Maria and the family have tried every clinical strategy included in her social work education and training.
Too often, there is no coordinated, carefully articulated system of care for struggling teens and their families; a welter of disconnected programs and services leaves many teens falling through the cracks. Instead of getting what they need, many teens and families get whatever services are available and affordable. Fortunately, there is a framework, described later in this article, to help social workers conceptualize the continuum of options so they can help guide families grappling with struggling teens.
Social workers are in a key position to help struggling teens and their parents. Knowing where to turn in times of crisis is a challenge. When crises emerge, most parents scramble frantically, grasping for information and help that, too often, turns out to be minimally useful, fragmented, and incomplete.
If they are familiar with the wide range of available services, programs, and specialty schools, social workers can guide parents and teens through the complex maze of options. Unfortunately, not all social workers are adequately informed about the full range of options because programs and services vary considerably from community to community, change over time, and often reflect funding source preferences, rather than a coherently conceptualized and well-articulated continuum of care.
To help parents navigate the disconnected jumble of programs and services, social workers can provide parents with the names of competent educational advocates and consultants who may be able to help parents and teens obtain needed services. Educational advocates—often attorneys—help people obtain specialized educational services from the public school system.
Educational advocates charge parents a fee and work with local, state, and federal education officials to ensure that students receive the services and special accommodations to which they are entitled by law. Advocates may file claims in court to force school districts to provide or pay for special needs services and programs outside the school district. Perhaps this private agency uses a sliding-fee scale or has a grant that provides this service free of charge. A social worker in a state public child welfare agency may be able to share with parents their professional experiences with specialty schools and programs for struggling teens.
Social workers can also link parents with other parents who can support them at IEP meetings and other negotiations with schools. It is important for social workers to help parents understand that, for financial reasons, school systems and agencies may be reluctant to provide the services a child needs. Hence, parents and their advocates must be relentlessly dogged in their insistence that needed services be provided.
Parents, very understandably, may become disheartened and angry when schools and agencies claim the child does not need a service that is, in fact, needed. A social worker can help parents manage their anger to more effectively argue their case and maneuver through bureaucratic obstacles. Selecting the Right Program or School: Questions to Ask In addition to offering traditional counseling and clinical services, social workers can acquaint parents with a wide variety of community-based options, alternative and therapeutic schools, and treatment programs that serve teens who struggle with significant behavioral, emotional, mental health, and substance abuse issues.
Sometimes, however, the type and level of care the teen needs are only available outside the home community. Residential treatment programs, therapeutic boarding schools, and wilderness therapy programs focus primarily on mental health, emotional, and behavioral issues, while including an educational component.
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Emotional growth boarding schools address mental health, emotional, behavioral, and educational issues simultaneously. Other boarding schools focus on specific learning disabilities, while also paying attention to the whole student. In short, different programs give different degrees of emphasis to personal and academic issues. Social workers, like parents, must resist the urge to plunge into programs and services because they are easily available, conveniently located, and relatively low cost. Parents of struggling teens—particularly teens who are oppositional and defiant—are naturally tempted to place the child in a school or program that promises to impose needed discipline and structure.
These schools and programs may use shame-and-blame methods that cause more harm than good for struggling teens who have personal and mental health issues contributing to their challenges.
Identifying, Screening, and Selecting Group Members
Generally, it makes sense first to consider home- and community-based programs and schools. Thus, the following list starts with the least restrictive home- and community-based options and progresses toward different kinds of residential schools and treatment settings. Prominent services, program, and school options include the following:. Mentoring programs encourage teens to stay focused on their education; provide support during crises; offer constructive ways to spend free time; and expose teens to career paths and options.
Mentors seek to enhance, but not replace the roles of parents, guardians, and teachers. Typical youth diversion programs offer first-time offenders individual and family counseling and links to other important social and educational services. These schools may be freestanding or sponsored by a community mental health center, family service agency, school district, or a collaborative composed of several social service and educational programs.
