolescents strive to develop independence and to distance themselves from their parents. They begin to form a personal and sexual identity of their own. It is also a period when childhood trauma may surface and when adolescents become aware of unconscious conflicts. The significance of adolescence lies in the fact that, along with childhood, it provides the foundation for adulthood. 3