Group Therapy for Teens: Clinical Paper
Typical programs require youths to participate in individual, group, and, when feasible, family counseling. Educational services may be included to help teens stay on track academically. Group homes typically provide shelter and a wide range of mental health, educational, and recreational services. Some independent living programs also serve teens whose families are able to pay for these services privately. Typical services include practice in daily living skills, money management, career and educational planning, mental health services, rental assistance, recreational and social activities, and case management.
The challenges of living full-time outdoors and developing wilderness survival skills help teens develop self-confidence and prosocial behaviors. As it matures and relationships deepen, individuals become interdependent. The four stages of this theory are safety, dependency, counterdependency, and independence. He also believes that this is not a simple linear set of stages.
leondumoulin.nl/language/self-help/child.php The group can move back and forth between them. The safety stage is a point in which the adolescents are figuring out what behaviors are acceptable are unacceptable, what might embarrass them, and what would make them feel comfortable. They are recognizing similarities and differences in each other and seeking commonalities between each other. The therapists questions and attempts to engage the members are felt and intrusive and interrogative.
Dependency, the second stage, is where the members become dependent on the therapist and believe they will be cured by them. The members are passive and lack initiative in starting discussions. They continue to work on issues of safety and trust. Rather than focus on issues of substance, the group may revert to scapegoating other members and talking about tangential issues to fill time. In the counterdependency stage, while still being dependent on the therapist, the members begin to fight their dependency.
This results in conflict with the group leaders. The group members at this point may express transference of anger toward other adults onto the group leaders to a great degree at this point. Finally, in the independent stage, the members will achieve autonomy, and have a sense of who they are and how they can continue in their lives. The group members will begin choosing the topics of discussion and leading the group independently. The group will begin giving constructive feedback to one another, with little therapist intervention.
Instead of spending their energies protecting and defending themselves from one another, they can reveal their feelings and work through their problems. The first of these is in the area of facing difficulties that arise within the group. Adolescents are prone to outbursts of threatening to leave a group, especially early in the beginning, if they feel they are being mistreated by the group. This results in the group becoming anxious and feeling guilty. The therapist must intervene appropriately so that the members are able to face their difference, express their opinions, and disagree.
If not, the group will stagnate. At this age, the members need to realize that difficulties and differences are normal, and that rather than ostracizing a member, they should be concerned for each other. This non-defensive posture needs to be modeled by the therapist by discussing their own behavior, teaching that they do not need to insist that they are always right, and being willing to admit if they make mistakes.
If a mistake is made, examining the rationale behind the decision that was made with the members can encourage them to examine their own thinking when they make decisions. And viewing the therapist as a human capable of making mistakes will make it easier for them to face making their own. Competition occurs normally and constantly in groups, with a pecking order especially being attempted to be established in adolescent groups.
The members are not all attempting to compete for the top spot, however. Some are competing to be the person in the sick role, while others the stupid role, and yet others the troublemaker. All the members naturally tend to fall back into the roles they play in their natural life outside of the group.
Adolescents also use physical activity as a tension release. The therapist may find that their group members are easily restless, walking around, touching each other, or wrestling with each other, especially when issues become too anxiety laden. As long as these activities do not overly interfere with the flow of the group, they serve to help release tension, and allow the members to continue to relate to one another.
As well as reigning in physical activity, the therapist must also reign in inappropriate communication patterns through teaching how to communicate in a group setting at the outset.
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Adolescents have a tendency to be preoccupied with themselves and tend to talk at the same time, cut each other off and not listen to each other. They will direct their attention to the leaders, as if they are in individual therapy. Finally, while in all forms of therapy transference is a common reaction, in adolescents it can be especially prevalent. The adolescent group has its own special place in therapy. It undergoes the group life cycle similar to that of an adult group, yet there are distinct differences. Dies , pp. The first is the initial relatedness, which centers on the clarifying of expectations, educating members regarding group processes, and addressing issues of engagement.
They need to be made aware that it is the here and now, not the history that is important, and it is the group, not the therapist that is the agent of change. They need to come to the understanding that it is a process of self-disclosure and feedback that will lead to self-understanding, increased self-worth, and increased coping strategies.
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Thus, this phase is centered on building appropriate expectations for what is to be accomplished during the time the group is to be together.